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The utilization of CO2 has become an emerging area of research in response to climate change and global warming. The electrochemical CO2 reduction reaction (CO2RR) holds significant promise as a technology to address this issue by converting CO2 molecules into various commercially valuable chemicals. While CO2RR to C1 hydrocarbons has achieved high activity and selectivity, the C-C coupling to produce higher hydrocarbons remains challenging due to low energy efficiency and the prevalent hydrogen evolution reaction (HER) on the same catalyst, leading to high hydrogenation rates. In this review, we aim to elucidate the fundamental challenges of C-C coupling and explore potential strategies to enhance the selectivity for higher hydrocarbon products. We discuss the mechanisms underlying the formation of C2 and C3 products, focusing on molecular catalysts that facilitate C-C coupling by positioning CO2 molecules in close proximity. Additionally, we provide a comprehensive overview of different approaches to improve higher hydrocarbon selectivity, along with future suggestions and recommendations for new researchers in the field. This review serves as a valuable resource for both academic researchers and industrial stakeholders aiming for the commercialization of CO2RR technologies.

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BACKGROUND: Bovine leukocyte adhesion deficiency (BLAD), bovine citrullinemia (BC), and deficiency of Uridine monophosphate synthetase (DUMPS) are the common autosomal recessive disorders affecting the global dairy industry. BLAD leads to poor wound healing and recurrent infections. In BC, ammonia builds up leading to neurological disorders and death. DUMPS results in developmental abnormalities. METHODOLOGY: In this study, tetra-primer amplification refractory mutation system polymerase chain reaction (ARMS PCR) based diagnostic tests were optimized for BLAD, BC, and DUMPS. A total of 250 animals (58 indigenous and 192 Holstein Friesian (HF)) were screened from all across Pakistan. In addition to validation of ARMS-PCR results through Sanger sequencing, the protein modeling provided structural insights of the disease-associated reported SNPs. Pathway analysis illustrated gene functions under normal and mutated conditions. Furthermore, haplotype and phylogenetic analysis of ASS1 (Argininosuccinate synthetase) gene were performed on study samples and NCBI retrieved sequences. RESULTS: The study's focus was to screen the herds for prevalence of carriers of genetic disorders, as they are the main source of disease dissemination. One animal was found carrier for BC, whereas no carriers were found for BLAD and DUMPS. The protein models corroborated the reported amino acid change in BLAD, and protein truncation in both BC and DUMPS proteins. SNPs found in NCBI retrieved sequences were either silent or missense and had no effect on protein structure. DNA network presented graphical illustration of haplotype interactions and phylogenetic analysis conferred evolutionary landscape of ASS1 gene. The combination of these approaches produced an in-depth genetic picture of BC in Pakistani cattle. CONCLUSION: The development of diagnostic tests and identification of the heterozygous BC sample underscores the significance of constant monitoring to avoid the unwanted dissemination of mutant alleles among Pakistani cattle, thereby promoting the general well-being and sustainability of the dairy sector.

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Photodetectors are one of the most critical components for future optoelectronic systems and it undergoes significant advancements to meet the growing demands of diverse applications spanning the spectrum from ultraviolet (UV) to terahertz (THz). 2D materials are very attractive for photodetector applications because of their distinct optical and electrical properties. The atomic-thin structure, high carrier mobility, low van der Waals (vdWs) interaction between layers, relatively narrower bandgap engineered through engineering, and significant absorption coefficient significantly benefit the chip-scale production and integration of 2D materials-based photodetectors. The extremely sensitive detection at ambient temperature with ultra-fast capabilities is made possible with the adaptability of 2D materials. Here, the recent progress of photodetectors based on 2D materials, covering the spectrum from UV to THz is reported. In this report, the interaction of light with 2D materials is first deliberated on in terms of optical physics. Then, various mechanisms on which detectors work, important performance parameters, important and fruitful fabrication methods, fundamental optical properties of 2D materials, various types of 2D materials-based detectors, different strategies to improve performance, and important applications of photodetectors are discussed.

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Introduction: Parkinson's disease (PD) is characterized by dopamine deficiency in the corpus striatum due to the degeneration of dopaminergic neurons in the substantia nigra. Symptoms include bradykinesia, resting tremors, unstable posture, muscular rigidity, and a shuffled gait. Thalictrum foetidum is traditionally used for neurodegenerative disorders. Objectives: This study aimed to explore the therapeutic potential of aqueous ethanolic extract of Thalictrum foetidum (AETF) against Parkinson-like symptoms and to investigate its underlying mechanism. Methodology: Thirty-six albino mice were randomly divided into 6 groups (n = 6): normal control, disease control, standard treatment (levodopa/carbidopa, 100/25 mg/kg), and 3 treatment groups (AETF at 200, 400, and 600 mg/kg). One hour before treatment, haloperidol (1 mg/kg, i. p.) was administered to induce Parkinson's disease in all groups except the normal control group. Results: Behavioral analysis showed significant improvement (P < .001) in motor function, muscular coordination, and reduced muscular rigidity and tremors. AETF also reduced oxidative stress. Histological examination of the brain showed reduced Lewy bodies, neurofibrillary tangles, and plaque formation. Conclusion: AETF alleviated PD symptoms by reducing neurodegeneration, modulating oxidative stress, and inhibiting the expression of nuclear factor-κB (NF-κB) and associated inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6).

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This review article offers a comprehensive analysis of current developments in the application of machine learning for cancer diagnostic systems. The effectiveness of machine learning approaches has become evident in improving the accuracy and speed of cancer detection, addressing the complexities of large and intricate medical datasets. This review aims to evaluate modern machine learning techniques employed in cancer diagnostics, covering various algorithms, including supervised and unsupervised learning, as well as deep learning and federated learning methodologies. Data acquisition and preprocessing methods for different types of data, such as imaging, genomics, and clinical records, are discussed. The paper also examines feature extraction and selection techniques specific to cancer diagnosis. Model training, evaluation metrics, and performance comparison methods are explored. Additionally, the review provides insights into the applications of machine learning in various cancer types and discusses challenges related to dataset limitations, model interpretability, multi-omics integration, and ethical considerations. The emerging field of explainable artificial intelligence (XAI) in cancer diagnosis is highlighted, emphasizing specific XAI techniques proposed to improve cancer diagnostics. These techniques include interactive visualization of model decisions and feature importance analysis tailored for enhanced clinical interpretation, aiming to enhance both diagnostic accuracy and transparency in medical decision-making. The paper concludes by outlining future directions, including personalized medicine, federated learning, deep learning advancements, and ethical considerations. This review aims to guide researchers, clinicians, and policymakers in the development of efficient and interpretable machine learning-based cancer diagnostic systems.

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This research investigates the intricate relationships between economic variables and how they affect South Asian nation's ability to develop sustainably. Given the growing concerns about climate change and global warming brought on by emissions of greenhouse gases, this study looks into the connection between emissions of CO2, green energy, industrialization, foreign direct investment, economic globalization, and financial development from 1995 to 2022. Second-generation panel techniques were employed in this study to look at the relationship between variables because of the potential of residual cross-sectional dependency and heterogeneity. The empirical outcomes display that green energy, economic globalization, and financial development reduce CO2 emissions by 1.839%, 1.223%, and 3.902% respectively. Industrialization and foreign direct investment degrade the environment by 4.302% and 1.893% respectively. A bidirectional causality link between green energy, industrialization, economic globalization, and CO2 emissions was found by Dumitrescu and Hurlin (D-H). Based on our findings, we recommend legislative support for renewable energy, cleaner technologies, and strict environmental regulations, aligning with the Sustainable Development Goals (SDGs). Encouraging FDI, sustainable practices, and financial development can drive economic growth while preserving the environment. As we approach COP28, this holistic approach to sustainable development becomes increasingly vital for South Asian countries to achieve their SDG targets and combat climate change.

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Obesity, a pervasive global health challenge affecting more than two billion people, requires comprehensive interventions. Traditional approaches, including lifestyle modification, and diverse drugs targeting a gastrointestinal hormone, including glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) (Liraglutide, Semaglutide, Exenatide, Albiglutide, Dulaglutide, Lixisenatide, Orlistat, Phentermine/Topiramate, Lorcaserin, Sibutramine, Rimonabant) offer tailored strategies; yet their effectiveness is limited and some drugs were taken off the market. Moreover, various surgical modalities, such as Roux-en-Y Bypass surgery, sleeve gastrectomy, intragastric balloons, biliopancreatic diversion with duodenal switch (BPD/DS), laparoscopic adjustable gastric band (LAGB), and vagal nerve blockade can be considered but are associated with numerous side effects and require careful monitoring. Consequently, there is a pressing need for novel anti-obesity treatments. In this landscape, tirzepatide, initially designed for type 2 diabetes (T2D) management, emerges as a potential game-changer. Functioning as a dual GIP/GLP-1 receptor agonist, it not only addresses control but also introduces a fresh perspective on weight reduction. This review intricately explores tirzepatide's mechanism, dissecting insights from clinical studies and positioning it as a major force in obesity treatment. In the middle of significant shifts in obesity management, tirzepatide presents itself as a promising and cost-effective intervention. Its Food and Drug Administration (FDA) approval marks a milestone in the realm of obesity therapeutics. Going beyond a recapitulation of findings, the conclusion emphasizes the imperative for ongoing exploration and vigilant safety monitoring in tirzepatide's application.

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BACKGROUND: Bystander-initiated cardiopulmonary resuscitation (CPR) can improve survival rates in individuals with out-of-hospital cardiac arrest (OHCA). Two CPR approaches are commonly utilized, standard (S-CPR) with mouth-to-mouth breathing and compression-only (CO-CPR). We conducted a systematic review and meta-analysis to compare clinical outcomes associated with S-CPR versus CO-CPR in OHCA. METHODS: A systematic literature search was conducted using PubMed, EMBASE, and the Cochrane Library. Eligible studies included randomized controlled trials (RCTs) focused on adult OHCA patients receiving CO-CPR or S-CPR. Forest plots were generated for pooled data analysis using Review Manager version 5.4. Random-effect analyses were used, and statistical significance was set at p < .05. RESULTS: Four randomized controlled trials were included in the final analysis, encompassing a total sample size of 4987 patients (2482 in the CO-CPR group and 2505 in the S-CPR group). CO-CPR was associated with significantly improved 1-day survival compared with S-CPR (OR = 1.15; 95% CI: 1.02-1.31; p = .03) and survival to hospital discharge (OR = 1.25; 95% CI: 1.01-1.55; p = .04). No heterogeneity was observed among the studies for either outcome. CONCLUSION: CO-CPR emerges as a promising strategy for improving outcomes in OHCA compared to S-CPR. However, further large-scale RCTs are required to generate more robust evidence.

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Colorectal cancer (CRC) is among the most prevalent cancers with a high mortality rate. Both genetic and environmental factors contribute to CRC development. This study aimed to assess the association of single nucleotide polymorphisms (SNPs) in the fatty acid binding protein-2 (rs1799883), Cytochrome P450 2E1 (rs3813865), TP53 (rs1042522), and Murine double minute 2 (rs1042522) genes with CRC. A cross-sectional case-control study was conducted at the Institute of Molecular Biology and Biotechnology from May 2020 to March 2021, involving CRC patients (N = 100) and controls (N = 100) recruited from the Multan district in Pakistan. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) were employed to investigate the studied SNPs. The association of SNPs in all genes with CRC was examined either individually or in various combinations. Genotypes at three SNPs, rs1799883 in FABP2, rs3813865 in CYP2E1, and rs1042522 in TP53, were found to be associated with the development of CRC, while rs1042522 in MDM2 was not. Patients who were married, smoked, lacked exercise habits or had a family history of CRC were at a greater risk of acquiring the disease. FABP2 gene rs1799883, CYP2E1 gene rs3813865, and TP53 gene rs1042522 polymorphisms are significant in the development of CRC in Pakistani participants.

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Cotton (Gossypium hirsutum L.) is of great economic importance as a cultivated crop in many parts of the world. In addition to being a pillar of the textile industry, cotton and its byproducts are used for livestock feed, seed oil, and other products. Bacillus thuringiensis crystal toxin (Bt) expression in cotton provides effective protection against chewing insects but does not defend plants from piercing/sucking insect pests. With the aim to create transgenic plants with resistance against piercing/sucking pests, we used Agrobacterium-mediated genetic transformation of cotton cultivar Coker 312 to express the Allium sativum leaf agglutinin (ASLA) gene from the phloem-specific rolC promoter. The ASLA transgene was stably inherited and showed Mendelian segregation in the T1 generation. Transgenic lines, expressing the ASLA gene, showed explicit resistance against major sap-sucking pests. Green peach aphid (Myzus persicae Sulzer) choice assays showed that 75% of aphids preferred untransformed cotton plants relative to those expressing the ASLA gene. In detached leaf bioassays, plants expressing ASLA caused 82% aphid mortality and 44-53% reduction in fecundity. Clip cage bioassays with whiteflies (Bemisia tabaci Gennadius) showed 74-82% mortality and 44-60% decrease in fecundity due to ASLA gene expression. In whole plant bioassays, whiteflies showed 77% mortality and a 54% decrease in fecundity on ASLA transgenics. Importantly, we did not observe a negative effect of the ASLA gene on ladybugs (Coccinella septempunctata) that consumed these whiteflies. Together, our findings demonstrate the potential of ASLA-transgenic cotton for providing protection against two devastating insect pests, whiteflies and aphids. The ASLA-transgenic cotton appears promising for direct commercial cultivation besides serving as a potential genetic resource in recombination breeding.

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Mercury ion (Hg2+) is considered a harmful neurotoxin, and real-time monitoring of Hg2+ concentrations in environmental and biological samples is critical. Fluorescent probes are a rapidly emerging visualization tool owing to their simple design and good selectivity. Herein, a novel fluorescence (FL) probe 2-(4-((6-((quinolin-8-yloxy)methyl)pyridin-2-yl)methyl)piperazin-1-yl)anthracene-9,10-dione (QPPA) is designed using piperazine as a linker between the anthraquinone group, which serves as a fluorophore, and N4O as the Hg2+ ligand. The probe exhibits FL "turn-on" sensing of Hg2+ because the complex inhibits the photo-induced electron transfer (PET) process. Moreover, QPPA can overcome the invasion by other possible cations, resulting in a clear color change from orange to colorless with the addition Hg2+. The chelation of QPPA with Hg2+ in a 1:1 ratio. Subsequently, the theoretically determined binding sites of the ligand to Hg2+ are validated through 1H NMR titration. The in situQPPA-Hg2+ complex can be subjected to Hg2+ extraction following the introduction of S2- owing to its robust binding capacity. The exceptional limit of detection values for Hg2+ and S2- are obtained as 63.0 and 79.1 nM (S/N = 3), respectively. Moreover, QPPA can display bright red FL in the presence of Hg2+ in different biological specimens such as HeLa cells, zebrafish, onion root tip tissues, and water flea Daphnia carinata, further providing an effective strategy for environmental monitoring and bioimaging of Hg2+ in living organisms.

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In today's globalized and interconnected world, businesses operate within an interconnected network with various stakeholders. Among these stakeholders, the pressure from consumers, investors, regulators, and communities for corporations to adopt environmentally responsible practices has intensified significantly. Therefore, this study investigates the relationship between stakeholder pressure and environmental performance (EP) in Pakistan's manufacturing sector while examining the potential moderating roles of environmental reputation, social reputation, virtual CSR, and green credit. Data was gathered by convenience sampling and a cross-sectional research approach. A structural questionnaire was given to 376 employees of manufacturing firms that are listed on the Pakistan Stock Exchange (PSE). The research hypotheses were tested using PLS-SEM techniques, which examined the interactions between these variables. The results reveal that stakeholder pressure significantly influences the environmental performance of manufacturing firms. Environmental reputation and virtual CSR negatively moderate the relationship between stakeholder pressure and EP. Moreover, social reputation and green credit positively moderate the relationship between stakeholder pressure and EP. These results contribute to the existing literature by shedding light on how stakeholder pressure influences firms' environmental behavior. Practical implications include integrating virtual CSR strategies, securing green financing options, and building strong environmental and social reputations to effectively respond to stakeholder demands and improve environmental performance.

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The application of solar-thermal surfaces for antifrosting and defrosting has emerged as a passive and environmentally friendly approach to mitigate the negative consequences of frost formation, such as structural damage and reduced heat transfer efficiency. However, achieving robust all-day frostphobicity solely through interfacial modification and solar-thermal effects is challenging in practical applications: The thick frost that accumulates at night strongly scatters solar radiation, rendering the solar-thermal coatings ineffective during the daytime. Additionally, these nanostructured coatings are susceptible to wear and tear when exposed to the outdoors for extended periods of time. To address these challenges, we present an innovative frostphobic surface that incorporates V-grooved structures with superhydrophobic solar-thermal layers (VSSs). The out-of-plane gradient structures facilitate spatially regulated vapor diffusion, an enhanced photothermal effect, and robust water repellency. These features not only prevent frost from covering the entire surface overnight, enabling effective solar-thermal defrosting during the daytime, but also protect the surface from deterioration. The combined merits ensure robust all-day frostphobicity and exceptional durability, making the VSS surface promising for practical applications and extending the lifespan in extreme environments.

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Bacterial pathogens manipulate host signaling pathways and evade host defenses using effector molecules, coordinating their deployment to ensure successful infection. However, host-derived metabolites as signals, and their critical role in regulating bacterial virulence requires further insights. Effective regulation of virulence, which is essential for pathogenic bacteria, involves controlling factors that enable colonization, defense evasion, and tissue damage. This regulation is dynamic, influenced by environmental cues including signals from host plants like exudates. Plant exudates, comprising of diverse compounds released by roots and tissues, serve as rich chemical signals affecting the behavior and virulence of associated bacteria. Plant nutrients act as signaling molecules that are sensed through membrane-localized receptors and intracellular response mechanisms in bacteria. This review explains how different bacteria detect and answer to secreted chemical signals, regulating virulence gene expression. Our main emphasis is exploring the recognition process of host-originated signaling molecules through molecular sensors on cellular membranes and intracellular signaling pathways. This review encompasses insights into how bacterial strains individually coordinate their virulence in response to various distinct host-derived signals that can positively or negatively regulate their virulence. Furthermore, we explained the interruption of plant defense with the perception of host metabolites to dampen pathogen virulence. The intricate interplay between pathogens and plant signals, particularly in how pathogens recognize host metabolic signals to regulate virulence genes, portrays a crucial initial interaction leading to profound influences on infection outcomes. This work will greatly aid researchers in developing new strategies for preventing and treating infections.

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Humans suffer from various diseases that require more specific drugs to target them. Among the different potent agents, ß-lactamases serve as good antibacterial agents; however, ß-lactamases are resistant to such antibiotics. The present study was designed to prepare efficient ß-lactamase inhibitor amides (12-15) from inexpensive, easily accessible, and bioactive precursors; Morita Baylis Hillman (MBH) adducts (5-8). The adducts (5-8) were primarily prepared by treating their respective aldehydes with the corresponding acrylate in the presence of an organic Lewis base at ambient temperature. The compounds were characterized using mass spectrometry, FTIR and NMR spectroscopy. Furthermore, in silico studies (using AutoDock Tools and AutoDock Vina programs) on the adduct and corresponding amide product revealed that all MBH adducts (5-8) and their product amides (12-15) are significant inhibitors of ß-lactamase. Additionally, among the MBH adducts, adduct 7 showed the highest binding affinity with ß-lactamase, whereas amide 15 was identified as a highly potent antibacterial based on its docking score (-8.6). In addition, the absorption, distribution, metabolism, and excretion (ADME) test of the synthesized compounds demonstrated that all compounds showed drug-likeness properties.

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Chromium (Cr) is a toxic metal in soil-plant system, hence causing possible health risks prominently in the areas with forgoing industrial activities. Copper nanoparticles (Cu NPs) have been reported as an excellent adsorbent for pollutants. Therefore, this study investigates how copper nanoparticles enhance onion growth while decreasing chromium uptake in onion plants. Additionally, it examines the potential health risks of consuming onion plants with elevated chromium levels. The results demonstrated that the addition of CuNPs at 15 mg kg-1 significantly improved the plant height (48%), leaf length (37%), fresh weight of root (61%), root dry weight (70%), fresh weight of bulb (52%), bulb dry weight (59%), leaves fresh weight (52%) and dry weight of leaves (59%), leaf area (72%), number of onion leaves per plant (60%), Chl. a (42%), chl. b (36%), carotenoids (40%), total chlorophyll (40%), chlorophyll contents SPAD value (56%), relative water contents (35%), membrane stability index (16%), total sugars (25%), crude protein (21%), ascorbic acid (19%) and ash contents (64%) at 10 mg kg-1 Cr. Whereas, maximum decline of Cr by 46% in roots, 68% in leaves and 92% in bulb was found with application of 15 mg kg-1 of Cu NPs in onion plants under 10 mg kg-1 Cr toxicity. The health risk assessment parameters of onion plants showed minimum values 0.0028 for average daily intake (ADI), 0.001911 for Non-cancer risk (NCR), and 0.001433 for cancer risk (CR) in plants treated with Cu NPs at 15 mg kg-1 concentration grown in soil spiked with 10 mg kg-1 chromium. It is concluded that Cu NPs at 15 mg kg-1 concentration improved growth of plants in control as well as Cr contaminated soil. Therefore, use of Cu NPs at 15 mg kg-1 concentration is recommended for improving growth of plants under normal and metal contaminated soils.

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The pressing global issue of organic pollutants, particularly phenolic compounds derived primarily from industrial wastes, poses a significant threat to the environment. Although progress has been made in the development of low-cost materials for phenolic compound removal, their effectiveness remains limited. Thus, there is an urgent need for novel technologies to comprehensively address this issue. In this context, MXenes, known for their exceptional physicochemical properties, have emerged as highly promising candidates for the remediation of phenolic pollutants. This review aims to provide a comprehensive and critical evaluation of MXene-based technologies for the removal of phenolic pollutants, focusing on the following key aspects: (1) The classification and categorization of phenolic pollutants, highlighting their adverse environmental impacts, and emphasizing the crucial need for their removal. (2) An in-depth discussion on the synthesis methods and properties of MXene-based composites, emphasizing their suitability for environmental remediation. (3) A detailed analysis of MXene-based adsorption, catalysis, photocatalysis, and hybrid processes, showcasing current advancements in MXene modification and functionalization to enhance removal efficiency. (4) A thorough examination of the removal mechanisms and stability of MXene-based technologies, elucidating their operating conditions and stability in pollutant removal scenarios. (5) Finally, this review concludes by outlining future challenges and opportunities for MXene-based technologies in water treatment, facilitating their potential applications. This comprehensive review provides valuable insights and innovative ideas for the development of versatile MXene-based technologies tailored to combat water pollution effectively.

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Background Among all the modalities of diagnostic radiology, ultrasonography is considered the least invasive one. However, this benefit usually comes at the cost of its subjective evaluation since it is purely a dynamic diagnostic modality. Thus, instead of ultrasonography, most clinicians usually rely on the report written by the radiologist. Objective The objective of this study is to evaluate the clinical practices of ultrasound reporting of superficial soft tissue masses. Materials and methods A closed-loop retrospective and prospective study was conducted at the Department of Radiology and Medical Imaging, Jinnah Hospital, Lahore between December 2023 and March 2024. In the pre-intervention phase, a randomly collected sample of 100 ultrasound reports documenting superficial soft tissue masses were included in the study and judged against standard criteria set by the Royal College of Radiologists (RCR). The intervention phase included regular presentations, identification of problems, and designing of preformed reporting forms. Post-intervention assessments were based on the judgment of 100 ultrasound reports in each cycle twice. Intervention and post-intervention assessments were done twice to correct the ongoing practices. Results During the pre-intervention phase, the ultrasound reports issued by the department of study showed only 41.5% compliance with the RCR structured reporting guidelines. However, after the first and second post-intervention phases, this percentage increased up to 98.3%. Overall, we observed a compliance difference of 56.5% between the pre-intervention and second post-intervention phases. Conclusion Integration of methods, such as briefing the residents on RCR guidelines, displaying parameters, and making structured report templates available, can greatly increase adherence to RCR guidelines for structured ultrasonography reporting. It also greatly enhances the comprehensiveness and reliability of ultrasonography reports for clinicians. Clinical audits should be routinely practiced in the settings of radiology.

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Background: Epilepsy is a persistent tendency to experience epileptic seizures and can lead to various neurobiological disorders, with an elevated risk of premature mortality. This study evaluates the efficacy of brivaracetam adjuvant therapy in patients with epilepsy. Methods: A prospective observational multicentre study that was conducted in Pakistan from March to September 2022, by using a non-probability convenience sampling technique. The population consisted of 543 individuals with a diagnosis of epilepsy for whom adjunctive brivaracetam (Brivera; manufactured by Helix Pharma Pvt Ltd., Sindh, Pakistan) was recommended by the treating physician. The research sample was drawn from various private neurology clinics of Karachi, Lahore, Rawalpindi, Islamabad and Peshawar. Data originating from routine patient visits, and assessments at three study time points, were recorded in the study case report form. Results: Across 18 clinical sites, 543 individuals participated, with a mean age of 32.9 years. The most prescribed dosages were 50 mg BD, followed by 100 mg BD. Notably, brivaracetam combined with divalproex sodium was the most prevalent treatment, followed by brivaracetam with levetiracetam. At both the 14th and 90th day assessments, a significant reduction in seizure frequency was observed, with 63.1% of individuals showing a favourable response by day 90. Treatment-naive individuals exhibited higher rates of seizure freedom and response compared with treatment-resistant individuals. Conclusions: The study demonstrates the effectiveness of brivaracetam combination therapy in epilepsy management, with notable reductions in seizure frequency and favourable clinical responses observed, particularly in treatment-naive individuals.