Study of the content of fluorides in atmospheric air in Bokhtar region and Tursunzade city of Tajikistan

Background: The emission and presence of air pollutants such as fluorides has over burdenized the public healthcare issues. The current study aimed to determine the content of fluorides in atmospheric air in Bokhtar region and Tursunzade city of Tajikistan. Methods: Based on the direction of wind, two zones were selected in the current study: experimental and control. In the first (experimental) zone, those areas were selected where the western, northern and northeastern directions of wind was significant. Dzhura Rakhmonov was assigned to the control zone with the shortest time for the eastward winds. In general, 72 samples of atmospheric air were taken in 12 settlements of the city of Tursunzade and 90 samples of atmospheric air in the Bokhtar region of the Khatlon province. To determine fluorine in air, a potentiometric method with an ion-selective electrode was used, which makes it possible to measure the potential concentrations of fluorides in atmospheric air. Results: Compounds of gaseous (hydrogen fluoride) and solid fluorine (salts of hydrofluoric acid), which are the main emission from various sources, were found in the atmospheric air of the populated areas of the city of Tursunzade, where the aluminum plant industry is located. The maximum amount of hydrogen fluoride in the experimental zone (Jamoat and Navobod) with a western wind direction was found in the autumn, which exceeded the MPC. However, the amount of solid fluorides in the western direction of the wind ranged from 0.01 to 1.0 mg / m3, which did not exceed the MPC value and was not significant. In control zone (Dzhura Rakhmonov) the said pollutants hydrogen fluoride and solid fluorine were not significant in autumn within accordance to MPC limit. The results of the study of atmospheric air in 15 administrative cities and districts of the Bokhtar region showed a complete absence of solid fluorides in all samples of atmospheric air. Conclusion: Compounds of gaseous fluorine and salts of hydrofluoric acid were found in the atmospheric air of populated areas of the city of Tursunzade, and no significant amounts in the Bokhtar region according to MPC and control. The maximum amount of fluorine compounds was found in the experimental zone (Jamoat Navobod) of the city of Tursunzade.

Comparative analysis and evaluation of current antidiarrheal prescribing trends with representative brand in pediatric population of Pakistan

Background: Prevalence of carpal tunnel syndrome (CTS) among pregnant women is very much common among the Background: Inappropriate management of diarrhea is the main cause of morbidity and mortality in the pediatric population worldwide, more especially in developing countries including Pakistan. Method: The sample size was calculated using World Health Organization (WHO) and Expanded Program on Immunization (EPI) info calculator. 240 prescriptions were collected from eight hospitals including four public hospitals (Pakistan Institute of Medical Sciences, Polyclinic Hospital, Holy family Hospital and Benazir Hospital) and four private hospitals (Hearts International Hospital, Maroof Hospital, Railway hospital, Bilal Hospital) of twin cities of Pakistan (Islamabad and Rawalpindi). Objectives: The purpose of this study was to analyze current prescribing trends of diarrheal management followed by comparative pharmaceutical evaluation of representative brands Parameters recorded from prescriptions were demographics (age and gender), presenting complaints and medications prescribed. Prescriptions were evaluated by their comparison with standard treatment guidelines. Results: Data were evaluated using a statistical package for social sciences (SPSS version 16.0) for descriptive statistics and cross-tabulations along with Chi square test. Diarrhea was presenting complaint in 106 (44%) of peads among age group 0-2 years. Out of 106 (44%) cases of diarrhea, 52 (20%) cases have prescribed an antibiotic in combination with other medications, which was not indicated according to standard guidelines. The use of oral rehydration solutions (ORS) was also limited. Zinc supplementation with ORS is indicated treatment for diarrhea and was prescribed to 21 (9%) cases. Conclusion: Hence, it has been concluded that standard treatment guidelines were not followed thoroughly which leads to increased morbidity, complications and cost.

Current trends in toxicoepigenomics research, limitations and future perspective

Toxicoepigenomics is new field emerged from the combination of toxicology and epigenetics. It is defined as the heritable changes in the gene activity induced by exposure to environment and toxicant substances such as heavy metals without any alterations in the existing nucleotide sequence. Research studies show that epigenetics plays important role in the development of certain human diseases such as diabetes and cancer. Hence toxicoepigenomics has evolved as an important new area in toxicology research. In toxicoepigenomics targeting DNA methylation alteration as a tool to identify the underlying causes of disease development exists as important trend in the current research design, but this aspect of toxicoepigenomics has been evaluated extensively. New mechanisms such as microRNA (miRNA) dysregulations need to be considered for future research work. Furthermore, it is important to consider different study designs such as the application of parallel in vitro and in vivo studies. This might be an interesting aspect of toxicoepigenomics research and will enable researchers to fill the gap in the existing research designs.

The role of pharmacy services and pharmacist comeback during COIVD-19. A narrative review

SARSCoV-2, a recently discovered coronavirus, causes COVID-19, which is a respiratory infection. The disease rapidly spread across the world, prompting a pandemic declaration. During natural calamities and outbreaks, pharmacists have long been involved in public well-being management such as precautionary safeguards, immunizations, screening, authentication of medicines safety and efficacy and also involved in emergency alertness and response. Pharmacy professionals are considered an integral part in response to the ongoing COVID-19 pandemic. Pharmacists and pharmacy services are at the combat zone for patients care and safety to enhance public health. The ongoing Covid-19 pandemic had a significant impact on healthcare services around the world. New policies and procedures will be implemented to fill the void. Pharmacists expect to adopt a variety of strategies to providing pharmacy services during and after the current pandemic. Pharmacists are playing an important role in the current epidemic. It's been over a year since the Covid-19 epidemic first eventuated, and it's still unclear how long the pandemic will endure. Hence, pharmacists and pharmacy professionals are playing crucial character in the prevention, treatment and mitigation of adverse outcomes due to the covid-19 pandemic. The current publication emphasizes the potential responsibilities and actions that pharmacists might undertake in a variety of healthcare settings to assist relieve strain on an overburdened healthcare system.

New hope on the horizon of chronic pain therapy; targeting PI3K, proinflammatory cytokines/AKT/nitric oxide

Pain is one of the most debilitating and unpleasant sensory or emotional condition which present itself in the form of complex phenomena. Safe and effective drug treatment for chronic pain is still a gigantic challenge in the field of research and quality of life. Recently phosphotidylinositide-3-kinase (PI3K) and its downstream regulator emerged as appealing targets for the development of new drugs having immense potential in various major disorders[1]. Researcher’s targeted different PI3K downstream signaling components both in central and peripheral level of nervous system using various models of chronic pain. Emphasis must be put on the importance of PI3K and its downstream molecules such as Akt, proinflammatory cytokines and nitric oxide as a potential target for the treatment of chronic pain. Researchers are paying serious efforts to identify those molecules which have high clinical outcome with least chances of side effects.

Drug interaction and rational drug therapy in hospitalized patients reported with stroke

Objective: The purpose of the current study was to determine prescription rationalities, any pharmacotherapy-based problems, and to determine drug interactions in patients with stroke. Methods: Patient case histories were determined using a standard questionnaire form having a patient tag, age, sex, past history, chief complaints, biochemical tests, treatment chart and other relevant information. Forty patients suffering from stroke and were on treatment were selected for the current study. The relevant information was recorded with respect to patient demographic data, disease incidence, drug interactions. Results: Most of the hospitalized patients were in the range of 51-60 (20% out of 40 patients) and 71-80 (22.5% out of 40 patients) years. The most frequent cause of hospitalization was Cerebro Vascular Accident (CVA) or stroke (57.5%). New drugs were added to the regimen of 37.5% of patients due to certain diseases. The dose was changed in the regimen of 17.5% of patients. In 7.5% patient dosage form was changed. 27.5% of patients were observed with the therapeutic alternative. Drug interactions were found in the prescription history of 30% of patients. Conclusion: Hence, it is concluded that most of the patients admitted to hospital with Cerebro Vascular Accident and stroke have irrational drug prescription and drug-drug interactions in their prescription history.

Prevalence and individual risk factors of carpal tunnel syndrome in pregnant women

Background: Prevalence of carpal tunnel syndrome (CTS) among pregnant women is very much common among the whole population. Due to rapid economic and social changes, an increasing trend of this disorder, as well as its individual risk factors, has also been observed in Pakistan. Objective: The present study aimed to find out the prevalence of CTS in pregnant women and to identify the risk factors associated with CTS in pregnancy. Material & Methods: Descriptive cross-sectional survey for the prevalence of CTS and a case-control study to find out the risk factors were administered on a sample of n=304 participants of pregnant women of Rawalpindi and Islamabad hospitals for six months from October 2016 to March 2017. Data was collected by non-probability convenient sampling through a self-structured questionnaire. The Association of risk factors was measured by odds ratio. Result: The present study showed the prevalence of CTS is 76(25%) based on Phalen’s test and the prevalence of CTS is 86(28.3%) based on Tinel’s test. History of CTS (OR=3.38) is the most common risk factor. Swelling (OR=2.74) is very common in pregnancy. Other factors including kidney disease, weightlifting, excessive household, cooking, and obesity, use of oral contraceptives, stress, smoking, sewing, diabetes, and thyroid dysfunction are also associated with CTS except for Rheumatoid arthritis, computer work and forceful griping. Conclusion: This study showed significant results regarding the prevalence and risk factors of CTS among pregnant women in the hospitals of Islamabad and Rawalpindi.

Effectiveness of glucose-insulin–potassium infusion for myocardial protection in non-diabetic patients during adult cardiac surgery

Background: Glucose-insulin-potassium (GIK) infusion is most commonly used in diabetic patients during cardiopulmonary bypass. Many studies suggest that the use of GIK infusion has beneficial outcomes mainly in myocardial protection, as myocardial protection is the main goal of Perfusionist during bypass surgery. In Pakistan, GIK is used normally in the diabetic patient as it has a good effect on insulin maintenance. Most surgeons use GIK in diabetic patients but many of the studies suggest that it has good post-op outcomes especially in myocardial protection. Method: This was an observational cross-sectional study conducted for 6 months, from November 2019 to April 2020 at the Pakistan Institute of medical sciences department of Cardiac surgery. Ethical approval was taken from the hospital ethical committee. It was consisting of 80 patients, 40 from group A (GIK infused) and 40 from group B (GIK non-infused) by using the Non-probability convenient sampling technique. Data was collected through pre-structured Performa. Results: In the early postoperative period, peak CKMB levels were high in the Non-GIK group (62.7375± 19.75393IU/L) versus (54.0005±11.41493IU/L) in the GIK group (p-value 0.000). Mean ventilation time in the GIK group was (10.85 ±6.302) hours versus (12.15 ±7.814) hours in the non-GIK group (p< 0.001). Similarly, ICU stay period was also shorter in the GIK group is (3.50 ±1.013) and in the non-GIK group is (3.50 ±0.906) (p>0.001). Conclusion: Glucose-insulin-potassium (GIK) infusion has a beneficial role in myocardial protection and is associated with better post-operative outcomes without increasing the risk of non-cardiac complications.

Frequency of halitosis among patients aged between 18 to 40 years reporting to Saidu group of teaching hospital, KPK, Pakistan

Background: Oral health is associated with first-class teeth as it is essential for the general health and wellness of human beings. Poor oral hygiene leads to major issues including halitosis. Halitosis refers to an unpleasant breath odor that affects self-confidence and people’s professional and social life. Objective: The main of the current study was to uncover the frequency of halitosis among 18 to 40 years aged patients reporting to Saidu groups of teaching hospitals, swat KPK. Materials and Methods: A hospital-based descriptive cross-sectional study was conducted to determine the Frequency of halitosis among the patients in 6 months. Data was collected using a questionnaire and convenience sampling technique. Results: Out of 288 patients, 156 (54.2%) patients were affected while the rest 132 (45.8%) patients were not affected by halitosis. It was found more among males than females. The highly associated risk factors were smoking, patients having no knowledge of tooth cleansing protocol, interdental brush, not brushing their tongue, no use of mouthwash, and lack of monthly dentist visits. Conclusion: More than half of the population are suffering from halitosis where males are highly affected as compared to females. Patients having poor knowledge of teeth cleaning protocol and infrequent dental visits were among the more common causes of halitosis among the said age population.