Peritonitis – Etiology and Treatment Options: A Systematic Review

Peritonitis is an infection with a substantial source of morbidity and death. The mortality rate is 10% to 60%. Its etiology may be infection of bacteria, viruses, or fungi. The objective of the current systematic review is to identify the causes of peritonitis and discuss available treatment options. A systematic review was conducted from the literature from January 2012 to December 2022. More than 60 articles were downloaded; after abstracting relevant information from the studies and assessing quality, data was synthesized and presented by PRISMA flow diagram. The most common cause was bacterial infection; followed by fungal and viral infections. Reported organisms were E. coli, Klebsiella spp., Streptococcus spp., M. tuberculosis, C. trachomatis, Pseudomonas spss., C. albicans, C. glabrata, C. krusei, Cryptococcus spp., and Aspergillus spp., and Feline-infectious-corona-virus. Empiric antibiotics therapy covers broad-spectrum antibacterials; antifungal and surgical interventions are treatment options. The acutely ill patient requires combined medical and surgical methods; culture sensitivity is highly advisable to reduce the chances of failure

Sensitivity of Epworth Sleepiness Scale in Detecting Obstructive Sleep Apnea in Pakistani Adults

Not Availabl

Bone Mineral Density in Children with Congenital Adrenal Hyperplasia

Not Availabl

Dyspeptic Symptoms In Type 2 Diabetes Patients

Not Availabl

Sodium-Glucose Co-Transporter 2 (SGLT-2) Inhibitors in Heart Failure: A Comprehensive Review of Literature

Type 2 diabetes mellitus (T2DM) is highly prevalent in the modern world due to a rise in obesity. Diabetes can give rise to many secondary ailments among which heart failure is the most common. Heart failure brings about confirmatory changes in the myocardium which shifts the metabolism from glucose to fatty acid which further impairs cardiac function. Among the antidiabetic agents, SGLT2 inhibitors such as empagliflozin and dapagliflozin have decreased heart failure exacerbations even in the absence of diabetes. We employed search engines such as Google Scholar, MEDLINE, and Euro PMC for our article search. The keywords such as heart failure, SGLT2 inhibitors, and diabetes were used. Duplicate studies were excluded during our analysis. According to the literature, several theories have been put forward on the mechanisms through which SGLT2 inhibitors can work in heart failure. Mainly they work by lowering blood pressure, improvement of cardiac energy metabolism, anti-inflammatory effect, protecting from cardiac remodeling, diuresis, and natriuretic effects

Hidden Hunger: A Looming Crisis in Pakistans Nutrition Landscape

Pakistan is facing a grave and often overlooked crisis in its nutrition landscape. Hidden hunger, a form of malnutrition resulting from inadequate intake of essential vitamins and minerals, poses a significant threat to the health and well-being of millions of Pakistanis. This editorial sheds light on the prevalence and consequences of hidden hunger in Pakistan, explores its underlying causes, and emphasizes the urgent need for comprehensive interventions to address this silent crisis

The Etiological Spectrum OF Short Stature among Children Attending Endocrine Clinic at Tertiary Care Hospital

Not Availabl

Wandering Spleen: A Rare Condition with Splenic Torsion and Infarction in an Elderly Patient

Ectopic spleen or wandering spleen is an uncommon presentation in which the spleen's anatomical location is different from its fixed position in the left upper quadrant of the abdomen, due to the absence of the typical peritoneal attachments; the spleen is more mobile inside the abdomen. Congenital or acquired conditions are the cause of this anomaly, which could ultimately result in torsion and splenic infarction. Less than 0.2% of wandering spleen cases are reported annually, making it a rare clinical manifestation. Splenic vascular pedicle torsion can result in complications that can cause symptoms of an acute abdomen as a result of ischemic necrosis of the spleen. Computed tomography and ultrasonography with Doppler or CEUS are essential for accurate diagnosis due to the vague clinical signs and potential complications. This case involves a 70-year-old elderly woman who complained of extreme abdominal pain and vomiting for three days. On physical examination, a tense right lower quadrant lump was palpated, when she visited the emergency room. An urgent CT scan was done for the acute abdomen which revealed torsion of the splenic pedicle in a wandering spleen

Managing Hepatic Encephalopathy - Combination of Lactulose and Rifaximin Versus Lactulose Monotherapy: A meta-analysis

Not Availabl

Knowledge, Perception, and Practice of Generic Medicine and Associated Factors among Community Pharmacists in Jaffna, Sri Lanka

Good knowledge of Generic medicines (GM) among healthcare professionals including pharmacists improves the effective usage of generic medicine among patients and thus reduces their healthcare costs. The objective of this study is to assess knowledge of GM among community pharmacists in the Jaffna district of Sri Lanka. An analytical cross-sectional study was conducted among all community pharmacists in the Jaffna district using a self-administered questionnaire. SPSS 26 analyzed data. Independent sample t-test and one-way ANOVA were used to assess the relationship between sociodemographic and work-related factors and knowledge of GM among community pharmacists at the 95% confidence interval and a P-value less than 0.05 was considered significant. Sixty-two pharmacists (92.54%) responded to the study. The median age of pharmacists was 42.5 years (IQR=18.5) and 58.1% of them were males. The total score for knowledge of generic medicine was 55. The mean score of knowledge on generic medicine was 37.37±11.86. Age, professional qualification (p=0.044), and participation in the workshop (p=0.023) had significant differences with knowledge of GM. Pharmacists have a negatively inclined perception of generic substitutes. However, most of them (95.2%) were practicing generic medicine substitution. Most of the pharmacists selected generic substitutes based on the customer's request (94.9%), followed by the quality of the generic medicine (67.8%) and familiarity of generic brands (67.8%). Community pharmacists lack knowledge and negatively inclined perception of GM. However, most pharmacists practice generic substitutions during dispensing. Conducting continuous professional development programs and workshops regularly and upgrading their professional qualifications to diploma or degree from certificate level could improve not only their knowledge of generic medicines but also good dispensing practice