Determinants of Increasing Trend of Self-Medication in a Pakistani Community

Purpose: To determine the major reasons, sources, diseases and drugs responsible for increasing trend of self-medication.Method: A community-based cross-sectional survey was carried out in the district of Faisalabad in Pakistan. Respondents (1488) were classified on the basis of age, sex, education, lifestyle and their economical level. A questionnaire was distributed among the sample population to collect data.Results: Majority of respondents involved in self-medication were aged between 15 and 20 years. Family members (N = 717, 48 %) were considered the major source of information for self-medicated drugs. Lack of time (N = 504, 37 %) while economic issues (N = 485, 33 %) were the major reasons for self-medication. Medical stores were the source of drug purchase by 1087 (73 %) respondents. Headache (N = 772, 52 %) and fever (N = 600, 40 %) were the main indications for self-medication while 694 respondents reported that they engage in single-dose self-medication. Paracetamol (N = 689, 46 %), other analgesics (N = 488, 33 %),  non-steroidal anti-inflammatory (N = 680, 46 %) were reported to be used frequently for self-medication.Conclusion: Self-medication is prevalent in the Pakistani community due to easy access to over the counter (OTC) and prescription-only medicines  (POM). This may lead to untoward effects in consumers of the products. Special interventions by relevant regulatory agencies regarding the sale of the drugs are therefore required.Keywords: Self-medication, OTC drugs, Pharmacist

‘Malnutrition: A serious concern among hospitalized patients’ a cohort study of nutritional screening among admitted patients using GRAZ malnutrition tool- GMT

Objective: To identify the risks, causes, and degree of malnutrition among admitted patients using GRAZ Malnutrition Screening tool with gender and age groups comparison among private and public hospitals. Materials & Methods: A comparative cohort study was conducted upon 385 admitted patients of two Government and private hospitals from 1st Dec- 2019 to 31st March- 2020. A standardized validated tool was used with categories of weight loss within the last 3 months, BMI, changes in appetite, the severity of the disease, and age greater than 65 with a cut-off score of 3. The data was entered and analyzed through SPSS- Version 19 by computing, frequency, percentages, and Chi-Square test, with significant cut-off limit for P-Value was set at 0.05. Results: Among the 385 admitted patients 52.2 % (n= 201) were males and 48 % (n=184) females. The vulnerable age group was 39-58 Year with 40 % (n= 157) while 33.5 % (n= 129) were among 28-38 Year. Only 6 % (n= 21) were under-weight with BMI <18 / < 20. The risk of malnutrition among admitted females was 65.7 % (n= 121) as compared to 52.2 % males (n= 105) with GMS >3.&nbsp

Does Short Term Atorvastatin Treatment Improve Symptomatic Control in Patients with Mild to Moderate & Uncontrolled Asthma?

Introduction: Asthma is a chronic disease characterized by recurrent episodes of breathlessness and wheezing. Keeping in view the problems in asthma control and side effects of available medication, there is a need for alternative treatments with better efficacies and fewer side effects. Atorvastatin is a statin that blocks HMG CoA reductase enzyme found in the liver, inhibiting the synthesis of cholesterol. Blockade of this pathway also inhibits production of GTPases which are involved in airway inflammation, airway remodeling and contraction of smooth muscles of the bronchi. Aims & Objectives: To evaluate the symptomatic control in mild to moderate and uncontrolled asthma patients using standard treatment versus its combination with atorvastatin. Place and duration of study: This study was conducted in Pulmonology Department of Lahore General Hospital; Lahore over a 4-week duration from October 2018 till February 2019. Material & Methods: Patients of mild to moderate and uncontrolled asthma were enrolled in this study based on inclusion and exclusion criteria. Patients were divided into two groups by lottery method, Group 1 and Group 2, with 34 patients in each group. Group 1 was continued with standard therapy of asthma and the Group 2 was administered atorvastatin 40 mg, once daily in addition to standard therapy for 4 weeks. The control of asthma before and after treatment was assessed based on Global Initiative for asthma (GINA) guideline questionnaire score. SPSS (Statistical Package for Social Sciences) version 22 was used for analysis of data. P-Value < 0.05 was taken as significant. Results: Nonsignificant results were obtained when comparison between the groups was made based on GINA guidelines questionnaire score by Mann Whitney Utest Conclusion: It was concluded that atorvastatin has no role in symptomatic control in patients of mild to moderate and uncontrolled asthma

Deep Learning based Classification of Thyroid Cancer using Different Medical Imaging Modalities : A Systematic Review

Deep learning algorithms have achieved a tremendous triumph in task-specific feature classification. Deep learning methods are very much effective when a large amount of training data is scarce. It has been significantly applied for disease classification from medical imaging. The paper aims to identify and summarize the scenario of current research on thyroid cancer using deep learning methods through different medical imaging modalities which are found at present so that reseachers become capable to select a useful and the most relevant approach which might be fruitful in dealing with thyroid cancer. This may also raise a need for more work out while dealing with future challenges. This Systematic literature review (SLR) has been presented by reviewing research articles published in well-reputed venues between 2017 to 2021. A comprehensive review was performed to appraise the deep learning approaches that have been applied in classifying a thyroid nodule disorder from different medical imaging modalities. The analysis is performed based on different parameters reported in selected research studies which include classification accuracy, true-positive (TP), false-positive (FP), true-negative (TN), false-negative (FN) sensitivity, specificity, and the area under the receiver operating characteristic curve (AUROC). A total of 2,149 research studies have been obtained by applying search queries in different journals’ databases, out of them 40 papers have been selected for this SLR. Among them 22 studies have contributed sufficiently to the construction of the evaluation table which enabled the test process of methods of deep learning, having sensitivity varies between 75% to 100% (mean 89.50%) and specificity ranged from 64% to 100% (mean 84.4 %). The outputs revealed that the Convolutional Neural Network (CNN) has produced significant accuracy and has been extensively applied in the diagnosis of thyroid cancer by medical professionals. Furthermore, it is concluded that if the thyroid cancer exposure is inappropriate then it may restrict the deep learning mechanism and make its reliability challenge able

Primary Sjogren's syndrome presenting as ptosis and eyelid swelling: A case report

Key Clinical Message This unique case report of primary Sjogren's syndrome (pSS) shows bilateral ptosis and significant periorbital edema, compromising vision. To avoid misleading diagnosis, antibody tests must be evaluated and interpreted in the context of clinical findings. Abstract Primary Sjögren's syndrome is an idiopathic, autoimmune disorder involving the lacrimal and salivary glands characterized by both localized and systemic manifestations including xerostomia and keratoconjunctivitis sicca. Myasthenia Gravis (MG) is also an autoimmune disorder characterized by the development of auto‐antibodies against nicotinic acetylcholine receptors that causes decreased muscle response to stimulation. It usually presents with ptosis and generalized body weakness. Ophthalmological involvement is common in both disorders but ptosis is very rarely seen in pSS. We report the case of a 27‐year‐old woman presenting to our clinic with the complaint of ptosis and eyelid swelling. She also had a positive anti‐acetylcholine receptor antibody test and her initial presentation mimicked Myasthenia Gravis. Her autoimmune workup revealed a positive titer of Anti Ro SSA antibodies. Myasthenia Gravis was ruled out on electrodiagnostic studies which showed no decremental response, and pSS was confirmed on lip biopsy. Our case highlights that it is important to interpret the antibody test results in the context of clinical findings as we can have spurious results in autoimmune diseases. Autoimmune conditions can have varying presenting complaints hence, clinical judgment should always overrule diagnostic investigations and should thus guide patient management

Design of A Modern Hydrogen Production and Recovery Facility (Spring 2003) IPRO 304C

The objective of this project is to design and provide an economic assessment of new flue gas cleanup processes to meet new and future environmental emissions standards. The issues to be considered in this project include technical viability, process integration, economic feasibility, and environmental disposal of waste streams. An economic assessment of the market-based prices of emissions allowances will be used to determine the best long-run strategy. An assessment will be made on the effects of implementation of new technologies on the cost of electricity for both low sulfur western coal, and high sulfur Illinois coal to determine if governmental incentives are needed to promote the use of Illinois coal. Students may focus on an existing power plant in Illinois which uses western coals and is not equipped with SOx/NOx/Hg control systems. Students are expected to use the principles of process design, to evaluate commercially available technologies for various pollutants or propose new approaches to the problem, integrate various technologies in the cleanup train, and perform an economic analysis of the overall processes.Sponsorship: IIT Collaboratory for Interprofessional StudiesProject Plan for IPRO 304C: Design of A Modern Hydrogen Production and Recovery Facility for the Spring 2003 semeste

Citrus Canker—Distribution, Taxonomy, Epidemiology, Disease Cycle, Pathogen Biology, Detection, and Management: A Critical Review and Future Research Agenda

Xanthomonas citri subsp. citri, a causative agent of the citrus canker (CC) disease, belongs to one of the essential groups of the bacterial phytopathogen family, Xanthomonadaceae. It has been a potential threat to the globally significant citrus fruit crop, which has remained under investigation for disease management and epidemiology since the 1980s. In Pakistan, the average yield of citrus is 11 t/ha, which is lower than other countries, including China, Brazil, and India, having average productions of 27, 26, and 22 tons/hectare, respectively. Citrus canker is one of the most devastating diseases, posing a significant threat to crop yield and fruit quality. To date, five distinct types (or forms) of the citrus canker have been recognized; the Asiatic (Canker A) form is most destructive and affects most citrus cultivars. Severe infection outcomes include dieback, defoliation, severely blemished fruit, premature fruit drop, and reduced fruit quality. The infection increases under humid, warm, cloudy climate, wind, and heavy rainfall. The analysis of plasmid and chromosomal DNA of X. citri subsp. citri depicted an evolutionary relationship among pathovars of Xanthomonas. The extensive study on the genome of X. citri subsp. citri has contributed to the current knowledge of plant host recognition of pathogens, host specificities, dissemination, and propagation. Regulatory programs, i.e., quarantine or exclusion, continued to be practiced, prohibiting infected citrus plant material into the existing stock. Other measures include removal of inoculums sources, resistant hosts, protective copper-containing sprays, and windbreak systems. In this review, we explored the latest trends in the areas of epidemiology, pathogenome, detection, host–pathogen interaction, biofilm formation, and management of X. citri subsp. citri