02472nas a2200229 4500008004100000024000700041245009400048210006900142260001600211300001000227490000600237520180800243653001802051653001402069653002102083653001402104100002002118700001702138700002002155700001802175856004902193 2023 eng d a0300aA Community Based Study on Various Aspects of Breast-Feeding Practices from Central India0 aCommunity Based Study on Various Aspects of BreastFeeding Practi cAugust 2023 a15-180 v93 a

Background: For optimum growth and development of new-borns breastfeeding is of utmost importance. Identification of breastfeeding practise gaps need to be identified and filled. Objectives: This study was undertaken to explore the breastfeeding practices, influence of literacy and prevailing cultural factors on different aspects of breastfeeding. Materials and Methods: Complete line listing of 576 breastfeeding women in the study area was done. Then the study subjects were interviewed by making house to house visits. Data was gathered on the participant’s demographics, breastfeeding knowledge, and practices. Privacy was maintained while conducting the interview. Anonymity and confidentiality were ensured to the study participants. Results: Data of 550 study participants was analyzed and presented here. 377 (68.5%) could not practice timely initiation of breast feeding. Most common reason (264, 70%) for the same was insufficient knowledge about it. Exclusive breast feeding was practiced by merely 44 (8%) subjects. Not good for health of new-born (108, 36.7%), not easily digested by the new-born (thick) (85, 28.9%) and myths prevalent in society (64, 21.8%) were three most common reasons for discarding colostrum by mothers. Lower socio-economic status, muslim religion and joint family were found to be associated with practice of exclusive breastfeeding. Conclusion: The issue of lower prevalence of early breastfeeding initiation and exclusive breastfeeding continues to persist in the study area. Still, colostrum is being discarded. Tailored and region-specific health promotion activities must be intensified in this regard by grass root level health care workers.

10aBreastfeeding10aColostrum10aCultural factors10aPractice.1 aSilawat, Sanjay1 aVerma, Vijay1 aYuwane, Praveen1 aDixit, Shivam uhttps://www.jppcm.org/article/2023/9/2/15-1801555nas a2200241 4500008004100000024000700041245008500048210006900133260001600202300000900218490000600227520081900233653001601052653002001068653001901088653002901107653001701136100002901153700002601182700003001208700002701238856004801265 2023 eng d a0100aEffect of Concurrent Co-Morbidity in the Management of Musculoskeletal Disorders0 aEffect of Concurrent CoMorbidity in the Management of Musculoske cAugust 2023 a7-100 v93 a

Musculoskeletal disorders exert a substantial impact on the quality of life of affected individuals as well as placing a major economic burden on work organizations and society in terms of compensation costs in the short term and lost wages in the long-term. Musculoskeletal conditions may occur with or without concurrent chronic conditions, which may affect the effectiveness of physiotherapy management. The impact of co-existing co-morbidities other than the primary diseases the patient is being managed for, on the treatment, and on the outcomes of physiotherapy programs for individual patient cannot be overemphasized. Hence, the purpose of this review was to summarize the management of musculoskeletal disorders and the impact of chronic conditions on their treatment outcome.

10aComorbidity10aElectrotherapy.10aManual therapy10aMusculoskeletal disorder10aRisk factors1 aOlanrewaju, Saliu, Akeem1 aOmoyemi, Ogwumike, O.1 aGbonjubola, Yusuff, Tunde1 aGordons, Alexander, E. uhttps://www.jppcm.org/article/2023/9/2/7-1001418nas a2200157 4500008004100000024000700041245008400048210006900132260001600201300001000217490000600227520092200233100002601155700003001181856004901211 2023 eng d a0400aImpact of Government Policy and Socio-Economic Hardship on Stroke Re-Occurrence0 aImpact of Government Policy and SocioEconomic Hardship on Stroke cAugust 2023 a19-200 v93 a

Recurrent stroke is a major contributor to disability and mortality in patients with stroke.[1] Several studies in western countries have shown that the recurrence risk was 11.2% within 12 months; 15% after 2 year and 9.5% within 5 years.[2-4] However, Africa appears to have the highest incidence, prevalence and case fatality of stroke.[5-9] Recurrent stroke still remains a challenge even with improved neuroimaging, acute stroke management, and disseminated use of secondary prevention.[10] The risk of recurrence of stroke has been earlier associated to previously undetected risk factors that are overlooked due to assumptions made about the etiology. Also, relevant risk factors of stroke recurrence and the recurrence patterns of the different stroke subtypes could be mapped systematically.[11]. Read more...

1 aGordons, Alexander, E1 aGbonjubola, Yusuff, Tunde uhttps://www.jppcm.org/article/2023/9/2/19-2002633nas a2200265 4500008004100000245006100041210006100102260001500163300000800178490000600186520191200192653001902104653003302123653001302156653001102169653001402180100001702194700001902211700001702230700001702247700001702264700002002281700001902301856004702320 2023 eng d00aImpact of Treatment on Asthma Control in Quetta Pakistan0 aImpact of Treatment on Asthma Control in Quetta Pakistan cMarch 2023 a1-50 v93 a

Background: Poorly controlled asthma may lead to decreased lung function, increase the risk of complications and more episodes of exacerbations, increased healthcare utilization, including more frequent hospitalizations and emergency room visits. Regular monitoring of asthma symptoms and lung function can help identify any potential issues in asthma control and ensure optimal management. Objectives: The study aims to assess the asthma control by the usage of asthma controller medications especially, corticosteroids, bronchodilators and leukotriene modifiers, among patients receiving treatment through well-validated questionnaire. Materials and Methods: A cross-sectional study with a sample of 361 was conducted in different public hospitals outpatient departments and clinics of Quetta Pakistan by using a convenience sampling technique. The Asthma Control Questionnaire (ACQ) was used to measure the asthma control of the asthmatic patients. The descriptive and inferential statistics have been done by using SPSS version 20 with a p value <0.05. Results: The study found that an average score of asthma control was 3.1±1.10 thereby indicating uncontrolled asthma with also 62.3% of study participants had uncontrolled asthma, no patient had controlled asthma. An increased number of medications including the use of corticosteroids and leukotriene modifiers posed an impact on asthma control of the study population. Conclusion: The study concluded that corticosteroids and leukotriene modifiers can be effective in asthma control and it is suggested for the future studies that route of administration and treatment guidelines must also be determined along with the asthma control to gain a complete picture of impact of treatment and management on any health outcomes.

10aAsthma Control10aAsthma Control Questionnaire10aPakistan10aQuetta10aTreatment1 aSehar, Sadia1 a-ul-Haq, Noman1 aTahir, Maria1 aRiaz, Sohail1 aNasim, Aqeel1 aSaood, Muhammad1 aYasmin, Riffat uhttps://www.jppcm.org/article/2023/9/1/1-502563nas a2200229 4500008004100000024000700041245013500048210006900183260001600252300001000268490000600278520184900284653001302133653001602146653001302162653001402175653001302189100003702202700001902239700002602258856004902284 2023 eng d a0200aKnowledge, Attitude and Practice of Brucellosis among Farmers Rearing Cattle in Belagavi Taluka - A One Year Cross-sectional Study0 aKnowledge Attitude and Practice of Brucellosis among Farmers Rea cAugust 2023 a11-140 v93 a

Introduction: Brucellosis is a zoonotic disease which is almost invariably transmitted by direct or indirect contact with infected animals or their products. It is also known as “Malta fever”, It is an important human disease in many parts of the world especially in the south and central Asia, Mediterranean countries of Europe, north and east Africa, and America and yet it is often unrecognized and frequently goes unreported. More than 500,000 new cases occur annually with an uneven global distribution. In India, bovine Brucellosis is widespread and in recent time it becomes more prevalent, perhaps, due to increased trade and rapid movement of livestock. Epidemiological evidence reveals that, in India, Brucellosis is recorded in almost all states but the scenario differs between states and is present in different species of animals including cattle, goats, buffalo, yaks, camels, horses, and pig. Objectives: To assess the knowledge, Attitude and practice of Brucellosis among Farmers Rearing Cattle. Materials and Methods: A cross-sectional study conducted in Belagavi Taluka among 400 farmers rearing cattle’s. Data was collected using predesigned pretested structured questionnaire after taking written informed consent. Based on the objective the data was analyzed in SPSS version-20 and expressed as percentage. Results: Majority 93.8% farmers had poor knowledge, 4.4% had average knowledge and 1.8% had good knowledge about brucellosis. 99.5% had positive attitude about brucellosis and 97.5% farmers’ had bad practice and only 2.5% had good practice in rearing cattle. Conclusion: Study revealed that majority of farmer’s had poor knowledge and bad practice but had positive attitude about brucellosis.

10aAttitude10aBrucellosis10aFarmers.10aKnowledge10aPractice1 aHiremath, Neelakanthayyaswamy, I1 aKangle, Ranjit1 aNarasannavar, Ashwini uhttps://www.jppcm.org/article/2023/9/2/11-1401487nas a2200229 4500008004100000245008100041210006900122260001500191300001000206490000600216520077900222653002201001653002801023653003701051653002601088653003301114100001501147700002101162700000501183700002001188856004901208 2023 eng d00aAn Overview on the Importance of Antibiotic Therapy in Post-surgery Patients0 aOverview on the Importance of Antibiotic Therapy in Postsurgery  cMarch 2023 axx-xx0 v93 a

Antibiotics are the class of medication that prevent the growth of infections that is caused by bacteria; antibiotics make it difficult to grow or multiply or directly killing them. But the widespread misuse of antibiotics can also lead to serious consequences. In the case of post-operative patients, the empirical antibiotics should be selected based on the site of infection, etiology, and pharmacokinetics of the antibiotics. Therefore the rational use of empirical antibiotics is based on the increase in the total count and also the spike in temperature. The review is focused on the time, duration, rationality, and selection of empirical antibiotics, and antibiotic prescription patterns in different departments and different age groups.

10aAntibiotic policy10aAntibiotic stewardship.10aAntibiotics prescription pattern10aEmpirical antibiotics10aNational treatment guideline1 aPS, Anitta1 aVarghese, Athira1 a1 aChandy, Vineeth uhttps://www.jppcm.org/article/2023/9/3/xx-xx01611nas a2200181 4500008004100000245009100041210006900132260001500201300000600216490000600222520106300228653000801291100001601299700001901315700002601334700002401360856004501384 2023 eng d00aVitamin D3 Analogues and Laboratory Tests Interactions: Public Health Awareness Glance0 aVitamin D3 Analogues and Laboratory Tests Interactions Public He cMarch 2023 a60 v93 a

Vitamin-D is available in the market in three different forms; cholecalciferol, alfacalcidol both of them are inactive and converted into active form calcitriol.[1] The conversion of both occurs by passing on liver hepatocytes by (25-hydroxylase) and kidneys (1-alfa-hydroxylase) while alfacalcidol is converted into active form only by the liver.[2,3] Thus, it means that those individuals whose Renal Function Tests (RFTs) and Liver Function Tests (LFTs) are raised they are unable to get benefits from cholecalciferol and those with raised LFTs will not get benefits from alfacalcidol thus the selection of choice in this condition will be calcitriol or 1, 25-dihydroxycholecalciferol is depicted in the (Figure 1).[4-6] To the best of our knowledge this will be the first attempt to highlight the selection of Vitamin D3 from different analogues. The main aim of this short comment to aware the public regarding the use of better alternative for the patients from the rest of three.

10aNil1 aKhan, Majid1 aRiaz, Muhammad1 aAmin, Muhammad, Usman1 aKhan, Ashraf, Ullah uhttps://www.jppcm.org/article/2023/9/1/602203nas a2200217 4500008004100000245005600041210005500097260001700152300000800169490000600177520159200183653002401775653002701799653001701826100001701843700001701860700002501877700002001902700001601922856004701938 2022 eng d00aAntibiotic Resistance: A Universal Issue of Concern0 aAntibiotic Resistance A Universal Issue of Concern cJanuary 2022 a4-70 v83 a

The antibiotic resistance forthwith is the worldwide severe health problem. Clinical and economically, outcomes are harmed by the antibiotic resistance, along with consequences ranging from a patient’s failure to respond treatment and the expensive and alternative drugs costs higher morbidity and mortality rates, preponderant hospital stays and the need for changes in standard therapy. The usage of antibiotic in the population as a whole a few leading sources of antibiotic resistance. Patients who do not have a prescription are frequently given ‘prescription-only’ medications like antibiotics by pharmacists in undeveloped nations like India. There is a lack of information on how community pharmacists use antibiotics which is critical for developing a viable and long-term intervention programmed to encourage judicious antibiotic use. Antibiotics are one of the most effective weapons to fight against life-threatening illnesses. Their discoveries have a significant impact on human as well as animal health. Consequently, because of the advent and spread of antimicrobial resistance, people all around the world including Americans are sinking due to intractable diseases. In this review, we will look at the trapping of antibiotic resistance on the general public health, community, society and health care system. Resistance to antibiotics is a danger sign that is putting strain on healthcare systems and resulting in severe health loss; we must continue to monitor and support activities aimed at preventing and controlling the infection.

10aClinical Pharmacist10aInfection Control Team10aPrescribers.1 aKhan, Hashim1 aMalik, Abdul1 aGaur, Praveen, Kumar1 aRastogi, Sameer1 aLata, Kanak uhttps://www.jppcm.org/article/2022/8/1/4-702416nas a2200241 4500008004100000245009800041210006900139260001600208300001000224490000600234520168900240653002501929653001401954653002301968100002001991700001902011700002002030700001702050700002002067700001702087700002102104856004902125 2022 eng d00aAssessment of Prescription Errors among Community Pharmacists in Quetta Balochitsan, Pakistan0 aAssessment of Prescription Errors among Community Pharmacists in cAugust 2022 a20-250 v83 a

Background: Community pharmacists can serve as a key source of scientifically correct drug information and can provide advice on how to utilise pharmaceuticals in a safe, appropriate, and cost–effective manner. The dispensing procedure at a community pharmacy is an important aspect of safe medication usage, and it is one of a pharmacist’s primary professional tasks, along with patient counselling. Objectives: To find awareness level of community pharmacist regarding prescription error and to find either they can find prescription errors or not. Methods: A cross sectional descriptive study was conducted in community pharmacies of Balochistan, Quetta by using simulated prescriptions containing identifiable errors in Quetta Pakistan. Analyses was performed on IBM SPSS. Results: As per qualifications the maximum 259 (92.8%) were Pharm-D degree holder. As far s experience is concerned most of them 197 (70.6%) had 1-3 years of experience. In all prescriptions Level of Errors Identification on individual Medicine. The result it was found that non identified errors were dominant in all prescription. Only the experience group was statistically significant (p<0.001). and rest of variables were non-significant (p>0.05). Conclusion: Understanding the types of prescription mistakes and the variables that contribute to them allows for error avoidance at the earliest stage of the pharmaceutical process. Preparing pharmacy, medical, and nursing students to recognise prescription mistakes enhances patient care and reduces the risk of negative outcomes.

10aCommunity pharmacist10aPakistan.10aPrescription error1 aNajam, Sherjeel1 aHaq, Noman, ul1 aSaood, Muhammad1 aNasim, Aqeel1 aDanish, Zeeshan1 aShah, Yasmin1 aAndleeb, Shabana uhttps://www.jppcm.org/article/2022/8/2/20-2501490nas a2200181 4500008004100000245006300041210006300104260001900167300001000186490000600196520095200202653002601154653001501180653002801195653001601223100002001239856004901259 2022 eng d00aCase Report on Amlodipine Induced Pitting Type Pedal Edema0 aCase Report on Amlodipine Induced Pitting Type Pedal Edema cSeptember 2022 a42-430 v83 a

Amlodipine is 1,4 dihydropyridine class of third generation calcium channel blocker which is indicated for the management of hypertension, coronary atherosclerosis, stable angina and it is also an alternative used for the nifedipine induced pedal edema. This case study aims to make report of the common adverse reaction pitting type pedal edema is occurring during the treatment with the same. Amlodipine has increased incidence rate of pedal edema compared to other calcium channel blockers. Here present 67 years old male patient who gradually develops pitting type pedal edema after the initiation of oral amlodipine for hypertension. The symptoms have been relieved after the cessation of drug and patient has been managed with alternative antihypertensive agent. This study helps to consider more regarding amlodipine therapy and aids to earlier prevention of serious adverse drug reactions occurring in patients.

10aAdverse drug reaction10aAmlodipine10aCalcium channel blocker10aPedal edema1 aSunil, Sahithya uhttps://www.jppcm.org/article/2022/8/3/42-4301411nas a2200193 4500008004100000245010200041210006900143260001300212300001000225490000600235520081800241653000801059653001601067653002301083653001801106653001901124100002501143856004901168 2022 eng d00aA Case Report on Bupivacaine Induced Limb Weakness; Type I Augmented Adverse Drug Reaction (ADR)0 aCase Report on Bupivacaine Induced Limb Weakness Type I Augmente cMay 2022 a18-190 v83 a

Bupivacaine is an amide-type, long-acting local anesthetic. It acts by preventing generation or conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold. Lower limb motor weakness is a well-known complication of epidural analgesia with local anesthetics. In this case report a 60yr old female developed Bupivacaine induced lower limb weakness post-surgery. This event was identified as Type 1 augmented ADR which was assessed and reported with the help of Naranjo ADR scale. The dose of Bupivacaine was reduced as per clinical pharmacist’s suggestion and that helped in recovery from the weakness on the same day. Type 1 augmented ADR is related to the pharmacological action of the drug or due to the exaggerated pharmacologic response.

10aADR10aBupivacaine10aEpidural analgesic10aLimb weakness10aNaranjo scale.1 aJohn, Jeffin, Gloria uhttps://www.jppcm.org/article/2022/8/1/18-1901538nas a2200181 4500008004100000245007000041210006600111260001800177300001000195490000600205520098200211653002901193653001201222653002801234653001701262100002801279856004901307 2022 eng d00aA Case Report on Hereditary Spherocytosis in a 22-Year-Old Female0 aCase Report on Hereditary Spherocytosis in a 22YearOld Female cNovember 2022 a49-500 v83 a

Hereditary spherocytosis is a rare genetically transmitted spherical shaped red blood cell disorder which leads to hemolytic anemia. The symptoms vary from asymptomatic to severe life-threatening anemia. The management includes splenectomy, blood transfusion and vitamin supplements. A 22-year-old female comes to tertiary care hospital with the complaints of fever, yellowish discoloration of eyes and urine. She was diagnosed with hereditary spherocytosis 10 years back and was continuously on blood transfusion. On day 1, her hemoglobin was 6.3 g/dL which falls under life-threatening anemia, total bilirubin was 7.9 g/dL, and direct bilirubin was 0.9 g/dL. She was given with blood transfusion for two days and hemoglobin level raised to 10 g/dL. This case presents life-threatening anemia and icterus associated with severe hereditary spherocytosis. The treatment in hereditary spherocytosis is quite challenging often because of its obscurity.

10aHereditary spherocytosis10aIcterus10aLife-threatening anemia10aTransfusion.1 aPathan, Umme, Habeeba A uhttps://www.jppcm.org/article/2022/8/4/49-5001514nas a2200193 4500008004100000245008000041210006900121260001600190300001000206490000600216520092600222653000801148653003401156653002401190653001801214653001601232100002301248856004901271 2022 eng d00aCase Series on Teicoplanin Induced Thrombocytopenia – An Issue of Concern0 aCase Series on Teicoplanin Induced Thrombocytopenia An Issue of  cAugust 2022 a34-350 v83 a

Teicoplanin is a glycopeptide antibiotic which inhibits peptidoglycan polymerization in gram-positive bacteria resulting in their cell death. Thrombocytopenia is a blood disorder in which platelet count falls below 100,000 cells/μl. Bleeding occurs when platelet falls below 20,000 cells/μl. In this case series, three patients with different clinical scenarios are explained who developed thrombocytopenia associated with teicoplanin administration during their course of medication. They were identified, assessed and reported for the ADR with the help of Naranjo ADR probability scale. As far as to our knowledge teicoplanin induced thrombocytopenia is not much studied and reported. In a current emerging use of higher antibiotics like teicoplanin, this is a serious life-threatening condition that has to be carefully monitored while on treatment with these types of higher antibiotics.

10aADR10aDrug induced thrombocytopenia10aHaemolytic anaemia.10aNaranjo scale10aTeicoplanin1 aZS, Mohamed, Aamir uhttps://www.jppcm.org/article/2022/8/2/34-3501410nas a2200229 4500008004100000245007900041210006900120260001300189300000900202490000600211520076300217653001300980653001300993653001701006653001501023653001701038100001701055700002201072700001801094700002101112856004701133 2022 eng d00aCoronavirus Disease (COVID-19): The Health and Well-being of Indian Women0 aCoronavirus Disease COVID19 The Health and Wellbeing of Indian W cMay 2022 a1-3 0 v83 a

The COVID-19 pandemic is primarily affecting women and girls, who are bearing the brunt of pandemic related deaths, illnesses, and socio-economic burdens. The pandemic is also harming the health, social and economic well-being of women around the world, but women are leading the response and are making vital contributions to the pandemic response. Women are over-represented among the pandemic’s victims and far more likely than men to be caring for loved ones with pandemic-related illness, or managing the pandemic’s impacts on their families, communities and countries. In response, women are stepping up to lead the health response, and they are making critical contributions to the pandemic response and to the pandemic

10aCOVID-1910aPandemic10avaccination.10aWell-being10aWomen health1 aKhan, Salman1 aLachyan, Abhishek1 aGautam, Somya1 aAwasthi, Supriya uhttps://www.jppcm.org/article/2022/8/1/1-302519nas a2200241 4500008004100000245014000041210007000181260001300251300001000264490000600274520172800280653002702008653002802035653001902063653002502082100001802107700002302125700001902148700001802167700002302185700002002208856004902228 2022 eng d00aDifferentiation of the β-thalassemia Trait from Iron Deficiency Anaemia by Red Cell Indices among Pregnant Women in Southern Haryana0 aDifferentiation of the βthalassemia Trait from Iron Deficiency A cMay 2022 a14-170 v83 a

Background: Due to similar red cell morphology, patients of beta thalassemia trait ( -TT) are often misdiagnosed as Iron Deficiency Anaemia (IDA) and given unnecessary iron medication. Facilities for diagnosing them are usually not available in underserved areas where health system and laboratory facilities are not strengthened. Aim: We planned this study to discriminate -TT from IDA by red cell indices among pregnant women in southern Haryana. Methods: One hundred and forty eight antenatal women were screened for presence of anaemia with help of haemoglobin value at the time of admission. Typing of anaemia was done. After staining, it was examined for red cell morphology and various red cell indices were also noted. Results: Of total 148 pregnant women, 104 were found to be anaemic thus the overall prevalence of anaemia was found to be 70.27% (104/148) in our study. Microcytic hypochromic picture (38.4%), followed by normocytic hypochromic to microcytic hypochromic (20.1%) was predominant on peripheral blood film (PBF) examination followed by dimorphic anaemia. RBC count was found to be normal in 85.5% cases followed by decreased count in 14.4% cases. None of the case had increased RBC count. MCV was normal in 58.6% of cases followed by decreased below 80 femtolitre in 28.8% of cases. Conclusion: Higher prevalence of anaemia in pregnant women indicates that anaemia still continues to be a major health problem in India. In resource constrained settings, where definitive diagnostic facilities do not exist; red cell indices may be used to discriminate -TT from IDA among pregnant women.

10aBeta thalassemia trait10aIron deficiency anaemia10aPregnant women10aRed cell morphology.1 aMangla, Divya1 aSingh, Sundar, Pal1 aBansal, Nikhil1 aGole, Sheetal1 aKharolia, Ravinder1 aSingh, Abhishek uhttps://www.jppcm.org/article/2022/8/1/14-1702678nas a2200277 4500008004100000245010900041210006900150260001600219300001000235490000600245520184600251653001502097653002102112653002902133653003402162653001202196100001602208700001902224700002002243700002002263700001702283700001702300700001702317700001702334856004902351 2022 eng d00aDrug Utilization Pattern in Elderly Hospitalized Patients in Tertiary Care Hospitals of Quetta, Pakistan0 aDrug Utilization Pattern in Elderly Hospitalized Patients in Ter cAugust 2022 a26-330 v83 a

Background: Changes in Pharmacokinetics and pharmacodynamics in different age groups, especially in elderly age group, have extensively been documented and studied and concurrent chronic diseases may underlie polypharmacy in elderly. Aim: The aim of this study was to assess drug utilization pattern in elderly hospitalized patients in tertiary care hospitals of Quetta. Methods: Specifically, designed questionnaire based, cross sectional study was conducted in Bolan Medical Complex Hospital and Sandeman Provincial Hospital Quetta with total of 397 participants. Non-Probability convenience sampling technique was used in this study. Cronbach alpha test was applied to check reliability of questionnaire, Cronbach alpha value was 0.886 that is acceptable range. Results: Majority of the participants were from age group 60 to 70 years (n=301, 75.8%), fever and cough were present in majority of hospitalized patients (n=180,11.7%). Majority (n=232, 58.4%) of participants were having uncontrolled disease with yearly health service utilization of more than 3 times (n=234, 58.9), medication recommended to majority (146, 36.8%) of participants were 4. Ceftriaxone was mostly prescribed in cough (n=162,90%), hypertension (n=114, 67.1%), fever (n=154, 85.6%) of cases, while in gastritis omeprazole was mostly prescribed (n=84, 73.7%). Most of the hospitalized patients were complaint to ceftriaxone, omeprazole, dimenhydrinate and diclofenac sodium. Conclusion: Ceftriaxone was most prescribed drugs among elderly patients that were admitted in different specialty departments. Most of the elderly patients had uncontrolled disease status. This study concluded that the compliance to medication was 82.1% of elderly patients.

10aCompliance10aDrug Utilization10aDrug utilization pattern10aElderly hospitalized patients10aQuetta.1 aAli, Tayyab1 aHaq, Noman, ul1 aRazaque, Ghulam1 aSaood, Muhammad1 aNasim, Aqeel1 aShah, Yasmin1 aTahir, Maria1 aKhan, Ramina uhttps://www.jppcm.org/article/2022/8/2/26-3300839nas a2200157 4500008004100000245004200041210004200083260001900125300000700144490000600151520041200157653000800569100002900577700002900606856004600635 2022 eng d00aEffect of Exercise on Drug Absorption0 aEffect of Exercise on Drug Absorption cSeptember 2022 a440 v83 a

Dear Editor,

Exercise is the systematic execution of physical activity for a specific purpose. At rest, in humans, skeletal muscle receives between 15% and 20% of the cardiac output, while during maximal exercise, this percentage reaches values of 80% to 90%.[1] Exercise places great demand on circulation. Read More . . .

10aNil1 aAbubakar, Ibrahim, Ahmad1 aAbdulrahman, Jibo, Garba uhttps://www.jppcm.org/article/2022/8/3/4402192nas a2200217 4500008004100000245014600041210006900187260001300256300000900269490000600278520142400284653002601708653002201734653003301756653006501789100001801854700001801872700001801890700001801908856004801926 2022 eng d00aAn Overview of Spontaneous Reporting, Targeted Spontaneous Reporting and Cohort Event Monitoring-Pharmacovigilance Methods: Myths and Facts0 aOverview of Spontaneous Reporting Targeted Spontaneous Reporting cMay 2022 a8-130 v83 a

Adverse drug reaction (ADR) reporting is an important safety concern to monitor safety among the patient. Pharmacovigilance (PV) is usually involves in detection of spontaneous adverse reaction, therefore these shall be submitted to the National Coordination Centre Pharmacovigilance programme of India (NCC-PVPI) which is located at Ghaziabad functioning under ministry of health and family welfare, Government of India. ADR is a global concern that causes serious impact on consumers both in terms of health and financial aspects. Hence monitoring of these adverse reactions is utmost important attribute to enhance patient safety. Perhaps, India is adopting spontaneous reporting (SR) system since 1998, henceforth targeted spontaneous reporting (TSR) system came into consideration in 2010, and that is a complimentary method to spontaneous reporting. This system is useful to establish evidence-based reports generation of specific drug and ADR combination, increase alertness and also helpful in recognizing harmful risks The main aim of this article is to encourage evidence-based decision making to enhance patient safety. In addition to this, establish a functional reporting system i.e. targeted spontaneous reporting system to monitor the safety of targeted medicines and to learn more about the safety profile of new medicines in the early post marketing phase in our population.

10aAdverse drug reaction10aPharmacovigilance10aSpontaneous reporting system10aTargeted spontaneous reporting and cohort event monitoring.1 aThota, Prasad1 aThota, Anusha1 aSarma, Phulen1 aMedhi, Bikash uhttps://www.jppcm.org/article/2022/8/1/8-1301428nas a2200217 4500008004100000245009400041210006900135260001800204300001000222490000600232520073700238653002700975653002201002653001301024653001501037653002201052653002901074100002901103700002901132856004901161 2022 eng d00aRecommended Dietary Measures in the Management and Prevention of Type 2 Diabetes Mellitus0 aRecommended Dietary Measures in the Management and Prevention of cNovember 2022 a45-480 v83 a

Type 2 diabetes has always remained one of the perturbing chronic diseases which cause numerous mortality rates globally. Proper and recommended dieting as well as lifestyle modification has been one of the approach in the treatment of Type 2 Diabetes Mellitus. Adherence to these nutritional approaches from several studies have shown positive results in the delay of the progression of these disease. More so, an increased risk for developing type 2 diabetes is associated with overweight and obesity, physical inactivity and high intake of saturated fats. Therefore, recommended nutritional diets and regular physical activity remains the part and parcel of the management of Type 2 Diabetes Mellitus.

10aLifestyle Modification10aNutritional Diets10aObesity.10aOverweight10aPhysical Activity10aType 2 diabetes mellitus1 aAbubakar, Ibrahim, Ahmad1 aAbdulrahman, Jibo, Garba uhttps://www.jppcm.org/article/2022/8/4/45-4802159nas a2200253 4500008004100000245013100041210006900172260001900241300001000260490000600270520132700276653003001603653001801633653002501651653004101676653002001717100002101737700001901758700001701777700002501794700001901819700001801838856004901856 2022 eng d00aA Review on Futuristic Scope of Agents Related to Amphibian’s Skin and Plants-based Sources in Type 2 Antidiabetic Therapies0 aReview on Futuristic Scope of Agents Related to Amphibian s Skin cSeptember 2022 a36-410 v83 a

Based on the current scenario type-2 diabetes has been labelled as one of the major health issues, approaching exponentially towards mind boggling stage of epidemic globally. Considering to its lifelong latency from early to old ages, less awareness to its particular genotype and phenotype and hefty cost involved in its management and treatment; there is substantial need for more advance, personalised and economical therapeutic approaches for its effective therapy and treatment. The current review here discusses peculiar agents from amphibian’s skin and rarely explored distinctive plant sources with potential to be a viable therapeutic option for type-2 diabetes, therefore, could be devised into effective future treatment strategy to it and also to its related microvascular and macrovascular complications. Based on the literature search the therapeutic scope of agents from amphibian’s skin and selected plants sources are delineated, sighting their activities and prospects as to be future revolutionary remedy to type-2 diabetes and associated hitches such as their insulin releasing ability in pancreatic beta cell lines and primary islets cells, effects on glucose level and on other metabolic parameters such as obesity, lipid profile and pancreatic beta cell function etc.

10aDistinctive plant sources10aGlucose level10aMetabolic parameters10aPeculiar agents and amphibian's skin10aType-2 diabetes1 aTripathi, Shipra1 aDubey, Vaibhav1 aSemwal, Alok1 aChaturvedi, Ratan, B1 aMusale, Vishal1 aNarain, Kamal uhttps://www.jppcm.org/article/2022/8/3/36-4102437nas a2200217 4500008004100000245013600041210006900177260001600246300001000262490000600272520171100278653001001989653002401999653002202023653002502045653001202070100002502082700003002107700003302137856004902170 2021 eng d00aAre we Giving Sufficient Protein in Parenteral Nutrition Support? A Cross-sectional Study on Adult Patients in Intensive Care Units0 aAre we Giving Sufficient Protein in Parenteral Nutrition Support cAugust 2021 a24-270 v73 a

Protein plays a significant role in nutritional support, especially for patients at intensive care unit (ICU) who commonly suffer from net loss of protein. ASPEN and ESPEN guidelines recommend a minimum protein of 1.2g/kg/day for ICU patients; Kidney Disease: Improving Global Outcomes (KDIGO) recommends 0.8g/ kg/day for chronic kidney disease (CKD) stage 4 to 5. This study aimed to determine whether adequate protein was given to adult ICU patients and identify the factors for discrepancy in local settings. A crosssectional study including all adult ICU patients receiving parenteral nutrition (PN) in Hospital Queen Elizabeth (HQE) and HQE II was conducted from January 2018 to April 2019. Relevant information was obtained from patients’ pharmacotherapy review forms. For patients receiving PN and enteral nutrition (EN) concurrently, protein from both sources was accounted for. Among the 52 patients, majority were male (n=41; 78.8%) with median age of 52 years old (IQR=34.5). Median duration of PN support was 6 days (IQR=6.3), and gastrointestinal perforation was the most common indication (n=11; 21.2%). All 45 non-CKD patients (86.5%) received minimum recommended protein of 1.2g/kg/day. Ten patients (19.2% out of 52) who received PN and EN concurrently received a higher average protein up to 1.5g/kg/day. Out of 7 patients (13.5%) with underlying CKD stage 4 to 5, two (3.8% of total 52 patients) received insufficient protein below 0.8g/kg/ day due to restriction of fluid (ROF). Majority of the patients received sufficient protein as per guidelines. In real-life practice, discrepancy may occur due to the fixed-content formulations of commercial PN bags.

10aAdult10aIntensive Care Unit10aNutrition Support10aParenteral Nutrition10aProtein1 aFong, Pui, Wun Fiona1 aSaedon, Mahmud, Majdi bin1 aBangguan, Stella, Caroline J uhttps://www.jppcm.org/article/2021/7/2/24-2702621nas a2200253 4500008004100000245015600041210006900197260001600266300001000282490000600292520183200298653001402130653001202144653000802156653001902164653002402183100001702207700001902224700001802243700002102261700001902282700001702301856004902318 2021 eng d00aAssessment of Disease State Awareness among Chronic Kidney Disease Patients Undergoing Hemodialysis in Divisional Headquarter Hospital Mirpur, Pakistan0 aAssessment of Disease State Awareness among Chronic Kidney Disea cAugust 2021 a34-380 v73 a

Background: Chronic Kidney Disease is a non-communicable disease which can often progress to kidney failure and can be a potential cause of some cardiovascular complications. There is need to assess awareness of disease to prevent progression. Objectives: The objective of the present study was to assess the disease state awareness among patients undergoing hemodialysis. Materials and Methods: A cross-sectional, non-experimental and questionnaire based study was conducted during December 2020 to Feburary 2021 in DHQ hospital Mirpur among patients undergoing hemodialysis. The questionnaire was translated into “Urdu” language, as it is native language of Pakistan. Descriptive and inferential statistics were used to analyse the results. SPSS version 20 was used for statistical analysis. Results: Amongst the 111 patients admitted in the hemodialysis center, 109 patients filled the questionnaire. Out of 109 patients, 58 (53.2%) were males. Urban residents were 56 (51.54%), 99 (90.8%) were Kashmiri, 30 (27.5%) had religious education, and 90 (82.6%) were non-occupational. Most of the patients were suffering from several co-morbidities such as, hypertension; 91 (83.5%), diabetes; 37 (33.9%), hyperlipidemia; 7 (6.4%), CVD; 19 (7.4%), hepatitis C; 23 (23.1%) and others; 15 (13.8%). Overall mean awareness score was 2.2±1.6. Among demographic variables, education and gender had significant p-values (p < 0.05). Conclusion: The awareness among patients was satisfactory but not adequate. Therefore, counseling programs about the disease and its management should be conducted in order to educate all the caretakers/patients with chronic kidney disease and end stage renal disease (ESRD).

10aAwareness10aChronic10aCKD10aRenal dialysis10aRenal insufficiency1 aRiaz, Sohail1 aNisa, Zaib, Un1 aMushtaq, Saba1 aIjaz, Qazi, Amir1 aSohail, Kashif1 aKhan, Abuzar uhttps://www.jppcm.org/article/2021/7/2/34-3801699nas a2200229 4500008004100000245010900041210006900150260001800219300001000237490000600247520101500253653000901268653002001277653001001297653001801307653002301325653001701348100002101365700001701386700001701403856004901420 2021 eng d00aBCG Induced Lymphadenitis: A Prerequisite in Parental Counseling during Pre and Post Vaccination Program0 aBCG Induced Lymphadenitis A Prerequisite in Parental Counseling  cDecember 2021 a49-500 v73 a

Bacillus-Calmette-Guerin (BCG) is a live attenuated vaccine and used to prevent tuberculosis since 1921. BCG vaccination is performed as a part of expanded program of immunization (EPI). BCG vaccine is considered as a safe technique of tuberculosis prevention because there are only local adverse reactions seen with this and serious adverse reactions are rare. Lymphadenitis is the most frequent side effect of BCG vaccination. Intradermal BCG vaccination gives rise to erythromatous formation that consists of a cutaneous nodule at the site of injection and subclinical involvement of the regional lymph nodes, which is self limiting and requires no treatment. Lymphadenitis is the most frequent side effect of BCG vaccination. Fine needle aspiration is the quick, safe, and cost effective technique for diagnosis in addition to the management of BCG lymphadenitis. Here we report a case of 10- months’ healthy male patient with left axillary lymphadenitis post BCG vaccination.

10aAEFI10aBCG vaccination10aFNAC.10aLymphadenitis10aPatient counseling10atuberculosis1 aSharma, Abhishek1 aBano, Gulnaz1 aMalik, Abdul uhttps://www.jppcm.org/article/2021/7/3/49-5002434nas a2200205 4500008004100000245006100041210006100102260001500163300001000178490000600188520186100194653001102055653001402066653002102080653002002101653001902121100001802140700002102158856004902179 2021 eng d00aBurden of Care among Caregivers of Mentally Ill Patients0 aBurden of Care among Caregivers of Mentally Ill Patients cMarch 2022 a52-580 v73 a

The presence of a person with mental illness in a family is often associated with social, emotional, behavioral and financial problems to the family. Therefore, the study was conducted with the aim of finding out the burden of care among the caregivers of mentally ill patients. Methods: A descriptive cross-sectional study was conducted with quantitative approach. A total of 97 family members was selected consecutively from the psychiatric outpatient department (OPD) and wards of Mental hospital. Results: The study revealed that 40.2 % of the caregivers had mild burden, 27.8% had moderate burden, 25.8% experienced little or no burden and 6.2% experienced severe burden. The mean score percentage of burden was highest in the area of relationship (44.46%) followed by loss of control over one’s life (40.08%) and emotional well-being (39.29%). There was significant statistical association between burden and caregiver’s age (p=0.017), educational status (p=0.001), marital status (p=0.378), occupation (p=0.307), relationship with patient (p=0.035) and duration of care-giving (p=0.026). There was statistical association between burden and patient’s gender (p= 0.010), age (p=0.40), marital status (p=0.50), duration of illness (p=0.01) and type of illness (p=0.09). Conclusion: It is concluded that greatest number of caregivers had experienced mild burden and nearly one-third experienced moderate burden. Highest amount of burden is observed in the area of relationship followed by loss of control over one’s life, emotional well-being, finances and burden in social and family life. Thus, there is a need to develop the strategies and support system to address and reduce their burden.

10aBurden10aCaregiver10aCaregiver Burden10aLevel of Burden10aMental Illness1 aDhami, Janaki1 aTuladhar, Sabina uhttps://www.jppcm.org/article/2021/7/4/52-5801252nas a2200145 4500008004100000245009800041210006900139260001800208300001000226490000600236520077800242100001701020700002001037856004901057 2021 eng d00aCOVID-19 in India: Weighing Schools Reopening Amid Black Clouds of Third Wave Hovering Around0 aCOVID19 in India Weighing Schools Reopening Amid Black Clouds of cDecember 2021 a41-430 v73 a

The Coronavirus disease (COVID-19) wreaked havoc across the globe with the onset of year 2020, which posed an extra ordinary situation in front of mankind. The black clouds of third wave are still hovering around us. We all have seen a lot of ups and downs with respect to every front of this disease including restriction of movements and closure of schools. In the current scenario, many voices are being heard to reopen the school with a justification that if we don’t open the schools then we going to witness a generation that has missed months or years of schooling. In this regard, we must weigh the decision or consideration of reopening of schools against amid third wave predictions in near future. Read more...

1 aGupta, Vikas1 aSingh, Abhishek uhttps://www.jppcm.org/article/2021/7/3/41-4302036nas a2200169 4500008004100000245004900041210004700090260001600137300001000153490000600163520158200169653000801751100002001759700001701779700002101796856004901817 2021 eng d00aCOVID-19 Pandemic and Bio-Ethical Challenges0 aCOVID19 Pandemic and BioEthical Challenges cAugust 2021 a20-230 v73 a

The Coronavirus disease (COVID-19) wreaked havoc across the globe with the onset of year 2020, which posed an extra ordinary situation in front of humankind. As the pandemic continues to progress, everyday challenges are faced by health worker in the history of mankind, because medical profession is bound by ethics our health workers are facing unprecedented ethical dilemmas and challenges in the era of COVID-19 pandemic.

Beauchamp TL and Childress JF articulated following four tenets of Biomedical ethics with which all the healthcare workers must abide Autonomy, Justice, Nonmaleficence and Beneficence.[1] India reported a record high of 352 991 daily confirmed COVID-19 cases and 2812 deaths on 25 April, according to the Johns Hopkins University database.[2] Hospitals in India have been pleading publicly for help as they run out of oxygen. At least 20 COVID-19 patients died at the private Jaipur Golden Hospital in North West Delhi following a dip in oxygen pressure.[3]

Scarcity of Resources in India in COVID-19 Pandemic forced country to take help from other countries in this pathetic condition. The UK announced it is sending nine airline container loads of supplies to India, including 495 oxygen concentrator devices, 120 non-invasive ventilators, and 20 manual ventilators. The first shipment is to arrive in New Delhi on 27 April with further shipments to follow later in the week.[4] Read more...

10aNil1 aSingh, Abhishek1 aOhlan, Sunny1 aAgrawal, Deepika uhttps://www.jppcm.org/article/2021/7/2/20-2302080nas a2200265 4500008004100000245009800041210006900139260001500208300000900223490000600232520132300238653001401561653001401575653002601589653001301615653001101628653001101639100001901650700002701669700002001696700002001716700001601736700001401752856004801766 2021 eng d00aKnowledge and Awareness about Leishmaniasis Disease in the General Public of Quetta, Pakistan0 aKnowledge and Awareness about Leishmaniasis Disease in the Gener cApril 2021 a9-130 v73 a

Aim: This study attempted to assess knowledge and awareness about Leishmaniasis disease in Quetta city, Pakistan. Materials and Methods: This was a questionnaire-based cross-sectional survey where 387 study respondents were targeted using the non-probability convenience sampling method for data collection. SPSS v 22.0 was applied for data analysis and P≤0.05 was considered statically significant. The Mann-Whitney and Kruskal-Wallis tests were performed to discover the relationship among variables. Results: Most respondents were from the age group 18-27 years 269 (69.5%) majority of whom were female 244 (64.0%). Most of the respondents had improved knowledge (73.6%), about the word Leishmaniasis, 50.6% of respondents were aware of the signs and symptoms, 54.8% of respondents were aware of the diagnosis, 64.3% of respondents had improved knowledge about treatment, 62.5% of the study population were aware of prevention and 40.8% of study respondents knew about the vaccination for leishmaniasis. Conclusion: This study exposed an overall better knowledge and awareness among the public about leishmaniasis disease and its causative agents, symptoms, diagnosis, treatment, prevention, and vaccination.

10aAwareness10aKnowledge10aLeishmaniasis disease10aPakistan10aPublic10aQuetta1 aAhmed, Tanzeel1 aJadoon, Sarmad, Sheraz1 aWaqas, Muhammad1 aAmmar, Muhammad1 aJian, Liguo1 aZhang, Qi uhttps://www.jppcm.org/article/2021/7/1/9-1302768nas a2200229 4500008004100000245013500041210006900176260001500245300000800260490000600268520205500274653001602329653001402345653002602359653001402385653001402399653001402413100002302427700002102450700002002471856004702491 2021 eng d00aKnowledge, Attitudes and Practices Related to Antibiotic Use Among Community and Hospital Pharmacists in Galle District, Sri Lanka0 aKnowledge Attitudes and Practices Related to Antibiotic Use Amon cApril 2021 a1-80 v73 a

Background: Pharmacists’ knowledge about and attitudes towards antibiotic impact on appropriate antibiotic supply. However, this information is lacking in Sri Lanka. Purpose: To evaluate the knowledge, attitudes and practice of antibiotic use and antibiotic resistance (AR) among community pharmacists and hospital pharmacists in Galle District, Sri Lanka. Methods: A cross-sectional study using a self-administered questionnaire was conducted to assess their knowledge about antibiotic use and causes of AR, attitudes towards antibiotic use and dispensing practice. Data were analyzed using descriptive and inferential statistics. Results: Ninety percent of the pharmacists (n=90/100) responded, comprising community pharmacists (n=43) with efficiency qualifications and hospital pharmacists with proficiency (n=45) or B.Pharm (n=2) qualifications. The hospital pharmacists' knowledge about consequences of inappropriate antibiotic use, ineffective treatment (100%) and AR (100%), were significantly higher than community pharmacists’ knowledge (91% and 86%; P=0.048 and 0.010, respectively). The knowledge about AR reasons, for example, antibiotic use for non-bacterial infections, was also significantly higher in hospital pharmacists (92%) than community pharmacists (74%), P=0.030. 84% of respondents had positive responses on all attitude statements. Most of the participants (98%) denied non-prescription antibiotic supply. Overall, greater knowledge about antibiotic use increased the likelihood of higher knowledge about AR (Adj. OR=3.94; 95% CI: 1.57-9.88; P=0.003) and positive attitude towards it (Adj. OR=3.71; 95%CI: 1.54-8.92; P=0.003). Conclusion: Extent of pharmacy qualification could impact the pharmacists’ antibiotic use and AR knowledge. Raising pharmacists' knowledge about antibiotic use may enhance their AR knowledge and attitudes towards it.

10aAntibiotics10aAttitudes10aCommunity Pharmacists10aKnowledge10aPractices10aSri Lanka1 aAmarasinghe, Meenu1 aViet, Ha, Nguyen1 aZawahir, Shukry uhttps://www.jppcm.org/article/2021/7/1/1-801353nas a2200205 4500008004100000245011300041210006900154260001800223300001000241490000600251520070900257653001100966653001300977653000900990653002500999653001901024100002901043700002601072856004901098 2021 eng d00aPatients with Asthma May Develop Cardiovascular Diseases during Covid-19 Lockdown Due to Physical Inactivity0 aPatients with Asthma May Develop Cardiovascular Diseases during  cDecember 2021 a44-450 v73 a

To abate the spread of coronavirus, decisions were made one of which is restrictions of movement and public gatherings. This has led to drastic increase in poor lifestyle behaviours that are detrimental to health such as physical inactivity, these behaviours augment the risk of cardiovascular diseases (CVDs) in individuals including patients with asthma. Asthma is well established as a risk factor for developing CVDs. Patients with asthma were physically inactive, limiting outdoor activities and regular physical activities during COVID-19 lockdown makes them more inactive. Therefore, these pandemic exposed individuals who are asthmatic to high risk of developing CVDs.

10aAsthma10aCOVID-1910aCVDs10aPhysical inactivity.10aPoor lifestyle1 aAbubakar, Ibrahim, Ahmad1 aMuhammad, Daha, Garba uhttps://www.jppcm.org/article/2021/7/3/44-4502373nas a2200229 4500008004100000245015400041210006900195260001800264300001000282490000600292520159400298653003501892653001601927653002001943653003601963653001801999653001502017653001902032100002202051700002102073856004902094 2021 eng d00aProbiotics and its Impact on Antibiotic-associated Diarrhea (AAD) and Clostridum difficile Infections (CDI) in Adult and Pediatric Patients: A Review0 aProbiotics and its Impact on Antibioticassociated Diarrhea AAD a cDecember 2021 a46-480 v73 a

A common adverse effect of antibiotic use is diarrhea. Probiotics are living micro-organisms, which may prevent antibiotic-associated diarrhea (AAD) by the normalization of an unbalanced gastrointestinal flora. The objective of this review was to assess the benefits and harms of probiotics used for the prevention of AAD in patients based on literature findings. Thus review of the literature using bibliographic databases and abstracting systems such as PubMed (1978- 2020) and Cochrane was conducted to find the effects of probiotics and compare AAD and CDI in both pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications (required surgeries and extended hospitalizations) than in adults. Literature studied revealed the finding that suggests that probiotic use in both adult and populations may be beneficial in the prevention of AAD among patients. Furthermore, the use of probiotics appears to be safe. The narrative review adds value to the current knowledge owing to the fact that adult and pediatric differences of AAD and CDi have not been studied in many review focusing on current evidence before ours. The differences in treatment modality across age groups should be taken into account when rating severity of disease and prescribing antibiotics. However, any differences should be taken into account when rating severity of disease and prescribing.

10aAntibiotic-associated diarrhea10aAntibiotics10aBifidobacterium10aClostridum difficile infections10aLactobacillus10aprobiotics10aSaccharomyces.1 aChakraverty, Raja1 aSasmal, Sudeshna uhttps://www.jppcm.org/article/2021/7/3/46-4802777nas a2200229 4500008004100000245012900041210006900170260001500239300001000254490000600264520205700270653001502327653001302342653002802355653002702383653001702410100001802427700001702445700001802462700001802480856004902498 2021 eng d00aA Progressive Assessment of Pharmacy Undergraduates’ Motivation and Satisfaction towards Pharmacy as a Professional Choice0 aProgressive Assessment of Pharmacy Undergraduates Motivation and cApril 2021 a14-180 v73 a

Objectives: The study is aimed to access the motivation, satisfaction and expectations of Pharm.D undergraduate towards pharmacy as a profession while attending a public university of Quetta city, Pakistan. Methods: This was a questionnaire based, cross-sectional analysis. The research was carried out at Faculty of Pharmacy and Health Sciences, University of Balochistan Quetta, Pakistan. All students registered in Pharm.D program (other than first professional year) were approached for data collection. Based on the objectives of the study, descriptive analysis was performed to present the frequency and percentage demographic characteristics and other study variables. Results: Out of 620 enrolled students, 475 respondents were involved in the survey with a response rate of 76.6%. Nearly 43% selected pharmacy as their first choice career whereas 60% of the students selected pharmacy based on the recommendations of their parents, friends and family. Working with patients and in the medical field was the biggest influencers for the pharmacy undergraduates as ≤ 90% of the students agreed to this statement. Additionally, job with a good career opportunity was also ranked as a influencer by the respondents (85%). Majority of the students (≤ 80%) were committed to the profession’ ideology and were content studying pharmacy. Sixty percent disagreed that they will change their profession if a chance is provided and 81% stated to continue their career as a pharmacist. Conclusion: Impact of family and friends, looking for an in-demand job with good career opportunities, and the desire to work in a health-related field were the main influencing factors in pharmacy students’ decision to study pharmacy. It is obvious from the findings that there is a need to guide high school students regarding their choice of undergraduate programs, and for these students to be made aware of the challenges and opportunities of studying pharmacy.

10aMotivation10aPharmacy10aPharmacy undergraduates10aProgressive assessment10aSatisfaction1 aSajjad, Bisma1 aIshaq, Rabia1 aIqbal, Qaiser1 aSaleem, Fahad uhttps://www.jppcm.org/article/2021/7/1/14-1801727nas a2200157 4500008004100000245009200041210006900133260001600202300001000218490000600228520121900234653000801453100003001461700002901491856004901520 2021 eng d00aRegular Physical Activity and Exercise in Prevention and Management of Diabetes Melitus0 aRegular Physical Activity and Exercise in Prevention and Managem cAugust 2021 a39-400 v73 a

Dear Editor,

Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both.[1] The national Diabetes Data Group (2000) indicated that DM consists of three different types, which include: Type 1, Type 2 and gestational diabetes.[2]

Type I DM also used to be referred to as juvenile diabetes or insulindependent diabetes and it is due to the destruction of β cells of the pancreas.[3] Also, Type 2 DM was previously referred to as “adult-onset diabetes”. It is used to be called non-insulin dependent diabetes or adult-onset diabetes.[4] Here, the pancreas usually produces some insulin, but the insulin might not be enough or the body cells get resistant to it. As such, the body cannot utilize the insulin that is released.[5] However, the third type of diabetes mellitus is the gestational diabetes, and it occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.[6]Read more...

10aNil1 aTunde, Gbonjubola, Yusuff1 aAbubakar, Ibrahim, Ahmad uhttps://www.jppcm.org/article/2021/7/2/39-4001725nas a2200133 4500008004100000245008500041210006900126260001500195300000700210490000600217520129300223100002901516856004601545 2021 eng d00aRegular Physical Activity during Pregnancy Improves Maternal Depressive Symptoms0 aRegular Physical Activity during Pregnancy Improves Maternal Dep cApril 2021 a190 v73 a

Dear Editor,

Depressive symptoms, such as extended feeling of sadness, decreased selfesteem, suicidal propensities, unconcern in activities, feelings of hopelessness and helplessness, low energy, difficulty in making decisions, sleep disorders, anxiety, petulance, and changes in eating patterns are related with an increased risk of health conditions such as osteoporosis, cardiovascular diseases, and dementia.[1] Women of childbearing age of about 22% have been estimated to have experienced depression at some point in their lives and pregnancy is a vulnerable time for depression compared with other periods of life.[2]

Depression is found to be higher during pregnancy than that in the postpartum period of childbearing women which was shown to be 10% - 30% prevalent in several studies.[3] Progesterone and oestrogens are found to be in large quantity during pregnancy period and are likely the cause of depression during pregnancy, it influences the neural structures that are known to be important in regulating mood by raising the sensitivity to changes in levels of b-endorphins and dopamine.[4] Read more...

1 aAbubakar, Ibrahim, Ahmad uhttps://www.jppcm.org/article/2021/7/1/1901393nas a2200133 4500008004100000245002200041210002200063260001500085300000700100490000600107520108300113100001701196856004601213 2021 eng d00aRetraction Notice0 aRetraction Notice cMarch 2022 a590 v73 a

The research article entitled “Vannala V, Balachandar, Kumaran K, Sigamani R. Biofilm formation on polytetrafluoroethylene coated versus uncoated brackets in a South Indian Population. Journal of Pharmacy Practice and Community Medicine. 2017;3(3):188-90. doi:10.5530/jppcm.2017.3.38 is retracted.[1] JPPCM received an email from the corresponding author, who asked if there was a way to edit or amend or withdraw the article that was previously published in JPPCM. The corresponding author and other authors of the manuscript were contacted by the JPPCM for clarification, and they stated that “By mistake, a portion of the literature review content was added in the result sections of the abstract as well as the text which was overlooked by us, and by mistake, it remained in our manuscript and got published.” The JPPCM journal editors agreed with authors’ decision and decided the manuscript to be retracted from the JPPCM website. JPPCM decision will be communicated to the corresponding author of the manuscript Sigamani et al., INDIA.

1 aAhmad, Akram uhttps://www.jppcm.org/article/2021/7/4/5901731nas a2200133 4500008004100000245002200041210002200063260001800085300000700103490000600110520141800116100001701534856004601551 2021 eng d00aRetraction notice0 aRetraction notice cDecember 2021 a510 v73 a

The research article entitled “Incidence and Assessment of Adverse Drug Reactions at a Tertiary Care Hospital” by Priyanka et al., Journal of Pharmacy Practice and Community Medicine. 2020;6(1). DOI:10.5530/jppcm.2020.1.5[1] is retracted.

After the above article was published, one of the readers reported that the authors had published the same article in the World Journal of Pharmaceutical Research. 2017 Aug 6;6(12):967-8.[2]

The Journal of Pharmacy Practice and Community Medicine (JPPCM) journal further investigated the publication in the World Journal of Pharmaceutical Research and found that the afore mentioned manuscript was self-plagiarized with a same title. The corresponding author and others of the manuscript was contacted by JPPCM journal for clarification, and they responded it is unknowingly plagiarised.

The JPPCM journal editors have further investigated and thus agreed that Priyanka et al., violated the journal policy and the self-plagiarized manuscript be retracted from the JPPCM website. JPPCM’ decision will be communicated to the corresponding author of the manuscript Priyanka et al., and others, INDIA.

Akram Ahmad, PhD Editor-in-Chief, Journal of Pharmacy Practice and Community Medicine.

1 aAhmad, Akram uhttps://www.jppcm.org/article/2021/7/3/5102373nas a2200205 4500008004100000245009400041210006900135260001600204300001000220490000600230520172100236653002501957653001801982653001502000653002202015653001302037100003302050700003502083856004902118 2021 eng d00aWhy some Pharmacists Make the Leap and Others do not “From Good to Great Pharmacists”0 aWhy some Pharmacists Make the Leap and Others do not From Good t cAugust 2021 a28-330 v73 a

Purpose: The purpose of this study is to define the requirements needed to be an Ideal pharmacist, in addition to determining the best traits that characterize the ideal pharmacist, which can help in explaining the quality indicators for leadership practicing. Methods: This is a descriptive study that was carried out through an online Google Drive survey, in the form of a questionnaire, to assess the skills needed by pharmacists. The data collection tool website was available mid- December 2019 through first February 2020. Descriptive statistics were used to report results. Results: Survey respondents were 905 pharmacists from different countries such as Egypt (384), UAE (75), KSA (326), etc. from different specialties. The most important traits of the great pharmacist as reported by the respondents was the ability of an ideal pharmacist to manage and discuss mistakes and to solve any medical problems. The most important reported skills included the skills of analytical, computer, communication, leadership, management, mentorship, medical research, and clinical practice. Another finding from the survey is related to the preferred expertise to be specialized. Moreover, continuing medical education (CME) programs can play an essential role in enhancing therapeutic and leadership skills. Conclusion: The terms and definitions for great leader may change with the times; however, it is important to understand the skills and abilities needed to lead. The ability to lead effectively is based on several skills, including communication, managing, and solving mistakes, clinical practicing, and integrity.

10aContinuous Education10aEffectiveness10aLeadership10aManagement Skills10aPharmacy1 aElshenawy, Rasha, Abdelsalam1 aMahmoud, Fatma-elzahraa, Ahmed uhttps://www.jppcm.org/article/2021/7/2/28-3302478nas a2200205 4500008004100000245015800041210006900199260001500268300001000283490000600293520175300299653003002052653002902082653001102111653002202122653002802144100002402172700002702196856004902223 2020 eng d00aAntibiotic Resistance Patters and Evaluation of Treatment of Inpatient with Urinary Tract Infections in Two Tertiary Care Hospitals at Kathmandu Valley0 aAntibiotic Resistance Patters and Evaluation of Treatment of Inp cApril 2020 a10-140 v63 a

Urinary tract infections (UTIs) is a common bacterial infection in humans of all ages but the prevalence increases with increased age. It is one of the most common types of community and hospital acquired infections. It is a common cause of infections among young, sexually active women; an estimated 1 in 3 women will develop a urinary tract infection before the age of 24 years. Escherichia coli are the leading cause of UTI in humans. It is one of the most common pathogen isolated in around 75% of uncomplicated UTI. It is a growing concern worldwide due to increasing rate of antimicrobial resistance. In Nepal, UTIs is also common disease among Nepalese population. According to the annual report of Ministry of health and population 2016/2017 morbidity of UTIs in Nepal was 3,16,711. The descriptive study was conducted in inpatient at MMCH and MMTH, Kathmandu, Nepal from 29th May to 31st August, 2018. The sample size was 200 with the inclusion criteria of provisional diagnosis of UTI and sent urine sample for culture. A descriptive study was designed by taking total 200 samples of UTI admitted in two hospitals MMCH and MMTH. Treatment of UTI before and after antibiotic susceptibility test was analyzed. Antibiotic susceptibility test was done with commonly used antibiotics. During the study period, total 200 patients were admitted with the provisional diagnosis of UTI, among them 57 (28.5%) micro-organism isolated. Urinary tract infection was more common among females than males. E. coli was the most commonly isolated organism. Urinary pathogenesis showed resistance to commonly used antibiotics like Amoxicillin followed by Ceftriaxone, Ofloxacin, Ciprofloxacin and Cotrimoxazole.

10aAntibiotic Susceptibility10aAntimicrobial Resistance10aE.coli10aEmpirical therapy10aUrinary tract infection1 aAdhikari, Pharsuram1 aKhanal, Dharma, Prasad uhttps://www.jppcm.org/article/2020/6/1/10-1402198nas a2200181 4500008004100000245004900041210004700090260001500137300000600152490000600158520173000164653000801894100001501902700001901917700001901936700001601955856004501971 2020 eng d00aBeef Ban in India: A Multi-dimensional Issue0 aBeef Ban in India A Multidimensional Issue cApril 2020 a10 v63 a

The Economic Times published an article in January 2019, highlighting the increasing problem of stray cattle in rural India. Four years ago, several states in India began making the decree to protect cows from slaughter at the end of their productive lives.[1] The largely Hindu population in India considers cows sacred and does not condone their slaughter.

In 2012, there were only 5 million stray cattle roaming the Indian streets, but now there is an estimated 40 million unproductive cattle at risk of being abandoned.[1] India only has 5,000 shelters, each with a capacity of 200; but these are near enough.[1] Cattle are being abandoned because they are beyond the age of productivity and the cost for a farmer to keep an unproductive cow is Rs. 7500/month. Prior to the beef ban, farmers could sell dried up cows for Rs. 20,000 to Rs. 50,000 each depending on their age. Farmers are facing a severe economic deficit since they can no longer sell their cattle for profit.[1] The abundance of stray cattle has also led to Indians being physically attacked. Cows trespassing on farmland and destroying crops have recently led to them being locked up inside schools and hospitals for containment.[1] Currently, there is much controversy between Indian political parties on resolving the economic and social stress that cow abandonment has caused on several states in India.[2] There has been argument about the former cattle trade being important for the rural economy and necessary to provide revenue for dairy farmers' unproductive cattle.[2]  Read more. . .

10aNil1 aKhan, Anam1 aRiedel, Taylor1 aHussain, Rabia1 aPatel, Isha uhttps://www.jppcm.org/article/2020/6/1/102413nas a2200265 4500008004100000245008300041210006900124260001400193300001000207490000600217520164300223653001701866653002201883653002301905653001301928653001601941653002001957100001801977700001401995700001502009700001802024700002302042700003302065856004902098 2020 eng d00aCould Lockdown Really Lockdown Covid-19 Spread: A Data-based Analysis in India0 aCould Lockdown Really Lockdown Covid19 Spread A Databased Analys cJune 2020 a25-280 v63 a

Objective: To compare the impact of lockdown in Maharashtra, Kerala and United States. Methodology: We conducted a prospective observational study in order to assess and compare the impact of lockdown between Kerala, Maharashtra and United States (US). The study involved the collection of data from two phases. The first phase is the time from the index case reported in each country till the 14th day after the declaration of lockdown in that country. The second phase involved the data collected from the 15th day to the 28th day of lockdown. Data storage and analysis were performed using Microsoft excel and SPSS version 24. Result: As per 21st April, 426 cases were reported in Kerala among which 307 (70.07%) recovered, active cases were 117 and 2 deaths (0.4694%). Whereas in Maharashtra 7628 cases were reported and among which 1076 had recovered and there was 323 deaths. The total number of cases reported before lockdown in Maharashtra was 97 and in Kerala was 95. After the 29 days of lockdown the increase in the number of cases in Maharashtra was significantly higher when compared with Kerala. Also, the recovery rate before and after lockdown in Kerala was 4.10% and 72.53% respectively. In Maharashtra recovery rate before and after was 70.93% and 14.00% respectively. Conclusion: The implementation of lockdown had a great impact on reducing the transmission of infection across the country. The number of cases also reduced due to this lockdown, but its effectiveness varied from place to place.

10aCorona virus10aCOVID-19 in India10aImpact of lockdown10aPandemic10aSARS- CoV-210aViral infection1 aSaijan, Sanjo1 aPaul, Aby1 aJoby, Joel1 aJoseph, Jeeva1 aSebastian, Stelvin1 aVilapurathu, Jobin, Kunjumon uhttps://www.jppcm.org/article/2020/6/2/25-2802910nas a2200217 4500008004100000245012500041210006900166260001700235300001000252490000600262520221600268653002502484653003002509653001502539100001702554700001802571700001902589700001702608700001802625856004902643 2020 eng d00aA Cross Sectional Assessment of Hospital Pharmacist’s Perception towards Online Health Information in Quetta, Pakistan0 aCross Sectional Assessment of Hospital Pharmacist s Perception t cJanuary 2021 a64-680 v63 a

Objectives: The current study aims to assess the perception towards use of online health-related information among hospital pharmacists practicing at public healthcare institutes of Quetta city, Pakistan. Methods: This was a questionnaire based cross sectional survey. Sampling frame of this study was all hospital pharmacists practicing at public hospitals of Quetta city, Pakistan. The data instrument consisted of three sections namely perception towards online health-related information, type of online health-related information used and barriers encountered while retrieving online health-related information. The data was coded and transferred to Statistical Package for Social Science v 20.0 and whereas both descriptive and inferential statistics were used for data elaboration. Results: Out of 116 hospital pharmacists, eight one responded with a response rate of 69.8%. Majority (86.4%) of the respondents agreed that the Internet provides useful and updated health-related information. Nearly 70% of the respondents were also of the opinion that it is their practice to visit an established website. The most sought out information was about drugs followed by general healthcare and disease-related information (92.5%, 74.0% and 61.7% respectively). The main barrier (40, 49.3%) was profusion of health-related information that at times becomes a barrier in obtaining the right information retrieve to scan through from the Internet. Statistical significant differences (p<0.05) were reported among educational status and certain items of the questionnaire whereby postgraduate pharmacists were more in agreement to the statements. Conclusion: It is evident that our respondents are connected to Internet for professional usage and integrate Internet as an adjunct support in their practice. However, certain barriers and limitations were also indentified. For an effective usage of internet based learning, the barriers need to be addressed and facilities should be provided to the hospital pharmacists so that they can utilize an important source of information during their professional practice.

10aHospital pharmacists10aOnline Health Information10aPerception1 aAkram, Azfar1 aIqbal, Qaiser1 aHaider, Sajjad1 aIshaq, Rabia1 aSaleem, Fahad uhttps://www.jppcm.org/article/2020/6/4/64-6803033nas a2200265 4500008004100000245014400041210006900185260001700254300001000271490000600281520219100287653002202478653003402500653002502534653001702559653001302576100001602589700001802605700001702623700002702640700001502667700001702682700001902699856004902718 2020 eng d00aDoctors’ Knowledge, Attitude and Objective Adherence with Hypertension Guidelines in Quetta, Pakistan: A Cross-sectional Analytical Study0 aDoctors Knowledge Attitude and Objective Adherence with Hyperten cJanuary 2021 a57-630 v63 a

Background: There is scarcity of published information about doctors’ knowledge, attitude and adherence with hypertension guidelines from Pakistan. Objectives: To evaluate doctors’ knowledge, attitude and objective adherence with the recommendations of Clinical Practice Guidelines (CPG) developed by American Society of Hypertension/International Society of Hypertension. Methods: This cross-sectional questionnaire-based study included 95 doctors from various health care facilities in Quetta, Baluchistan to evaluate doctors’ knowledge of and attitude towards guidelines. Physicians’ endearment with ASH/ISH (2014) guidelines was evaluated by the prescriptions they wrote to 1900 hypertensive individuals (20 prescriptions of each enrolled doctor). Data was analysed using SPSS 20. Results: 58.9% doctors had sufficient knowledge of guidelines. Doctors’ with specialization and consultants, doctors of age >35 years and who were in clinical practice for >5 years had significantly (p-value<0.05) greater knowledge and more guidelines adherent practices than their counterparts. There was a significant association between doctors’ knowledge and practice scores. (rs=0.758, p-value <0.001). Overall, doctors had positive attitudes towards guidelines. A total of 1385 (72.9%) prescriptions were judged guidelines adherent. In multivariate analysis, guidelines adherence had statistically significant positive association with the presence of any comorbidity (OR=2.804, p-value<0.001), heart failure (OR=5.101, p-value<0.001), chronic kidney disease (OR=2.384, p-value<0.001) and benign prostatic hyperplasia (OR=3.137, p-value=0.009) and negative association with diabetes mellitus (OR=0.265, p-value<0.001). Conclusion: Only 58.9% doctors were adequately aware of guidelines recommendations. A fair number of patients (72.9%) received guidelines adherent prescriptions. Doctors’ poor knowledge of guidelines preferred antihypertensive agents in diabetic hypertensive patients reflected in their practices.

10aDiabetes Mellitus10aDuration of clinical practice10aGuidelines adherence10aHypertension10aPakistan1 aKhan, Mirza1 aAhmed, Nafees1 aWahid, Abdul1 aKhan, Syed, Liaquat Al1 aKhan, Asad1 aAkbar, Zarka1 aBibi, Palwasha uhttps://www.jppcm.org/article/2020/6/4/57-6302190nas a2200241 4500008004100000245012900041210006900170260001700239300001000256490000600266520141600272653002201688653001501710653002201725653001901747653001701766100002601783700002001809700002301829700002201852700002501874856004901899 2020 eng d00aEffectiveness of e-Learning during the COVID-19 Pandemic among the Undergraduate Medical Students in Nepal: An Online Survey0 aEffectiveness of eLearning during the COVID19 Pandemic among the cOctober 2020 a40-430 v63 a

Introduction: The COVID-19 pandemic has shifted the medical education to the virtual mode in most of the countries. Though online learning has been practiced for long and proved to be effective, its usefulness should be looked for in developing countries like Nepal. Methods: An online survey was conducted among undergraduate medical students with the help of a structured self-administered questionnaire consisting of demographic information, modalities of online classes they are taking and their opinion regarding the online classes. Results: Most of the students had access to the devices and internet facilities though some of the students responded that they have no internet facility at home. More than half of the students have answered that they are having some sort of visual problem after the online classes have started. Most of the students responded that the internet connectivity issue is a hindrance to online learning. More than half of the students strongly disagree that online class should be continued even after the pandemic is over. Conclusion: There are lots of obstacles in virtual learning in resource-limited countries like ours. The effectiveness of e-learning should be evaluated among the students and the shortcomings of virtual learning should be addressed by concerned authorities.

10aCOVID-19 pandemic10ae-learning10aMedical education10aMedical school10aOnline class1 aAdhikari, Purushottam1 aPaudel, Sumedha1 aPandey, Rajan, Raj1 aParajuli, Abhigya1 aPyakuryal, Abhishree uhttps://www.jppcm.org/article/2020/6/3/40-4301678nas a2200169 4500008004100000245004900041210004700090260001400137300001000151490000600161520123300167653000801400100001801408700001701426700001601443856004901459 2020 eng d00aFecal-Oral Transmission of COVID-19 in India0 aFecalOral Transmission of COVID19 in India cJune 2020 a18-190 v63 a

Although the spread of COVID-19 through droplets, surface contact and aerosolized transmission has been well-publicized, the fecal-oral route is yet another identified method of transmission. According to a meta-analysis by the New England Journal of Medicine, it was found that fecal viral shedding continues throughout the disease, even after nasopharyngeal tests appear negative. Moreover, gastrointestinal symptoms seem to be common for COVID-19 patients, with a prevalence of approximately 18%.[1,2] It was also found that patients with digestive symptoms experience significantly longer hospital stays.[3] As India’s number of COVID-19 cases continues to increase, concerns about fecal-oral transmission are being raised in a country that has the highest open defecation rates in the world, where approximately 620 million people defecate in the open. It is a problem that comes with severe public health consequences, including diarrhea, high child mortality, spread of diseases, malnutrition and stunting of growth.[4] Public health officials should be concerned about how this will affect India’s transmission of COVID-19. Read more.....

10aNil1 aGoff, Allyson1 aAhmad, Akram1 aPatel, Isha uhttps://www.jppcm.org/article/2020/6/2/18-1902759nas a2200253 4500008004100000245007900041210006900120260001400189300001000203490000600213520203500219653002702254653001102281653002702292653000902319653001302328653001802341100002502359700001702384700001602401700001502417700002402432856004902456 2020 eng d00aFerrous Sulphate-Induced Black Color Discoloration of Teeth: A Case Report0 aFerrous SulphateInduced Black Color Discoloration of Teeth A Cas cJune 2020 a29-300 v63 a

Introduction: Several medications will lead to dental discoloration. Black color teeth discoloration is due to iron ferric salts and more commonly ferric sulfide and the exact mechanism for tooth staining due to iron salt is unknown. Still, this evidence is more common with the liquid iron supplement exposure used for the prevention and management of anemia. Case presentation: A 16-year-old female patient admitted to a female general medicine ward with complaints of black color teeth discoloration for one month, fever insidious in onset for three days, breathlessness and dry cough for three days and loose stool three episodes per day since three days. She was a known case of Chronic Kidney Disease since the age of 18 months and on regular medication. No significant family history was present. On Examination, The patient was having black color teeth discoloration BP-110/70mm of Hg, PR-104bpm and SPO2-98%). On lab Investigation, her blood test revealed (Hb-6.5gm/dl) and Scr 5mg/dl and S. Urea is 127mg/dl, Sodium- 131mEq/L hence diagnosed as Acute Gastroenteritis with Urinary Tract Infection and CKD major with severe anemia and with mild Right hydroureteronephrosis due to bladder outlet obstruction. Treatment: She was treated with Inj. Ciprofloxacin 400mg IV Twice daily, Inj. Metronidazole 500mg IV Thrice daily, Inj. Ceftriaxone 1g IV Twice daily, Tab. Ferrous sulfate + folic acid (IFA) 335+0.5mg PO Twice daily, Tab. Folic Acid 5mg PO Once daily, Tab. Calcium Carbonate + D3 500mg PO Once daily, Tab. Sodium bicarbonate 200mg PO Thrice daily, Syrup Dextromethorphan + Chlorpheniramine + Phenylephrine 10ml Thrice daily. Conclusion: The patient was in the long run (18 months) therapy of iron supplement. The teeth discoloration was developed due to the chronic toxicity of iron supplement (Ferrous sulfate). The iron-rich diet was recommended for the patient and the sulfate salt of iron changed to fumarate salt.

10aAdverse drug reactions10aAnemia10aDrug-induced disorders10aIron10aStaining10aSulfate salts1 aRawal, Kala, Bahadur1 aGirish, H.N.1 aG.J, Andrew1 aAnusha, S.1 aLuhar, Min, Bahadur uhttps://www.jppcm.org/article/2020/6/2/29-3002648nas a2200253 4500008004100000245013500041210006900176260001700245300001000262490000600272520187900278653001202157653001502169653001302184653001102197653001902208100001802227700001702245700001802262700002002280700002702300700001802327856004902345 2020 eng d00aFrequency of Anxiety, Depression and Stress among Pharmacy Undergraduates of Annual and Semester System: A Cohort-Based Comparison0 aFrequency of Anxiety Depression and Stress among Pharmacy Underg cOctober 2020 a35-390 v63 a

Objectives: The current study was aimed to evaluate the anxiety, depression and stress (AD&S) among two different academic performance systems (i.e. semester and annual system). Methods: A questionnaire— based, cross-sectional survey technique was adopted. The Depression, Anxiety and Stress Scale (DASS) was used to assess the AD&S among pharmacy undergraduates enrolled at Faculty of Pharmacy and Health Sciences, University of Balochistan Quetta. SPSS v 20.0 was used for data coding and analysis whereas both descriptive and inferential statistics were used for data elaboration. Results: Two hundred and eighty-nine pharmacy undergraduates participated in the study with a distribution of 43.3% belonging to the annual academic system and 56.7% from the semester system. Students Majority were of 20 years old (59, 20.4%), including both male (194, 67.1%) and female (95, 32.9%). The mean AD&S scores of the entire cohort were 14.15±9.3, 13.61±7.9 and 18.18±8.2 respectively representing moderate AD&S among pharmacy undergraduates. Statistically significant difference (p<0.05) was reported among students of annual and semester system for all three variables of study whereby the students of semester system were more in AD&S as compared to the annual system. Conclusion: Based on the findings of current study it is suggested that measure should be taken to reduce the AD&S among students for better academic performance. This is achievable by engaging students by inquiring their queries and problems faced during the semester-related activities. By doing so, a stress-free environment is predicted hence bringing academic prosperity among students leading to the development of a more qualified and satisfied future pharmacist.

10aAnxiety10aDepression10aPharmacy10aStress10aUndergraduates1 aAzam, Mehmood1 aIshaq, Rabia1 aIqbal, Qaiser1 aJan, Syed, Umer1 aMengal, Mohammad, Alam1 aSaleem, Fahad uhttps://www.jppcm.org/article/2020/6/3/35-3902659nas a2200205 4500008004100000245010000041210006900141260001700210300001000227490000600237520203800243653002502281653001302306653001102319653002402330653001302354100001802367700001902385856004902404 2020 eng d00aImpact of Structured Diabetes Pharmaceutical Care Training on Practices of Community Pharmacist0 aImpact of Structured Diabetes Pharmaceutical Care Training on Pr cJanuary 2021 a46-520 v63 a

Objectives: The diabetes epidemic in India has placed it in the second position in having the largest number (77 million) of adults with diabetes, worldwide. Diabetes is a chronic progressive disease that can be effectively controlled by medication adherence, monitoring and managing well on regular basis. A well-trained pharmacist can help the patients to achieve good glycaemic control by providing them pharmaceutical care. This study aims to evaluate the effect of tailored diabetes pharmaceutical-care training on the practices of pharmacists and the subsequent impact on patients’ clinical outcomes. Methods: A prospective interventional quantitative study was conducted to assess the impact on Knowledge, Attitude and Practice (KAP) levels of community pharmacists after providing diabetes pharmaceutical care training. The selected trained pharmacists enrolled type-2 diabetes patients to assess the practice component further, by observing patients’ outcomes in terms of knowledge, attitude, practices along with clinical outcomes in terms of glycemic control, post pharmaceutical care provision. A descriptive analysis and statistical evaluation, using SPSS Version 21. Key Findings: Significantly improved outcomes were observed across all the pharmacist participants in terms of KAP levels, from baseline to post-interventional training (p<0.0001). Also, a considerable impact on patients' knowledge, awareness, practices and clinical outcomes was noted in the intervention group. Clinically there was a significant reduction in fasting blood glucose levels, postprandial blood glucose levels, HbA1c and control in systolic and diastolic blood pressure (p<0.05) was also observed. Conclusion: Community pharmacists who had completed structured training in diabetes care could practice pharmaceutical- care well and help patients with type-2 diabetes in achieving good glycemic control.

10aCommunity pharmacist10aDiabetes10aImpact10aPharmaceutical care10aTraining1 aPawar, Sunita1 aPawar, Atmaram uhttps://www.jppcm.org/article/2020/6/4/46-5202436nas a2200229 4500008004100000245008300041210006900124260001500193300001000208490000600218520172700224653002601951653002501977653001802002653001902020653002202039100002802061700001502089700003302104700002002137856004902157 2020 eng d00aIncidence and Assessment of Adverse Drug Reactions at a Tertiary Care Hospital0 aIncidence and Assessment of Adverse Drug Reactions at a Tertiary cApril 2020 a15-170 v63 a

Background: Adverse drug reactions have proved a significant problem in healthcare for decade. Healthcare professionals have a responsibility in use of rational drugs for their patients. Objectives: The aim of the study was to determine the prevalence of ADRs in a tertiary care hospital to determine the most common Therapeutic Class of Drugs causing ADR and to determine the most common Organ system affected by ADR. Methods: The Prospective, observational study was conducted in the wards of St. Philomena’s Hospital, Bangalore between January 2016 and August 2016. All In-patients were monitored for ADRs during their admission period. Results: Over the study period of 12 months, a total of 374 ADRs were reported in 600 patients. The ADRs observed were higher in female patients [196 (52.4%)]. A predominance of gastro- intestinal reactions [70 (18.71%)] was observed. Therapeutic classes of drugs frequently associated with ADRs were antibiotics [84(22.4%)] followed by antihypertensive agents [63 (16.84%)] and antidiabetic [37 (9.89%)]. The most common drugs involved in causing ADRs were Furosemide and Cefoperazone and the most commonly reported ADR was Diarrhoea [28 (7.4.8%)] followed by Itching 2[9 (7.75%)]. Majority of the ADRs [95 (74.80%)] were managed by withdrawing the suspected drug. The causality assessment of the ADRs were carried out using the Naranjo’s Scale algorithm and the majority of the ADRs were found to be definite [41 (32%)]. Conclusion: Continuous monitoring by a clinical pharmacist in hospital setup will reduce the occurrence of ADR and improve the patient safety.

10aAdverse drug reaction10aCausality assessment10aNaranjo scale10aPatient safety10aPharmacovigilance1 aPriyanka, Pulimi, Divya1 aVithya, T.1 aHiremath, Shobha, Rani Rajee1 aPrasad, Shankar uhttps://www.jppcm.org/article/2020/6/1/15-1703114nas a2200337 4500008004100000245012500041210006900166260001700235300001000252490000600262520204800268653001202316653002402328653002102352653001402373653001002387100003102397700002902428700003002457700002202487700001802509700002702527700002702554700003102581700003602612700001502648700001802663700001602681700003002697856004902727 2020 eng d00aKnowledge, Beliefs and Factors Affecting the Use of Generic Medicines among Patients in Ibb, Yemen: A Mixed-method Study0 aKnowledge Beliefs and Factors Affecting the Use of Generic Medic cJanuary 2021 a53-560 v63 a

Objectives: This study was aimed to explore the knowledge and beliefs of patients in Ibb, Yemen, regarding generic medicines and identify factors affecting their use of these medicines. Methods: A mixed qualitative and quantitative study was conducted between Jan 1 and Mar 31, 2017 in Ibb, Yemen. A total of 310 patients participated in this study. The questionnaire used for data collection comprised of two sections. The first section covered participants' demographic information and contained six questions addressing patients' ability to differentiate between generic and brand-name medications. The second section comprises 15 items regarding patients' beliefs about generic medicines, answered using a five-point Likert scale. Additionally, seven patients were interviewed using a semi-structured interview guide to explore further the factors affecting their generic medicine use. Results: Only 17.4% of patients knew the difference between generic and brand-name medicines. Approximately 59 (19%) patients believed that generic medicines' efficacy was the same as that of brand-name medicines, while 42 (13.5%) believed that generic medicines took longer to take effect. The vast majority of patients (252) (81.3%) believed that generic medicines were appropriate for less serious medical conditions. Only 84 patients (27.1%) believed that generic medications were the same as brand-name ones. Furthermore, the majority of patients held negative beliefs about generic medicines. The study also found that the price of medicines, physicians' recommendations, and pharmacy dispensers contributed to patients' use of generic medications. Conclusion: This study found that Yemen patients have insufficient knowledge of and negative beliefs about generic medicines. Special oriented and well-designed programs to educate and improve patients and healthcare professionals' understanding and beliefs about generic medicines are urgently needed.

10aBeliefs10aBrand-name medicine10aGeneric medicine10aKnowledge10aYemen1 aAl-Worafi, Yaser, Mohammed1 aAlseragi, Wafa, Mohammed1 aAlakhali, Khaled, Mohamed1 aMing, Long, Chiau1 aOthman, Gamil1 aHalboup, Abdulsalam, M1 aAlshahrani, Sultan, M.1 aAlshakhshir, Sami, Mustafa1 aAl-Shami, Abdulkareem, Mohammed1 aAli, Majid1 aAdam, Mansour1 aWajid, Syed1 aElkalmi, Ramadan, Mohamed uhttps://www.jppcm.org/article/2020/6/4/53-5602713nas a2200265 4500008004100000245013300041210006900174260001500243300001000258490000600268520189100274653001402165653003702179653001702216653001602233653001302249653002502262100001902287700001802306700001902324700002002343700001702363700001802380856004902398 2020 eng d00aPublic’ Perception, Awareness, Expectations and Experiences towards the Role of Community Pharmacists in Quetta City, Pakistan0 aPublic Perception Awareness Expectations and Experiences towards cApril 2020 a05-090 v63 a

Aim: The study is aimed to assess public perception, awareness, expectations and experiences towards the role of community pharmacists (CPs) in Quetta City, Pakistan. Methods: This was a questionnairebased, cross-sectional survey. Keeping the aim of the study in mind, a questionnaire was developed by the research team through mutual consensus, experience sharing and extensive literature review. By using an online calculator, 423 respondents were approached conveniently for the data collection. The SPSS v.20.0 was used for data coding and analysis. Based on the objectives of the study, descriptive statistics were applied for data analysis. Results: The mean age of the respondents was 30.61±9.95 and males dominated the group (318, 75.2%). Eighty-one percent of the respondents agreed that CPs provide consultation on how medicine works, identify and prevent errors and are good in explaining things to their level of understanding. Nearly 70% of the respondents expected CPs to take personal responsibility for resolving drug-related problems, to educate them about the appropriate use of medicines and to monitor the response of drug therapy. All respondents were positive when they were asked about their expectations from the CPs. Respondents agreed that CPs are a reliable source of drug information and are important healthcare professionals (80.4 and 77.3% respectively). Counseling was endorsed by 60% of the respondents while CPs were held responsible for resolving drug problems. Conclusion: Although the study findings revealed certain limitations, study respondents had positive attitudes, experiences and constructive expectations towards CPs. The findings also indicated consumer preferences for the evolution of community pharmacist professional services in Pakistan.

10aAwareness10aCommunity pharmacist Quetta city10aExpectations10aExperiences10aPakistan10aPublic’ perception1 aKamran, Kashif1 aIqbal, Qaiser1 aHaider, Sajjad1 aAnwar, Muhammad1 aIshaq, Rabia1 aSaleem, Fahad uhttps://www.jppcm.org/article/2020/6/1/05-0902509nas a2200289 4500008004100000245014700041210006900188260001700257300001000274490000600284520162700290653001401917653001801931653001001949653002001959100001601979700001901995700001902014700001702033700001902050700002202069700001802091700001902109700001902128700002302147856004902170 2020 eng d00aQuality of Life among Geriatric Population: A Community-based Study in the Rural Field Practice Areas of a Tertiary Care Hospital in Mangalore0 aQuality of Life among Geriatric Population A Communitybased Stud cOctober 2020 a31-340 v63 a

Background: Quality of life among elderly needs assessment as they are the growing population nowadays and also are more vulnerable to many morbid conditions. Objectives: The objective of this study is to assess different domains of quality of life and its relationship with socio-demographic factors. Methods: A Community based study was done among 153 persons aged 60 years and above from 13.06.2018 to 20.06.2018 in the rural field practice areas of Department of Community Medicine, Father Muller Medical College, Mangalore Karnataka. The World Health Organisation, Quality of life-BREF Questionnaire was used and analysis done using SPSS version 23.0. Results: The mean Quality of life score was maximum in social health domain (72.90 ±1.63) followed by environmental health domain (63.10 ±3.71) and physical health domain (61.60 ± 2.96). The lowest was in psychological health domain (57.90 ± 2.61). Better scores of physical health domain, Psychological health domain and social health domain was seen among the elderly who had easy contacts with other people in the community. Environmental health domain score was better among the elderly people belonging to the Christian religion. Conclusion: In our present study, social relationship domain had higher mean Quality of life score when compared to other domains; where as psychological domain was affected badly among the elderly population. Further counselling and research can be done to explore the factors affecting the psychological domain.

10aGeriatric10aHealth status10aIndia10aQuality of life1 aV, Narayana1 aKumar, Saurabh1 aPrabhu, Sudhir1 aBhat, Sowmya1 aDsouza, Oliver1 aKrishna, Nishanth1 ashetty, Achal1 aD'souza, Moira1 aThomas, Anissa1 aSuresh, Sucharitha uhttps://www.jppcm.org/article/2020/6/3/31-3402457nas a2200145 4500008004100000245008900041210006900130260001700199300001000216490000600226520200600232653000802238100001602246856004902262 2020 eng d00aRole of Clinical Pharmacist in Context of World Health Organization against COVID-190 aRole of Clinical Pharmacist in Context of World Health Organizat cOctober 2020 a44-450 v63 a

Dear Editor,

Since December 2019, the outbreak of novel human virus on the name of COVID-19 spread in China from Wuhan city around the world to 183 countries in 2020.[1] This virus considered lethal for many people. Most of the people who infected get respiratory symptoms include cough, shortness of breath, sneezing and fever. The novel virus transmitted in contact person to person via droplets of cough or sneezes from infected person or animal. High risks to those peoples who are in outbreak areas or with other complications include immune-compromised patients, diabetes mellitus, cardiac diseases and any other co-morbidities.[2] Clinical Pharmacists are more easily accessible healthcare professionals to public and key figures of health care team regarding infectious diseases. According to Amir M et al. Clinical Pharmacy is the liaison of pharmacist with physician in which Clinical pharmacists prescribing medications.[3,4] Wasim et al. articulated that Clinical Pharmacists are independent prescribers in United Kingdom.[5] In current pandemic pharmacists may consider secondary prescriber due to physician’s self-illness and inpatient focuse.[1] World Health Organization being a standard organization around the world providing health to worldwide population, mandate some qualities upon the Pharmacists that a good pharmacist bears seven qualities every quality called as star thus named as “Seven stars Pharmacist” includes communicator, teacher, decision maker, leader, manager, lifelong learner, caregiver[6] additional two are researcher and pharmapreneur thus total becomes “Nine stars Pharmacist” (Figure 1), almost all of these are implemented in developed countries in outbreak of novel corona virus which was expected WHO few years ago now the time for these professionals proving their selves. Read more...

10aNil1 aKhan, Majid uhttps://www.jppcm.org/article/2020/6/3/44-4501570nas a2200217 4500008004100000245012500041210006900166260001500235300000800250490000600258520087700264653002401141653002201165653002501187653001401212653001401226653003001240100001601270700001901286856004701305 2020 eng d00aStrategic Assessment of Challenges to Clinical Pharmacists in Pakistan and their Historical Relationship with Physicians0 aStrategic Assessment of Challenges to Clinical Pharmacists in Pa cApril 2020 a2-40 v63 a

This study through light on actual role of Clinical Pharmacists and their relationships with Physicians as well as challenges to Clinical Pharmacists in Pakistan. Pharmacy is a patient oriented profession and a Pharmacist should be clinically smart and strong, the relation between Physician and Pharmacist of many decades but unfortunately this area of Pharmacist is not meeting the modern challenges of clinical practice, in Pakistan Pharmacy. Strategies includes curricula modification, incorporation of “7 stars Pharmacist qualities recommended by WHO”, more focus on practical knowledge rather than theoretical, vacancies announcement, training regarding prescription and paid one year internship like other countries in order to stabilize health care team and to provide rational drugs to the patient to improve both health and wealth

10aClinical Pharmacist10aClinical Pharmacy10aHealth care triangle10aPakistan.10aPhysician10aWorld Health Organization1 aKhan, Majid1 aRiaz, Muhammad uhttps://www.jppcm.org/article/2020/6/1/2-401434nas a2200181 4500008004100000245006200041210006000103260001400163300001000177490000600187520093600193653000801129100001501137700001801152700001701170700001601187856004901203 2020 eng d00aTo Suppress or to Mitigate COVID-19: That is the Question0 aTo Suppress or to Mitigate COVID19 That is the Question cJune 2020 a20-210 v63 a

In India, public health experts have been debating the most effective way of combating COVID-19 (or SARS-COV-2 virus) while balancing the amount of lives lost and trying to preserve the economy. This virus is particularly challenging for India as the population is so large, and the healthcare system is still developing to meet the needs of its citizens. While social distancing has been and is being widely practiced worldwide to mitigate the further spread of COVID-19, it is apparent that more aggressive public health measures are needed to further decrease the numbers of infected people. Already, India has extended its lockdown from March 24th to the end of May.[1] By better understanding how this virus propagates, as well as by considering the unique needs of India, experts can better determine the best measures to fight further spread. Read more.....

10aNil1 aKhan, Anam1 aGoff, Allyson1 aAhmad, Akram1 aPatel, Isha uhttps://www.jppcm.org/article/2020/6/2/20-2102196nas a2200241 4500008004100000245014500041210006900186260001700255300001000272490000600282520147800288653000801766653000901774653001301783653001601796653000901812653001501821653001101836653002001847100001701867700002101884856004901905 2020 eng d00aUnapproved Combination Therapy of Doxycycline and Ivermectin in Covid-19 Pandemic, an Opportunistic Chance of Self-medication: A Case Report0 aUnapproved Combination Therapy of Doxycycline and Ivermectin in  cJanuary 2021 a69-710 v63 a

To date, no standard drug therapy has proven effective to counter COVID-19 disease. There are only hit and trial based on assumptions and weak evidence that are directing prescribing practices for asymptomatic to symptomatic and serious cases of COVID-19. ICMR being the apex body, responsible for framing the guidelines for the management of disease in India has not yet approved the use of combination doxycycline and ivermectin in the prophylaxis or treatment of Covid-19 cases but being used in the treatment of COVID-19 infection. Their adverse drug reactions individually are well known among scientific community. Doxycycline ADRs range from gastrointestinal, urogenital, neuropsychiatric, respiratory, nervous system to skin and appendages. We have reported a case of doxycycline induced drug allergy (rashes) all over the trunk and legs as a result of self-medication. The event happened after a female patient had complaints of persistent fever and weakness consumed doxycycline and ivermectin on her friend’s advice and developed rashes on her trunk and legs. The above ADE is very mild but alarming for the medical fraternity that warrants strict compliance with the electronic/text/online prescription. The usage of doxycycline and ivermectin in the treatment of COVID-19 disease, as an indication of treatment should not be considered prior to any concrete evidence or issuance of treatment, guidelines by the apex body in India.

10aADE10aADRs10aCOVID-1910aDoxycycline10aICMR10aIvermectin10aRashes10aSelf-medication1 aBano, Gulnaz1 aSharma, Abhishek uhttps://www.jppcm.org/article/2020/6/4/69-7101749nas a2200205 4500008004100000245007700041210006900118260001400187300001000201490000600211520113400217653001301351653002201364653002501386653002101411653001801432100001801450700002601468856004901494 2020 eng d00aUnion Therapy-An Urgent Need to Health Care for Covid and Future Threats0 aUnion TherapyAn Urgent Need to Health Care for Covid and Future  cJune 2020 a22-240 v63 a

Human suffering through infections is inevitable. History has witnessed drastic negative impacts of infectious plagues which were primarily managed through prayers and latter through medicines. In spite of high technology at present COVID-19 and other resistant infections and diseases still pose a threat to global health and still is unchecked. Thus to combat it a modality Union therapy is conceptualized which synergistically uses the past and present medical techniques to cope up the COVID. It tries to merge the positive effects of supernatural medicine with modern medicine to make therapy comprehensive complete in all aspects. This effort would help to cope up new emerging diseases like COVID and in cases of palliative care where psychological aspects and the patient’s religious and spiritual needs play a role. Overall it will help to frame a bridge between past and present treatment modalities by scientifically assessing and merging the objective similarities in them. It will help to foster new areas and make therapy acceptable and accessible to a wide range of global population.

10aCOVID-1910aHolistic Medicine10aIntegrative medicine10aMytho scientific10aUnion Therapy1 aKala, Kanishk1 aSodhi, Rupinder, Kaur uhttps://www.jppcm.org/article/2020/6/2/22-2402798nas a2200217 4500008004100000245017700041210006900218260001800287300001000305490000600315520202300321653003202344653002202376653002002398653002002418653002702438653001002465100002902475700002702504856004902531 2019 eng d00aAssessment of Pharmacist Dispensing Practices and their Educational Role toward Patients on Oral Cytotoxic Drugs Regimen in Radiation and Isotopes Center at Khartoum, Sudan0 aAssessment of Pharmacist Dispensing Practices and their Educatio cDecember 2019 a63-680 v53 a

Background: Increasing use of oral cytotoxic chemotherapy among cancer patient in Sudan, rising important concern about safety practicing and using of these drugs. This study aimed to assess and demonstrate pharmacist dispensing pattern and their educational role toward patients on oral cytotoxic drugs regimen in Radiation and Isotopes Center at Khartoum (RICK). Methods: Across-sectional study was carried out at (RICK) hospital pharmacies. Data collected by using self-administered questionnaire distributed to all staff in active works (40 pharmacists) during February 2016. Results: All the participants responded to the questionnaire. The study reported variation among pharmacists when checking prescription. In which 97.4% of them checked drug name while only 76.9% calculating the dose according to the body surface area. For the patients-pharmacist counseling and it is effectiveness the study revealed that 77.5% of pharmacist providing counseling for the patient at the first visit. 75% of pharmacists counseling the drugs regimen. 28.1% of them including the drugs side effects and management. The counseling of the drugs handling and storage was registered by 65.6% of the participants. 53.1% of the pharmacists advice the patients to swallow the tablets and not crush it. The drugs interaction was counseled by 9.4% and only 2% of pharmacists counseled patients about medications teratogenicity. The finding revealed significant association between pharmacist experience and counseling practice by chi-square (p-value=0.008) while, the hospital training and staff attending has on significant association with (p-value=0.922, p-value=0.479). Conclusion: The study concluded that dispensing practice among pharmacists was main divers. Moreover, most of the pharmacists followed no standard when counseling patients and their experience becomes the main source when educating them.

10aOral cytotoxic chemotherapy10aPatient education10aPharmacist role10aSafe practicing10aSide effect management10aSudan1 aMohamed, Alaa, Abdelaziz1 aAwad, Mousnad, Mohamed uhttps://www.jppcm.org/article/2019/5/4/63-6801656nas a2200145 4500008004100000245007100041210006900112260001800181300001000199490000600209520122000215653000801435100001801443856004901461 2019 eng d00aBlessing of Knowledge-Based Empathy to Engender Prudent Prescriber0 aBlessing of KnowledgeBased Empathy to Engender Prudent Prescribe cDecember 2019 a58-590 v53 a

“It is the patient who carries the burden of illness, but the compassionate physician shares that burden, lifting it when possible and lightening it when that is all that can be done. This sharing of the burden has always been the hallmark of the medical profession”.[1]

The American University of Antigua, College of Medicine’s Admissions Committee and a few others fells that compassion, strong work ethic, professionalism, knowledge, confidence, humility, passion, empathy, being humane, respectfulness and thoroughness are indispensable prerequisites for a good physician to master.[2,3] Physicians require to own comprehensive and up to date medical knowledge that can be revoked at the drop of a hat.2 Updating medical doctors’ knowledge regularly is an essential necessity, as medical science is changing and progressing, especially the field of pharmacological intervention.[2,4-6] Hereafter, could argue against their acquired knowledge through undergraduate studies.[2] Henceforward, acquisitions and updating knowledge is a fundamental prerequisite to a good physician.[7-9]

10aNil1 aHaque, Mainul uhttps://www.jppcm.org/article/2019/5/4/58-5901313nas a2200181 4500008004100000245008400041210006900125260001800194300000700212490000600219520078200225653000801007100001701015700001901032700001601051700001801067856004601085 2019 eng d00aGestational Diabetes Mellitus in Pakistan: Undiagnosed Threat to Pregnant Women0 aGestational Diabetes Mellitus in Pakistan Undiagnosed Threat to  cDecember 2019 a800 v53 a

Dear Editor,

Gestational Diabetes Mellitus (GDM) is a rare disorder and due to non-uniformity in its diagnostic criteria and changes over time in the recommended glucose values,[1] it is a major and a severe problem during pregnancy. But the time has reached to draw peoples’ attention towards this major medical complication of pregnancy. Women with risk factors such as age greater than 25 years; being overweight i.e., BMI > 27kg/m2 before pregnancy and BMI > 30kg/m2 during pregnancy; family history of diabetes; the previous history of pregnancy-induced hypertension and weight of the previous baby of ≥4.5kg have a greater incidence of hyperglycemia during their pregnancy period.[2]

10aNil1 aTahir, Maria1 aHaq, Noman, ul1 aAbid, Arooj1 aZafar, Abeera uhttps://www.jppcm.org/article/2019/5/4/8002419nas a2200289 4500008004100000245014500041210006900186260001800255300001000273490000600283520149800289653001701787653001501804653001501819653001201834653001301846653002001859653001601879653001501895653003901910100001801949700003101967700002301998700003002021700002902051856004902080 2019 eng d00aInternet Addiction a Global Concern: A Cross-Sectional Appraisal amongst Imminent Medical Doctors of National Defence University of Malaysia0 aInternet Addiction a Global Concern A CrossSectional Appraisal a cDecember 2019 a75-790 v53 a

Background: Recent evolution in terms of technology and availability of the internet has brought several innovations that made work and access to information straightforward. Nonetheless, the danger of pathological internet addiction and its adverse consequences are frightening. Objectives: The primary goal of this research is to determine the level of internet addiction among undergraduate medical students at National Defence University, Malaysia. Methods: A structured questionnaire comprising of section A consisting of student demographic information and section B made up of Dr. Kimberly Young’s 20 items internet addiction test (IAT) in 5-point Likert’s scale. Internet addiction scores were classified based on Young’s scale. Results: The response rate obtained from this study was 89.6%. Out of the 224 respondents, only 4 (1.8%) were found to be regular internet users, 98 (43.8%) were established to be mild addicts, 110 (49.1%) were moderate addicts and finally, 12 (5.4%) were severe internet addicts. There was a statistically significant difference in the mean internet addiction score between males and females, with males having higher ratings. Conclusion: The prevalence of internet addiction among undergraduate medical students is high and needs to be controlled. As such, the use of the internet at colleges and universities may need to be regulated.

10aApprehension10aCompulsion10aDependence10aGadgets10aInternet10aMedical Student10aSmart Phone10aTechnology10aYoung’s Internet Addiction Scale1 aHaque, Mainul1 aAbubakar, Abdullahi, Rabiu1 aNaina-Mohamed, Isa1 aSaidin, Nurfarhana, Binti1 aAzhar, Nadia, Iman Khair uhttps://www.jppcm.org/article/2019/5/4/75-7902857nas a2200265 4500008004100000245011500041210006900156260001800225300001000243490000600253520203100259653002202290653000902312653002102321653000902342653001402351100002502365700002502390700001802415700003002433700002902463700002702492700002302519856004902542 2019 eng d00aPharmacotherapeutic Consideration of Gastro Esophageal Reflux Disease among Geriatric Type 2 Diabetic Patients0 aPharmacotherapeutic Consideration of Gastro Esophageal Reflux Di cDecember 2019 a69-740 v53 a

Background: Gastro-esophageal Reflux disorder is return of the stomach's contents back up into the esophagus. Whereas diabetes is a metabolic disorder in which there is either no production of insulin or there is resistance to insulin being produced by body. Objectives: The aim of the systematic review is to study the pharmacotherapeutic consideration of GERD among elderly type 2 diabetes patients. Methods: This study analyzed 15 articles identified and selected according to the study criteria. PRISMA guidelines were used for identification and screening of literature. Data search covered several primary databases, including PubMed/MedLine, Wiley library, Scopus, Clinical Trial Registry, etc. Result and Findings: The data shows obese patients with BMI > 30kg/m2 with type 2 diabetes have higher chances of GERD. The findings also suggested increase in socioeconomic status shows increase incidence of type 2 diabetes mellitus with time and it also plays vital role to lifestyle modifications such as physical exercise e and dietary habits. The prevalence values of GERD by skipping breakfast, snacking during bedtime, late night eating and eating fast were 32.0%, 13.7%, 27.1%, 28.8% and 44.4%, respectively. Late night eating was independently positively associated with GERD in patients with type 2 diabetes; the adjusted odds ratio was 1.46 (95% CI 1.03 to 2.05). No relationships were found between not eating breakfast, snacking at bedtime or eating fast and GERD. Conclusion: The review findings suggested that patients with type 2 diabetes are at double risk of GERD as the metabolic disorder are making it worst. GERD can be avoided by minimizing the risk of type 2 diabetes either by controlling obesity by bariatric surgery or by exercise and more active lifestyle. There are some important considerations to decrease the incidence of GERD by evaluation and treatment in the older patients.

10aDiabetes Mellitus10aDiet10aGastroenterology10aGERD10aGeriatric1 aAhmed, Mahin, Gulzar1 aGillani, Syed, Wasif1 aHaddad, Issam1 aAhmad, Khawla, Mohamad Ka1 aAbdullahi, Rukkaya, Musa1 aBello, Fatima, Danlami1 aMohamadi, Nastaran uhttps://www.jppcm.org/article/2019/5/4/69-7401234nas a2200265 4500008004100000245004300041210004300084260001800127300001000145490000600155520058700161653001400748653001300762653001800775653000900793653000800802653001100810653001300821653001500834653001400849100001800863700001800881700002000899856004900919 2019 eng d00aPromote Healthy Emotions in Your Child0 aPromote Healthy Emotions in Your Child cDecember 2019 a60-620 v53 a

Emotional development starts at an early age. This development is significant that it facilitates the children who are in preschool and assist their interaction with others. Indeed, emotional development expedites the overall development of children both in social and intellectual ways. This article aims at conceptualizing developmental mechanisms that promote healthy emotions in children. In a nutshell, views of this article indicate that fostering emotional health in children by using the knowledge about wellness that can shape your healthy life.

10aEncourage10aFeelings10aFrame of mind10aGood10aKid10aMental10aPhysical10aSilhouette10aYoungster1 aBhagat, Vidya1 aHaque, Mainul1 aHusain, Rohayah uhttps://www.jppcm.org/article/2019/5/4/60-62