Cannabis abuse is a common public health issue and may lead to considerable adverse effects. Along with other effects, the dependence on cannabis consumption is a serious problem which has significant consequences on biochemical and clinical symptoms. This study intends to evaluate the harmful effects of the use of cannabis on thyroid hormonal levels, cardiovascular indicators, and psychotic symptoms in the included patients. This prospective multicenter study was conducted on cannabis-dependent patients with psychotic symptoms (n = 40) vs. healthy control subjects (n = 40). All participants were evaluated for psychiatric, biochemical, and cardiovascular physiological effects. Patients were selected through Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria and urine samples, exclusively for the evaluation of cannabis presence. Serum thyroid stimulating hormone (TSH), T3, and T4 levels were measured using the immunoassay technique. Patients were assessed for severity of depressive, schizophrenic, and manic symptoms using international ranking scales. Various quantifiable factors were also measured for the development of tolerance by cannabis. Among the patients of cannabis abuse, 47.5% were found with schizophrenia, 20% with schizoaffective symptoms, 10% with manic symptoms, and 22.5% with both manic and psychotic symptoms. In the group–group and within-group statistical analysis, the results of thyroid hormones and cardiovascular parameters were non-significant. The psychiatric assessment has shown highly significant (p < 0.001) difference of positive, negative, general psychopathology, and total scores [through Positive and Negative Syndrome Scale (PANSS) rating scales] in patients vs. the healthy control subjects. The study revealed that cannabis abuse did not significantly alter thyroid hormones and cardiovascular parameters due to the development of tolerance. However, the cannabis abuse might have a significant contributing role in the positive, negative, and manic symptoms in different psychiatric disorders.

These computational insights explained the mixed-competitive enzyme kinetic behavior of 4APB. This study outlines a strategy for designing novel derivatives of 4APB with potentially better AChE inhibitory activities through interaction at the PAS and AS sites.

Purpose: To evaluate the antipsychotic drugs most commonly prescribed for schizophrenia patients in Peshawar, Pakistan and to analyze the treatment costs associated with these drugs. Methods: One hundred patients diagnosed with schizophrenia were recruited from outpatient psychiatry departments in Peshawar, Pakistan and followed for one year. Demographic data were collected for each patient at the beginning of the study. A questionnaire was used to collect antipsychotic prescription information at 4, 8 and 12 months. The cost of antipsychotics was obtained from PharmaGuide, Pakistan. The cost associated with antipsychotic drug use was statistically analyzed using post hoc tests. Results: Of the patients who completed this study, 68.1 % were prescribed second-generation antipsychotic (SGA) drugs, 6.9 % first-generation antipsychotic (FGA) drugs, and 25.0 % a combination of SGAs and FGAs. Furthermore, 40.3 % of the patients who completed the study received antipsychotic monotherapy and 34.7 % antipsychotic polytherapy. In monotherapy, risperidone was the most commonly prescribed antipsychotic drug, used by 44.8 % of patients while in polytherapy, risperidone plus olanzapine was the most commonly prescribed combination, used by 32 % of patients. Switching of antipsychotic drugs was observed in 25 % of patients. The mean annual cost of antipsychotic therapy was US$79.90 (8079 Pakistani rupees). Risperidone treatment cost was US$60.30 (PakRs 6095), constituting 52 % of the total monotherapy cost. The cost of SGAs was significantly higher than the cost of FGAs (p < 0.05). Conclusion: The results provide policymakers with appropriate information necessary for managing pharmacotherapy plans for the treatment of schizophrenia.

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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).