No abstract

<p>Intensive groundwater exploitation has depleted groundwater storage and led to a series of geo-environmental problems in Beijing Plain, China. To cope with the groundwater depletion problem and achieve sustainable groundwater development, groundwater abstraction has been reduced and Managed Aquifer Recharge (MAR) and Environmental Flow Release (EFR) projects have been piloted and planned. To evaluate the effectiveness of the proposed measures in restoring groundwater storage depletion in Beijing Plain, a 3D transient groundwater was constructed to simulate the effects of these proposed measures regionally and locally. Results show that with the reduction of groundwater abstraction, the declining trend of groundwater level has been stopped. The implementation of MAR and EFR projects have successfully enhanced the groundwater recharge and restored the connectivity of the surface water and groundwater. Prediction model results also show that with the large-scale MAR implementation and current level of groundwater abstraction, groundwater levels and groundwater storage will slowly increase in the next 30 years. With these combined measures in Beijing Plain, sustainable development of groundwater resources is expected to be achieved in the near future.</p>

Pharmacoeconomics deals with the cost and consequences of pharmaceutical products and services. It helps in determination of drug therapies or treatments that gives maximum benefit at lower cost. The aim of this study is to evaluate prescribing trends of antibiotics and to analyze their cost effectiveness. This prospective, observational and non-interventional clinical study was led for a period of 6 months from April 2018 to September 2018 at Government hospital (Liaquat University hospital Hyderabad) and various private clinics of Hyderabad. Through purposive sampling technique 400 samples were gathered. 400 samples with various bacterial infections were included in which 170 patients had Urinary Tract Infections, and 216 had Respiratory Tract Infections 14 patients were suffering from H. Pylori. Levofloxacin was the most recommended class in UTI, while Macrolides was the most recommended class in RTI. Out of 400 patients 152 patients were recovered, 16 patients left therapy due to GIT symptoms and allergic reactions and remaining patients were out of reach. Costs of antibiotics were calculated according to the duration of therapy prescribed. Antibiotics were mostly prescribed for the duration of 7 days. To conclude, Cost of antibiotics therapy was high which puts a considerable burden on the patients.

Pharmacoeconomics is the branch of health-economics where cost and outcomes are compared for patient’s treatment therapies and services in a health care system. Hypertension is one of the most common serious medical conditions in Pakistan and throughout the world. A large number of antihypertensive medications alone or in combinations are being prescribed. Pharmaco-economic studies are helpful in prescribing the most appropriate medication with required outcomes at minimum cost. Objective of study was to assess the prescription trends and cost-effectiveness among different classes of antihypertensive medications prescribed at different clinical setups of Hyderabad, Pakistan. A Prospective observational study was carried out at cardiac OPD of Liaquat University Hospital, Hyderabad from April 2018 to April 2019. According to inclusion and exclusion criteria, 400 prescriptions containing antihypertensive Drugs were collected via purposive sampling technique for pharmacoeconomic analysis during the study period. In Government setting, Monotherapy (83%) was more frequent than combination therapy (17%). The most frequent and the most cost-effective monotherapy was Enalapril maleate 5 mg having cost/day 4 Rs. In combination therapies, Lisinopril 20 mg + HTZ 12.5 mg was the most frequent. Spironolactone 50 mg + furosemide 40 mg was found to be the most cost-effective combination with cost/day 5 Rs. In private settings, the trends of antihypertensive monotherapy (75.5%) were more frequent than combination therapy (24.5%). The most frequent monotherapy was Telmisartan 40 mg while the most frequent antihypertensive combination was Amlodipine besylat 10 mg + Valsartan 160 mg. Metoprolol tartarate 100 mg and lisinopril 5 mg were cost-effective monotherapies with cost/day 5 Rs each and the combination of candesartancelexetil 16 mg + HTZ 12.5 mg was the most cost-effective. It is concluded from the current study that the prescription trends of antihypertensive medications were relatively cost-effective at Government setting but overall, the antihypertensive treatment cost was high which puts a substantial economic burden on patients.