Acetaminophen is the most widely over the counter used analgesic in the world, and the World Health Organization advises using it as first-line treatment for pain issues (WHO).However, various side effects have been documented with its use such as nausea, vomiting, constipation at low doses whereas in large doses, it might even result in hepatoxicity.Recent literature suggests that the use of acetaminophen in pregnancy even in optimal doses could result infant being born with ADHD and autism, so in this short communication we talk about the prevalence of neurodevelopment disorders in infants as a result of its use, as well as shed light to the measures that should be adopted to minimize the adverse effects.

Alopecia areata is a disease in which an active immune response is triggered against the hair follicles, causing hair loss. The extent of this hair loss is proportional to the number of hair follicles attacked. Alopecia areata is classified into three types depending on the area of hair fall: alopecia areata, alopecia totalis, and alopecia universalis. Alopecia areata has an approximate worldwide prevalence of 1 in 1000 people1. The current, well-known treatment of alopecia areata is intralesional corticosteroid injections, with 60-70% of patients reporting some form of hair growth afterward, while other treatments include topical immunotherapy, Minoxidil, and Anthralin2. Similar treatment methods, along with hair transplants and platelet-rich plasma (PRP) therapy, are used in Pakistan, which has been effective to some extent in controlling or stopping the progression of the condition3. Baracitinib, which has already been approved for rheumatoid arthritis and atopic dermatitis, is a Janus kinase (JAK) inhibitor that blocks the proteins known as JAK enzymes, which are involved in immune signalling and inflammation. It is unclear as to how the immune system of the body causes alopecia areata. A possible mechanism is by sending out signals that interrupt the events of hair growth. Baracitinib stops the communication among the immune cells responsible for causing hair loss which ultimately inhibits the signals mentioned above and lessens the response to injury, resulting in hair regrowth4. Thus, it can be thought of as a potential treatment for severe alopecia areata. Recently, in June 2022, FDA approved baricitinib as the first systematic treatment for alopecia areata after two clinical trials were conducted by Brett King et al. The trial showed promising results regarding the use of barticinib as after 36 weeks of exposure, oral baricitinib outperformed placebo in terms of promoting hair growth in patients with severe alopecia areata. The proportion of participants that achieved at least 80% scalp hair coverage at 36 weeks was estimated to be 38.8% with 4-mg baricitinib, 22.8% with 2-mg baricitinib, and 6.2% with placebo in trial 1 and 35.9%, 19.4%, and 3.3%, respectively, in trial 25. ---Continue

Dear Madam, the sudden emergence of the monkeypox virus occurred in 1970, after which it firmly anchored its roots in 11 countries in the African region. The virus belongs to the same genus as the variola and cowpox virus, the Orthopoxvirus.(1) Monkeypox is not as virulent as smallpox and usually clears up on its own without treatment, with symptoms occurring over 2-4 weeks. The disease ensues following viral entry via pharyngeal and intradermal routes, after which it spreads from the site of entry to local lymph nodes. (2)The infective period is classified into an invasive period which is typified by swelling of lymph nodes, severe anaesthesia, and headache lasting for 5 days; and the second period marked by dermatitis lasting for three days. However, monkeypox does not spread easily from person to person. Wearing clothes worn by someone else, sexual contact with an infected person, inhalation of contaminated droplets, and close contact with open wounds can eventually transmit the virus from one person to another.(1) Currently, there has been an outbreak of the monkeypox virus with nearly 200 cases being reported in more than 20 countries, the majority of which are non-African with Europe being the epicenter of this outbreak. The fact that monkeypox is detected in people with no apparent connection to one another and that a significant number of cases are being reported in homosexual men has been alarming.(3)Although no case of monkeypox is reported yet in Pakistan, NIH has placed Pakistan on high alert against the virus in light of cases being reported in non-endemic countries. Pakistan lacks facilities for diagnostic tests for the virus. However, efforts are being made to forestall an outbreak with arrangements made to screen the inbound passengers and declare a patient “suspected” based on their symptoms until proper diagnostic kits arrive in the country.(4) Vaccina vaccine, which proved to be the cornerstone in eradicating the smallpox virus, offered a coincidental immunity against monkeypox too. However, smallpox was termed eradicated in 1980 and the subsequent cessation of the smallpox vaccine means the supply of these vaccines is scarce. Current treatment for monkeypox include the use of antivirals such as Tecovirimat and Brincidofovir; (5) and the use of FDA approved attenuated live virus vaccine, the JYNNEOSTM.(1) The need of the hour deems it imperative that we as a community work in unison to prevent an outbreak in Pakistan. ---Continue