Background The role of a pharmacist in primary health care settings of Pakistan is still obscure. Thus, we aimed to demonstrate the pharmacist-led improvements in glycemic, blood pressure and lipid controls in type 2 diabetes mellitus (T2DM) patients of Lahore, Pakistan. Methods The first open label, randomized control trial conducted at a primary health care facility of Lahore, Pakistan by enrolling 244 uncontrolled type 2 diabetes (hemoglobin A1 c, (HbA1c); 10.85 ± 1.74) patients. The pharmacological intervention included identification of drug related problems, drug interactions, change in dose, frequency and therapy switches in collaboration with physician, while non-pharmacological intervention consisted of diet, lifestyle and behavior counseling. Outcome measures were glycemic (HbA1c), blood pressure and lipid controls. Results In intra-group comparison, compared to control arm ( C , n = 52), subjects in the intervention arm ( I , n = 83) demonstrated significant differences in process outcome measures; baseline vs final, such as HbA1c ( C ; 10.3 ± 1.3 vs 9.7 ± 1.3, p <  0.001, I ; 10.9 ± 1.7 vs 7.7 ± 0.9, p <  0.0001), systolic blood pressure (SBP) ( C ; 129.9 ± 13.9 vs 136 ± 7.1, p = 0.0001, I ; 145 ± 20.4 vs 123.9 ± 9.9 mmHg, p <  0.0001), diastolic blood pressure (DBP) ( C ; + 4, p = 0.03, I ; − 7 mmHg, p <  0.0001), cholesterol ( C ; 235.8 ± 57.7 vs 220.9 ± 53.2, p = 0.15, I ; 224 ± 55.2 vs 153 ± 25.9 mg/dL, p < 0.0001), triglycerides ( C ; 213.2 ± 86.6 vs 172.4 ± 48.7, p = 0.001, I ; 273 ± 119.4 vs 143 ± 31.6 mg/dL, p < 0.0001) and estimated glomerular filtration rate (eGFR) ( C ; 77.5 ± 18.6 vs 76 ± 14.2, p = 0.5, I ; 69.4 ± 21.3 vs 93.8 ± 15.2 ml/min/1.73m 2 , p < 0.0001). Likewise, inter-group improvements were more significant in the subjects of intervention group at final follow up in comparison to control for various process outcome measures; HbA1c ( p < 0.001), SBP ( p < 0.0001), DBP ( p = 0.02), cholesterol ( p < 0.0001), triglycerides ( p < 0.0001), SCr ( p < 0.001), eGFR ( p ...

Background Crimean Congo Haemorrhagic Fever (CCHF), a tropically neglected infectious disease caused by Nairovirus, is endemic in low middle-income countries like Pakistan. Emergency health care professionals (HCPs) are at risk of contracting nosocomial transmission of CCHF. We, therefore, aim to analyze the knowledge, attitudes, and perceptions (KAP) of at-risk physicians, nurses, and pharmacists in Pakistan and the factors associated with good KAP. Method A validated questionnaire (Cronbach’s alpha 0.71) was used to collect data from HCPs in two CCHF endemic metropolitan cities of Pakistan by employing a cross-sectional study design. For data analysis percentages, chi-square test and Spearman correlation were applied by using SPSS version 22. Results Of the 478 participants, 56% (n = 268) were physicians, 37.4% (n = 179) were nurses, and 6.5% (n = 31) were pharmacists. The proportion of HCPs with good knowledge, attitude, and perception scores was 54.3%, 81, and 69%, respectively. Being a physician, having more work experience, having a higher age, working in tertiary care settings, were key factors for higher knowledge (p < 0.001). The correlation coefficient showed significant positive correlation between attitude- perception (r = 0.560, p < 0.001). Conclusion We have observed average knowledge of HCPs. Therefore, we recommend time to time education campaigns and workshops in highly endemic CCHF regions to be launched by health ministries and HCPs, in particular nurses, encouraged to follow authentic academic sources of information to prevent nosocomial transmission.

Background: Hyperlipidemia is the elevation of low density lipoprotein levels resulting in fat deposites in arteries and their hardening and blockage.  It is the leading cause of several life threatening pathological conditions like hypertension, cardiovascular diseases, diabetes etc. Purpose: The objective of this study was to prepare and optimize nontoxic, biocompatible β-CD-g-MAA/Na + -MMT nanocomposite hydrogels with varying content of polymer, monomer and montmorillonite. Moreover, lipid lowering potentials were determined and compared with other approaches. Methods: β-CD-g-MAA/Na + -MMT nanocomposite hydrogels (BM-1 to BM9) were prepared through free radical polymerization by using  β-CD  as polymer, MAA as monomer, MBA as crosslinker and montmorillonite as clay. Developed networks were evaluated for FTIR, DSC, TGA, PXRD, SEM, sol-gel fraction (%), swelling studies, antihyperlipidemic studies and toxicity studies. Results: Optimum swelling (94.24%) and release (93.16%) were obtained at higher pH values. Based on R 2 and “n” value LVT release followed zero order kinetics with Super Case II transport release mechanism, respectively. Tensile strength and elongation at break were found to be 0.0283MPa and 94.68%, respectively. Gel fraction was between 80.55 – 98.16%. Antihyperlipidemic studies revealed that LDL levels were markedly reduced from 522.24 ± 21.88mg/dl to 147.63 ± 31.5mg/dl. Toxicity studies assured the safety of developed network. Conclusion: A novel pH responsive crosslinked network containing β-CD – g – poly (methacrylic acid) polymer and MMT was developed and optimized with excellent mechanical, swelling and release properties and lipid lowering potentials.

BACKGROUND COVID-19 Lockdown has limited the non-essential movement of people. Consequently, the effects of lockdown had a remarkable impact on everyday life, including health, social sector, economic decline, supply chain sectors and education sector. Just because the social distancing is in ascend, people are looking up new ways to connect and Smart Phones are the most convenient, accessible, and cost-effective way to stay connected during this pandemic. People have become significantly dependent on their smart phones during COVID-19 pandemic that allow to work from home and stay connected with the world. Smartphone addiction is known as nomophobia (NMP) which is a fear of not using smart phone. OBJECTIVE This nondrug addiction is as dangerous as drug addiction. It produces behavioral modifications in everyday habits and actions. Much research is available on nomophobia, to the best of author’s knowledge, there is no literature available on the prevalence of NMP during COVID-19 lockdown METHODS It was a descriptive cross-sectional study. Subjects fulfilling the selection criteria were enrolled in the study through public sector universities of Islamabad and Rawalpindi. Non- Probability convenient sampling technique was used to select 580 students of both genders from 18 to 24 years of age. 18 Students who were corona positive or having any known psychiatric disorder were excluded from the study. A cross sectional survey was conducted online by via Google form. Validated Nomophobia Questionnaire (NMP-Q) was utilized. A self-reported questionnaire regarding demographic data and information regarding use of smart phone. It is the most widely used measurement instrument, proposed by Yildrim and Correia, anyone can use it for noncommercial research and educational projects. NMP-Q includes 20 Likert scale items rated from 1 strongly disagree to 7 strongly agree. The lowest score on the NMP-Q is 20 and 140 is the highest. 20 represent absent of nomophobia, 21 – 59 mild level, 60 – 99 moderate level and 100 – 140 severe nomophobia. Google forms automatically analyzed the collected data. RESULTS A total of 580 subjects 290 (50%) were male and 290 (50%) were female. Mean age was 21 ± 2.3 years. Out of 580 subjects 460(79.31%) were nomophobic. Subject who had severe nomophobia were 19%, moderate nomophobia 58% and mild nomophobia 23%. Subject reported that they could not stay away from their smart phones and keep their phones with them even at bedtime. 226 (38.9%) subjects never turned their phone off. 253 (43.6%) subjects carry a power bank with them so they may not run out of battery. Out of 290 female students 199 (68.6%) were nomophobic and out of 290 male subjects 261 (90%) were nomophobic. So, nomophobia was more prevalent in male. Most frequent reason for using smart phone was social networking (WhatsApp, Facebook, twitter, Instagram, tiktok, snapchat) 91% and playing games 73%. CONCLUSIONS High prevalence of nomophobia was found. Due to COVID -19 lockdown students have straight off become dependent on smart phones that allow them to work and learn from home and take online classes. Smart phone is only source of entertainment for them so there is a huge percentage of a student having moderate nomophobia. So time of using smart phones should be regularized in order to avoid serious harmful effects due to prolong use.

The COVID-19 stress and increased job pressure have largely affected healthcare professionals’ various life domains. This study particularly explores the effect of stress caused by treating COVID-19 patients on medical doctors’ wellbeing. To explore this phenomenon, we interviewed 12 doctors treating COVID-19 patients in hospitals of metropolitan cities in Pakistan. The thematic analysis using NVivo V.12 Plus software of interviews resulted in four major themes, COVID-19 Stressors, Effects of Stress, Nature and Personality, Stress Relievers, and Stress Coping Strategies. Physicians were physically and emotionally stressed as a result of the intense work. Although they were carrying a lot of pain and hurt on their insides, participants demonstrated a sense of professional determination to overcome obstacles. Physicians are currently dealing with their emotional issues, and they should have access to complete professional help to ensure their wellbeing. The COVID-19 pandemic’s mental health effects are anticipated to last far longer than the physical health effects. This study is well-positioned to investigate frontline physicians’ opinions and attitudes concerning the COVID-19 and its impact on their daily lives and mental health. This research will help implement context-specific innovative mental health solutions to help the frontline workers.