ABSTRACT… Introduction: ACS is defined as the cluster of symptoms arising due to the rapid drop of blood flow to the heart because of coronary artery obstruction. It is stated that worldwide around 17 million people die due to cardiovascular diseases of which half of the deaths are reported due to ACS. Chest pain is known to be the most leading factor associated with ACS. Objectives: To determine the frequency of acute coronary syndrome, its types and common contributing factors in patients presenting with typical chest pain in a secondary care hospital. Study Design: Cross sectional study. Setting: Medical Unit, PAF Hospital Mushaf Sargodha. Period: October 2013 to March 2014. Methodology: A total of 280 patients of either gender, aged 20 to 80 years presented with typical chest pain with or without conventional risk factors were included in the study. Results: Majority (68.9%) was males and 31.1% were female. Acute coronary syndrome was observed in 131(46.8%) patients. Out of these 131 patients, 55% had NSTEMI, 28.2% had unstable angina and 16.8% had STEMI. A higher proportion of females were found to have ACS as compared to males (75.9% vs 33.7%, P-value<0.0001). Out of 131 patients, 40.5% were diabetic, 29.8% were hypertensive 16% were hyperlipidemic, while 13.7% were smokers. Conventional risk factors except smoking were observed more in females as compared to males. Conclusion: Majority of patients with acute coronary syndrome were females and diabetic. NSTEMI was the most common type of ACS. Prevalence of conventional risk factors was found more in females with ACS. Key words:Acute coronary syndrome, ST-segment elevation, Non-ST segment elevation, unstable angina pectoris. Article Citation: Lashari NA, Lakho NI, Ahmed S, Ahmed A. Acute coronary syndrome; frequency, contributing factors and types in patient with typical chest pain. MBBS FCPS

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Pharmacy is an expanding profession with new and expanded duties for pharmacists. Pharmacology training should adjust to local and global trends to graduate quality pharmacists1. The five years of basic pharmacy education is inadequate for excellent quality of treatment, which might impair patients' health. Several nations, including the USA, have expanded basic pharmacology training to 6 years and established Pharm D as entrance level for any area of practice2. Countries that have implemented postgraduate training produce practice-ready pharmacists in varied sectors, depending on specialty and local requirements. Regional pharmacy authorities supply a large number of institutional rotation locations for pharmacy students, whereas hospital rotations have become a career necessity3. This rotation aims to provide students experience as pharmacists in a multidisciplinary context. The rotation's goals and activities include comprehending patients' drug-related requirements, pharmacists' regulatory, ethical, and professional duties, and medication distribution4. This clinical rotation offered a number of issues for institutions, especially in offering possibilities for students to engage in the pharmacist's job. Students should perform a set of specific clinical activities for which they are educated in hands-on workshops, followed by observation by a clinician or physician. Students do activities under indirect supervision after skill assessment. This technique lets students participate in direct medical care and help specific patients.5The duration of the rotation is inadequate for skill development, thus students must do duties under indirectly supervision of the institution's physician to begin hospital pharmacy practice.

Objective: To determine the performance of patient reported outcome measurement information system inpatients with rheumatoid arthritis in our setup. Study Design: Cross sectional study. Place and Duration of Study: Division of Rheumatology, Fatima memorial hospital, Lahore Pakistan, from May2019 to Jul 2019. Methodology: A total of 191 patients of either gender, aged more than 16 years with sero +ve rheumatoid arthritis were included in the study. Results: Majority of patients 156 (81.67%) were female and male 35 (18.32%) with mean age 38 ± 12.19 years.Diagnosed as rheumatoid arthritis and compliant with csDMARDs. Out of all these, majority were in low diseaseactivity (LDA) 72 (38%), remission 62 (32%), moderate 42 (22%) and high disease activity 16 (8%). Mean T-score of all measures showed variations of scores as disease progresses. For all measures, mild change was noted between low disease activity and moderate disease activity whereas high difference was seen in remission and high disease activity. Highest correlations were seen among similar constructs of physical health, mental health, and social health. Fatigue was strongly correlated with social role and social activity. Conclusion: There was a considerable impact of rheumatoid arthritis on physical, social and mental healthcalculated with patient reported outcomes measurement information system-29 (PROMIS-29).