Background: The main aim of the study is to evaluate the efficacy of empagliflozin 10 mg once daily over 12 weeks as add-on therapy to metformin plus sulfonylurea in patients with type 2 diabetes mellitus with inadequate glycemic control.Methods: It is a prospective, observational, study conducted in patients of Sri Badhrakali Diabetic Center located in Warangal, Telangana, India. The efficacy of empagliflozin 10 mg was assessed by measuring the change in the glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI) at the baseline and 12 weeks, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and after 24 hours of treatment.Results: In the present study, the addition of empagliflozin to metformin and Sulfonylurea therapy for 12 weeks provided 0.87 % reduction in HbA1c. The mean changes of FPG from baseline to 12-week is -26 mg/dl. At 24 hours empagliflozin significantly reduced blood pressure with mean changes of SBP and DBP -4.147 and -1.526 mmHg respectively. The mean changes in BMI from baseline to week 12 is -0.638 kg/m2.Conclusions: Empagliflozin 10 mg provided ancillary reduction in HbA1c outside of metformin and sulfonylurea. Controlled body weight, HbA1c, blood pressure decreases diabetes progression, decreased risk of diabetic complications and reduced risk for cardiovascular disorders.

Pulmonary arterial hypertension [PAH] is a rare and potentially fatal disease whose management is usually restricted to a few specialized centers. The crucial vascular modifications in pulmonary arterial hypertension are endothelial-cell proliferation, vasoconstriction, thrombosis and smooth-muscle cell. As patients don't essentially board in the neighborhood to those centers, daily care and emergencies ought to be delegated to the primary and second lines. Reduced contractility of mycardium, decreased venous return and abnormal rate of exchange of gases leads to deprivation of oxygen to cell and death. Diagnosing and management of pulmonary arterial hypertension is critical. There is no cure for PAH. Modern developments regarding cell biology, molecular genetics and of idiopathic pulmonary arterial hypertension create new insights and therapeutic targets in the management. However, there are several treatment options that aim to reduce symptoms, improve the quality of life, and slow disease progression. This short review provides an outline of our therapeutic protocols supported out there information. Based on the analysis of the reasons for death in the PAH population, a review of the main emergencies is provided. Drugs include vasodilators, anticoagulants, antiplatelet agents, antiinflammatory therapies, and vascular-remodeling therapies. Most of the drugs have pleiotropic effects.

This review focus on strong association of smoking and alcohol use with a variety of adverse human health effects, most prominently with cancer and cardiovascular diseases and a number of negative outcomes as a risk factor for diseases and health impacts: crime, road incidence and for some, alcohol dependence. To keep track of alcohol consumption and smoking and its consequences and to raise awareness amongst the public and policy-makers, national monitoring systems to be developed. Tobacco smoking is highly prevalent throughout the world and is, perhaps, the greatest modifiable risk factor for increased morbidity and mortality. Physicians, Pharmacists, Nurses and other healthcare providers have substantial opportunities to influence the pattern of smoking and alcohol usage. Keywords: Alcohol, Smoking, Coronary Heart Disease, Hepatotoxicity, Cancer, Atherosclerosis, Cytochrome P450 enzymes, Alcohol-Drug Interactions, Smoking-Drug Interactions, Smoking and Alcohol Cessation.

Objective: The main aim of the study is predominately utilizing clinical pharmacist in the provision of continuing diabetic education programs to emphasize and re-emphasize the importance of risk factors, prevention, adherence to medication and behavioral changes to prevent recurrences of the disease, their progression, and ultimately minimize hospitalization. Specific goals are to improve clinical outcomes for patients with diabetes-to maintain optimal plasma glucose concentrations Fasting, Post-prandial Plasma Glucose, and Glycated Hemoglobin. Study design: A prospective interventional study in the Outpatient General Medicine Department, for a period of six months from October 2018 to March 2019. Results: HbA1c levels were reduced from baseline by −1.107 ± 0.8634, Fasting Plasma Glucose levels and Postprandial blood glucose levels were reduced from baseline by −24.2218 ± 5.70352 and −30.1891 ± 1.40592 respectively. Conclusion: A trained clinical pharmacist by providing diabetes education and care can significantly reduce hyperglycemia, thereby improving the quality of life in diabetes patients and ultimately reducing health care costs associated with these morbidities.

Malaria, of the genus Plasmodium, is caused by the protozoan parasites. Most of the transmission is through the bite of an infected female anopheline mosquito. More than 500 million people are affected with malaria each year, resulting in 1-2 million fatalities. Falciparum is responsible for the majority of malaria deaths. Pregnant women, children, and anyone who are immunocompromised have the highest rates of morbidity and mortality. Myalgias or arthralgia, malaise or weakness, headache, and chills are the most common symptoms. Microscopy, antigen detection, and polymerase chain reaction (PCR) are among the procedures used to detect malaria parasites. Malaria in pregnancy is a major cause of severe maternal anemia, low birth weight neonates, preterm delivery, and higher infant and maternal death, with primigravidae experiencing these issues more frequently than multigravidae. Chloroquine is the first-line drug for treating three so-called benign malaria, Plasmodium vivax, Plasmodium malaria, and Plasmodium ovale. Artemisinin and derivatives are now mostly used in various regimens. For chloroquine-resistant falciparum malaria- quinine, mefloquine, sulfadoxine-pyrimethamine and for chloroquine-sensitive; chloroquine or combination of chloroquine or primaquine are used. The steady decline in the effectiveness of existing anti-malarial monotherapies, most endemic countries have adopted artemisinin combination therapy (ACT) Primaquine helps to prevent malaria recurrence. Severe malaria is a multi-organ disease - Cerebral malaria, pulmonary oedema, acute renal failure, severe anaemia, acidosis and hypoglycemia.