Hina Rehman

Introduction: With the increase in the incidence rate of COVID-19, healthcare professionals (HCPs) being at the frontline of the outbreak response are at higher risk of getting exposure and suffering from the infection. The present study aimed to evaluate the knowledge, attitude, and precautionary practices of HCPs towards COVID-19. Methodology: The current study was a descriptive, cross-sectional, online study directed to the HCPs working in a metropolitan city of Karachi, during February 2020 and March 2020 using a self-administered questionnaire. A systematic random sampling approach was adopted. Results: A total of 286 completed surveys were incorporated in the investigation with a response rate of 74.28%. The median (interquartile range, IQR) knowledge score was 18.79 (17.64-19.57). Physicians were found to be more knowledgeable (OR: 1.32, 95% CI: 0.17-4.26, p = 0.003) as compared to other HCPs. Similarly, the HCPs working in private work settings (OR: 1.94, 95% CI: 1.54-2.79, p=0.001), having more experience (OR = 1.82; 95% CI = 1.64-2.78; p < 0.005) were found to be more well-informed than HCPs working in public sector (OR = 0.81; 95% CI = 0.63–0.72; p = 0.004). The correlation between the knowledge and attitude of respondents was found to be significantly correlated (correlation coefficient: 0.13, p < 0.005). Conclusions: The findings of the study revealed that HCPs were well conversant and have an optimistic attitude towards COVID-19. Further contemplates are required to evaluate the understanding of HCPs at a national level so that viable mediations could be planned to combat this pandemic.

National diseases burden of cardiovascular diseases is the top leading cause of death in Pakistan. In this study, Pakistani has been assessed for Atherosclerotic Cardiovascular Disease (ASCVD) on the basis of American Herat Association (AHA) guidelines. The aim of the study is to assess and inform about 10-year risk and life time risk in people residing in the largest metropolis city Karachi and aware about the use of statins as per revised Pooled Cohort Equation guidelines. The study sample size was 1760 with the age of 39 to >80 years with non-atherosclerotic diseases. Both genders without language barrier with or without elevated lipid were included. Clinical investigations including HDL, B.P and serum TG were included for calculating the ten year and life time risks on the basis of 7.5%. Results shows that the Odd ratio >1 found between age and TC however significant relationship (p50% study population required moderate and high intensity statin however <30% needed life style modification for reducing cardiac on risk. It is concluded that current recommendations are not for South Asians and may under or overlook the risks of individuals living in this continent. This study estimates the cardiovascular risk burden in the population of Karachi, Pakistan who were non-atherosclerotic undiagnosed and un-treated. This risk assessment may modify the algorithm and successfully identify the risk burden in present study groups.

Cough is the common disease condition which affects patients of every age. Numerous OTC medications available in community pharmacies however no antiviral treatment and even antibiotics has been shown to be effective without pre-existing lung infection. The treatment approach of medicinal herbs has been recognized for many decades and even longer for the treatment and prevention of cough. The aim of this study was to evaluate the safety and efficacy of Mukalbion poly herbal chewable tablets for the treatment of cough with improved palatability against a marketed brand (Poly herbal). For the formulation development of test group, the herbs were supplied by the Procurement department of Herbion Pakistan Pvt. Ltd. Althea officinalis (roots), Hedera helix (leaves) and Sisymbrium irio (seeds) were used for the manufacturing of Mukalbion (poly herbal, test group) chewable tablet. The comparative control clinical trial was carried out during a time frame of 07 months with sample size of 70 patients as per epidemiological software for sample size and each group contained 35 (+/- 5) patients. Chewable tablets were administered and evaluated for effectiveness after 15 days of treatment. The data were collected by the patients through clinical trial questionnaire. The validated quality of life questionnaire (LCQ).-was also used for assessment. The results were analyzed by applying paired sample T test by using IBM SPSS version 20.00. The p value was <= 0.005 at 95% confidence interval for cough variables including cough bouts, viscosity of sputum, chest congestion, sore throat and shortness of breath. The LCQ cough scale score was higher in test group as compared to control group. The test group also showed well tolerated in term of palatability. None of the patient claimed any of the side effects and no compliance were observed against the marketed brand.

The highly oriented modern detection techniques provide a precise and definite tool for investigation in natural medicines. Current study directed the standardization of eminent biomarker Vasicine in a natural cough syrup. A highly accurate and precise method of High-performance thin layer chromatography (HPTLC) has been developed to certify the quantity of vasicine inside the syrup. Ethyl acetate, chloroform, ethanol and ammonia (6:3:1: 1 v/v) were mobile phase for the study. The TLC plate silica gel G60F254 was used with CAMAG Scanner III and CAMAG Linomate 5. The detected Rf value was 0.51 in both sample and reference standard at 254 nm. International conference of Harmonization (ICH) guidelines were followed for the validation of the developed method. Linearity was achieved in the range of 200 mu g to 1600 mu g with co-efficient correlation r(2)=0.9995. Accuracy was found in between 98.9 to 101.4% however precision was good at both inter and intra-day. As per the standardization of ICH, the developed method was found to be reproducible and showed sharp similar peak with high resolution.

Pakistan among other South Asian developing countries is the seventh most populous country in the world. Despite offering inexpensive research resources, patient pool, well-established GCP compliant institutions and skilled researchers Pakistan has been unable to draw attention of multinational companies. Pakistan holds largest patient pool both treated and naïve, high burden of communicable diseases, established and accredited institutes, internationally certificated trainers yet Pakistan deal with challenges in global market. The division health facilities are mainly into private and public but due to unjust distribution of health sectors, rural remain the main area of concern due to lack of availability of the treatment. Even being an ideal site for clinical trials, Pakistan faces tremendous difficulties in achieving rank in international market due to fragmentation of national infrastructure and ethical consideration. Extensive investment and advancement is needed in improving the clinical research in Pakistan. This document discusses these challenges and failed opportunities in clinical research of Pakistan.

Oxidative, reductive, lipoxygenase and angiotensin converting enzyme (ACE) activities are the condition where there is an inequity among concentrations can cause a multiple pathological effects. Vast results of medical plants and the remarkable contribution on humans has been observed since centuries. The current study has showed the antioxidant, lipoxygenase, ACE inhibition, urease activity and reducing ability in vitro on linkus formulation, including lozenges and syrup. The anti-oxidant activities was assessed by scavenging ability of the linkus on free radical (DPPH; C18H12N5O6) 2,2’-diphenyl-1-picryl hydrazyl. For lipoxygenase measurements, purified lipoxygenase with lionoleic acid as substrate was used for the activity, however for lipoxygenase activity the thiocholine and diothiobisnitrobenzoic acid (DTNB) was used. Indophenol method has been used for determination of urease activity, however the reducing ability has been assessed by the conversion of ferric into ferrous state. In vitro results of linkus syrup as compared to standard showed good anti-oxidant and reducing ability. Moderate activity of urease, lipoxygenase and ACE inhibition were observed with comparison of standard. These activities of polyherbal formulation might be helpful for reducing cough and related symptoms. Key words: Antioxidant activity, reducing ability, urease activity, lipoxygenase and ACE inhibition, linkus.