Atif Ali

Antiepileptic drugs (AED) are progressively utilized for off-label conditions other than epilepsy, like bipolar disorder and migraine. The objective of this study was to evaluate current prescribing patterns and utilization of AED in pediatric, neurosurgery, and psychiatry wards and to compare them to the standard treatment guidelines. A descriptive, cross-sectional study was conducted in Ayyub Teaching Hospital, Abbottabad from December 1st, 2018 to April 2019. Data on demographic and clinical characteristics, utilization patterns of AED, adherence to standard treatment guidelines, and frequency of potential drug–drug interactions were analyzed using descriptive statistics. Among 410 patients, 54.3% (n = 223) were male, 45.6%(n = 187) were female, and 63.7% (n = 261) were from the 1 to 18 years’ age group. The majority 47.3% (n = 194) were from the pediatric ward followed by neurosurgery 28.7%(n = 118). Among the studied patients, 96.1% of them had comorbid conditions other than epilepsy alone. With regards to types of seizures unclassified seizures were the most common seizure type (59.8%; n = 245) followed by generalized tonic clonic seizures 23.4% (n = 96). In this study, the most frequently utilized AED was sodium valproate 59.0% (n = 242) followed by antiepileptic first-generation medicines were commonly used (76.3%). Although a total of 77.6% of the patients showed nonadherence to National Institute for Health and Care Excellence guidelines and 87.6% of them showed drug interactions. Findings from this study showed prescription patterns and utilization of AED in patients with epilepsy and non-epilepsy disorders which may help healthcare providers in making accurate clinical decisions.

Honey is a viscous, hygroscopic liquid in nature. It has the ability to treat wounds, wrinkles, aging, and inflammation. This study’s objective was to create and characterize a nanoemulsion containing honey and evaluate its stability.

The aim of this work was to assess the effects of typical and optimal use of sunscreens in photosensitivity under UV exposure during the COVID-19 pandemic. First, a cross-sectional study was conducted among 384 participants to find out about photosensitivity in COVID-19 pandemic using a validated questionnaire involving demographic characteristics and Fitzpatrick skin type to measure skin phototypes that also included information about skin reactions upon sun exposure, the incidence of photosensitivity, and photoprotection behaviour. It was further extended by finding photosensitivity among 200 medical staff and patients that were recovered from COVID-19 infection. Next, the study involved 22 participants in two groups: optimal use with 2 mg per cm ² sunscreen and typical use for 7 days. The sunscreen used was an SPF 50+ product with various ingredients. Instrumental measurements were taken at baseline and 7th day visits to quantify skin melanin and erythema values. 54.9 % of participants had a history of photosensitivity, skin redness after sun exposure (38.0 %), skin protection (74.2 %), always using sunscreen (21.1 %), and applying sunscreen twice a day (12.2 %). A significant association between age, photoprotection behaviour, and photosensitivity was found. The incidence rate of photosensitivity in the population was 90/1000. 63.5 % of the participants agreed to specific skin related manifestations of COVID-19; preventive measures for COVID-19 infection made their skin sensitive (65 %); enhanced photosensitivity of the skin after taking preventive measures (53.5 %); use of hand sanitizers made their skin sensitive (63.5 %); and use of sunscreens was helpful in treating photosensitivity (58.5 %). In addition, there was a decrease in skin melanin and erythema values with optimal use of sunscreen and an increase in skin melanin and erythema values with typical use of sunscreen. When the paired sample t test was applied, the result was found to be significant. It was determined that the COVID-19 pandemic had a high incidence of photosensitivity. Skin sensitivity was increased by using hand sanitizers. Additionally, it is important to prioritise using sunscreen optimally to avoid skin photosensitization. More work on large numbers of participants of different populations in various regions is required in the direction of population guidance.

In the current study, the solubility and permeability of Osthole-loaded microemulsion were enhanced, which increased bioavailability. In addition, Carbomer 940 was added for prolonged drug delivery. The microemulsion was prepared after the screening of Kukui oil, Labrasol (surfactant), and transcutol-P (co-surfactant). Pseudoternary phase diagrams were employed to find the microemulsion region. Box Behnken Design (BBD) was employed for optimizing microemulsions. Variables were related and compared using mathematical equations and response surface plots (RSP). MEBG was then compared with control gel on the basis of stability studies, drug permeation, skin irritation studies, and anti-inflammatory studies. Microemulsion preparations depicted a pH of 5.27 - 5.80, a conductivity of 139 - 185 μS/cm, a poly-dispersity index of 0.116 - 0.388, a refractive index of 1.330 - 1.427, an average droplet size of 64 - 89 nm, homogeneity, spherical shape, viscosity 52 - 185 cP. Predicted values of Optimized microemulsions showed more reasonable agreement than experimental values. The microemulsion was stable and non-irritating on Rabbit skin. MEBG showed a significant difference from control gel for percent edema inhibition from the standard. The permeation enhancing capability of MEBG using a suitable viscosity fabricates it promising carrier for transdermal delivery of Osthole.

Although Mangifera indica L. extract (M-Ext) of the peel and kernel possesses potent antioxidant and excellent antiaging qualities, the effects are only partially seen because of the skin’s limited ability to absorb it. M-Ext was loaded into nanolipid carriers (M-NLCs) in this work to create a green topical formulation that would boost antiaging efficacy and address penetration deficit. Compound identification was done using GCMS and atomic absorption spectroscopy for heavy metals in M-Ext. M-Ext was also evaluated against oxidative stress antioxidant enzymes. The M-NLCs were fabricated and evaluated for their physicochemical characterizations. Cytotoxicity and cell permeation analysis of M-Ext and M-NLCs were carried out in fibroblasts and HaCaT cell lines. An ex vivo permeation study of M-Ext and M-NLC-loaded emulsion was performed through rat skin and the kinetic parameters were determined. Kinetic data showed that the ex vivo permeation of M-NLC-loaded emulsion through rat skin followed the Higuchi model. The safety profile was evaluated in human volunteers after written consent. Three months’ in vivo investigations were conducted using the optimized M-NLC-loaded emulsion and vehicle (B-NLC-loaded emulsion) on human cheeks for comparison. The volunteers’ skin erythema level, melanin contents, TEWL index, moisture contents, sebum level, elasticity, pH, and pore size were examined after the first, second, and third month via noninvasive techniques. There were significant findings for physicochemical characterizations and in vitro and ex vivo studies. The findings demonstrate that the green nanolipid carriers amplified the overall antioxidant effectiveness and may represent an emerging treatment strategy for oxidative stresses and aging.

Continuous contact of air pollutants on human skin has produced early ageing and led to roughness, dryness, poor elasticity, increased wrinkling and irregular pigmentation of the skin. The present study was carried out to fabricate an anti-pollution cosmetic-based w/o/w multiple emulsion containing D-biotin, prepared by a one-step formation as protection for the skin against the effects of air pollutants and further used for in vitro and in vivo evaluation. A similar multiple emulsion without D-biotin was also prepared in the same way. Each of the tested multiple emulsions (CB2 and CF2) was applied to the cheeks of 15 human volunteers for a testing period of 90 days. Both emulsions were assessed for skin melanin, erythema, hydration and elasticity values. The droplet sizes of CB2 and CF2 stored in the dark were 10.92 ± 0.23 and 15.4 ± 0.12 μm, respectively. The size distributions of CB2 and CF2 ranged from 4.55 ± 0.1 to 26.056 ± 0.34 μm and from 1.97.16 ± 1.2 to 45.13 ± 2.17 μm, respectively. The rheological parameters showed non-Newtonian, pseudo-plastic and shear thinning behaviour, while pH remained within an acceptable range. No considerable physical changes were observed. The skin irritation testing indicated that CB2 and CF2 were safe after application and did not cause any skin irritation. The skin melanin, erythema, moisture and elasticity values of both the right and left cheeks of the volunteers were measured at baseline visits: 15, 30, 45, 60, 75 and 90 days of time intervals. While CB2 showed insignificant effects, therefore, it was demonstrated that CF2 decreased skin erythema content and increased skin elasticity and hydration significantly but had an insignificant effect on skin melanin content with respect to time. Good sensory attributes were also achieved. Therefore, CF2 is a promising new approach for protection of the skin from the deleterious effects of air pollutants.

Because of the potential of significant geographic variation in the compositions of snake venoms, much insight can be gained by examining individuals originating from diverse locations, and detailed characterization of any species can only be done by including animals from the entire range. Pakistani N. naja (formerly N. naja karachiensis) venom was decomplexed by applying diverse techniques and found a concoction of proteins (a total of 43 venomous proteins comprising 11 super families) from 6 to 200 kilodaltons in size. Among them three finger toxins (58%), phosphoplipses A₂ (19%), snake venom metalloproteinases (5%), l-amino acid oxidases (5%), helvepryns (3%), vespryns (2%), cobra venom factor (2%), 5′-nucleotidases (2%), venom nerve growth factor (2%), and Kunitz type serine protease inhibitor (2%) were included. It is the first report that this venom possesses significantly higher percentage of three finger toxins belonging to the cytotoxins (32% overall) and α‐neurotoxins (32% overall, predominately long chain neurotoxins, 24% overall) compared to N. naja from other geographic locations. Better understanding of intraspecific variations in venom can improve the development of location-specific anti-venoms. Furthermore, this pool of diverse toxins could potentially be a source of novel drug candidates for the treatment of muscarinic acetylcholine receptors mediated nervous disorders.

The skin is fortified with a setup of lipophilic and hydrophilic, enzymatic and non-enzymatic antioxidant systems. Ascorbyl palmitate (AP) and sodium ascorbyl phosphate (SAP) are reported as lipophilic and hydrophilic antioxidants, respectively used for skin care. Present study was aimed to assess the combined AP (in oil phase) and SAP (in aqueous phase) via multiple emulsion (ME₁) for controlling sebum secretions in healthy human females. FTIR analysis of AP and SAP was performed for identification. Multiple emulsions (ME₁ and control) were prepared and analyzed for physical stability. Antioxidant activities of AP, SAP as well as ME₁ (with combination of these compounds) were determined by DPPH method. 11 female volunteers were included in a single-blinded, placebo-controlled, split-face comparative study. Volunteers were instructed to apply ME₁ on left cheek while control (without AP and SAP) on right cheek, for a period of 90 days. A non-invasive photometric device (Sebumeter^®) was used for the measurement of sebum secretions on both sides of the face with subsequent time intervals. A good antioxidant activity of ME₁ was observed. ME₁ treatments reduced significant facial sebum secretions as compared with control/placebo treatments. It was concluded that combined AP and SAP supplementations to skin proved a promising choice for controlling facial sebum secretions and could be evaluated for undesired oily skin and acne reductions for beautifying the facial appearance.

Purpose: To explore the prevalence of risk factors for coronary artery disease (CAD) in Southern Punjab, Pakistan. Methods: A cross-sectional survey was conducted for the prevalence of risk factors for CAD among 200 patients admitted at the different hospitals of Southern Punjab, Pakistan from December 2012 to April 2013. A questionnaire was used to collect data, including demographic information, family health history, dietary habits, physical activity and tobacco use. History of hypertension, diabetes mellitus (DM) or its treatment was recorded after observing their medical reports. Results: The proportion of females and males was 65.53 and 34.46 %, respectively. Of the 200 patients, the mean age of males was 52.7 years and 55.8 years for females. The most prevalent coronary artery risk factors were physical inactivity (52.5 %), hypertension (52 %), poor dietary habits (48.5 %), fatty food consumption (47.5 %), obesity (38 %) and smoking (37 %), respectively. Other less common risk factors were diabetes (30 %) and family history of CAD (20 %). Conclusion: CAD was seen in only 20 % of the subjects; the prevalence of individual risk factors ranged from 30 to 52.5 % and can be improved by encouraging the patients to adopt a healthy life style. Keywords: Risk factors, Prevalence, Coronary artery disease, Diabetes, Southern Punjab

Symptoms-Based Evaluation of Iron Deficiency Anemia in Students of Bahawalpur Correlated with their Eating Habits