Aims: The primary aim of the present research was to provide awareness about the latest trends of drug practices of national athletes of Pakistan for the improvement of their sport performance. Methodology: The samples were national athletes belonging to various sports departments of national level. The athletes were selected using snowball and convenient sampling approaches. The questionnaire employed for the data collection was self-administered. With the optimistic consent of the athletes, 80 questionnaires were dispatched at their home addresses. Therefore, 62 athletes (77.5%) returned the filled questionnaires. The requisite information of all filled questionnaires was coded in SPSS-26 software to get the desired results. Moreover, descriptive statistics through frequencies and percentages was executed to draw the findings and further discussions of the present study. Results: The mean age of the national athletes was noted 34.17 years with 2.8 std. deviation and the age range was found between 30 to 38 years. The descriptive statistics of drug practices by national athletes calculated through occasionally, sometimes and frequently. Majority of the national athletes followed and practiced the trends of drugs while participating in their national games and championships to enhance their sport performance to approach the winning position and get the medals. Conclusion: It was concluded that athletes may not aware the side effects and hazards of these drug practices using anabolic steroids, charas, marijuana, aspirin, cocaine, and heroin. National associations and federations should conduct seminars and awareness workshops for the athletes prior to their participation in sport competitions so that national athletes may save themselves from the side effects and afterwards physical damages.

Background: Mycobacterium Tuberculosis (MTB) is one of the most ancient diseases of mankind. Pulmonary tuberculosis (PTB) is the most common, despite the diagnosis and treatment of TB. Many studies reported, a collaboration between PTB susceptibility. In our research study, we report meantime findings after enrolling 732 of a planned 212 participants. Study Design: A descriptive cross-sectional study. Methods: The study conducted on patients with TB in west India was conducted in the Department of Microbiology, Index Medical College; Indore Madhya Pradesh. Patients suspected of PTB were qualified for screening if their age varied from 25 to 60 years and with both gender, signs and symptoms associated with PTB such as cough for more than 2 weeks, fever, weight loss, chest pain, and abnormal chest X-ray findings in results and cartridge-based nucleic acid amplification test (CBNAAT) positive. All Patients were monitored monthly while they visited in TB and chest clinic for TB treatment. Results: A total of 937 patients were selected for the study. Out of which only 732 patients were enrolled. About 212 patents were positive for CBNAAT and 520 were found negative. The confirmed positive CBNAAT patients do not have a history of tuberculosis. In this study about 21.72% were ZN stain positive, 33.46% were culture positive and 28.96% were CBNAAT positive. Conclusion: The current scenario of traditionally AFB-negative PTB is not sensitive enough to establish the diagnosis of active tuberculosis without CBNAAT. They underdiagnose PTB and over-treat people without PTB.

Introduction: An accurate, specific and precise reverse phase UV spectrophotometric method was developed for the simultaneous estimation of Naproxen and Esomeprazole in tablet dosage form. Naproxen and Esomeprazole tablets were used to relieve the spondylitis, osteoarthritis and rheumatoid arthritis in adults’ juvenile idiopathic arthritis in children. Methods: Simple and accurate UV spectroscopic method was developed using Naproxen and Esomeprazole tablet and results were tabulated. Results and Discussion: The optimum conditions were established for the analysis of the drug. The maximum wavelength of Naproxen (λmax) was found to be 231nm and for Esomeprazole was 301nm respectively. The linearity of the method developed was in the range 10-50 μg/ml for Naproxen and 30-70 μg/ml for Esomeprazole. Calibration curves for Naproxen and Esomeprazole showed a linear relationship among the absorbance and concentration. The line equation observed for Naproxen is Y= 0.0374X + 0.0805 with r² of 0.9936 and for Esomeprazole drug was 0.0377 X+0.0576 with R² of 0.9962 . Validation parameters were performed as per ICH guidelines for all validation parameters like linearity, accuracy, precision, LOD and LOQ. The results of LOD and LOQ were found to be within the range. Conclusion: The proposed method for Naproxen and Esomeprazole was simple, yet sensitive and precise for repeated analysis of Naproxen and esomeprazole in bulk and tablet formulations.

Background: Pelvic floor disorders (PFDs) are a group of common conditions that create a great distress to the lives of many female patients. The role of women health physiotherapy (WHPT) in managing PFDs is crucial. Scarce data in the literature describe the awareness, attitude, and practice of WHPT among female physiotherapists and to the best of our knowledge, none are reported in Saudi Arabia. This paper hypothesizes that female physiotherapists in Saudi Arabia are less motivated to practice WHPT and that being less motivated have led to acquiring a lower level of awareness to the specialty. Additionally, it aims to explore the beliefs of female physiotherapists toward WHPT. Methods: An online questionnaire was distributed among female physiotherapists working in Saudi Arabia. Participants were asked to identify other colleagues to include in the sample. Reliability of the questionnaire was tested using a pilot study. Results: The majority of respondents [75.9%] are specialists and 69.2% reported years of experience ranging from 1 to 5. Around 46.9% of respondents were motivated to practice WHPT and 82.1% agreed that physiotherapy is important in treating PFDs. Additionally, Respondents who were motivated to practice WHPT displayed a significantly higher level of awareness to the specialty and understood the importance of pelvic floor rehabilitation (PFR) as an intervention for PFDs. Conclusions: There is adequate level of awareness of female physiotherapists in Saudi Arabia to WHPT and a great motivation to practice the specialty. The study highlighted the need to organize various educational programs and workshops that focus on WHPT and PFR.

Background: This study sought to determine, in retrospect, the effect of Sacubitril/Valsartan on the echocardiographic and functional class of ambulatory HFrEF patients taking conventional heart failure therapy. Methods: We conducted a retrospective observational single-center cohort of ninety HFrEF patients with NYHA Class II-III attending as an outpatient at a tertiary cardiac care facility between November 2018 and January 2020. Standardized two-dimensional transthoracic echocardiography and functional class evaluation were conducted at baseline and after 03-month of SV treatment. Results: At 03-month follow-up evaluation, SV treatment was found to contribute substantially in reversing the cardiac remodeling of HFrEF patients as evidenced by improvement in LVEF (28.51±5.06 to 36.01±10.63; p < 0.001), LVEDD (57.29±7.99 to 53.14±8.22; p <0.001), and LVESD (46.07±9.49 to 43.20±9.22; p <0.001). Additionally, an improvement in sPAP (34.13±9.49 to 32.46±8.14; p <0.001) was observed along with a significant NYHA functional class recovery (2.76 to 1.89, p < 0.001). Upon gender-based stratification, the data suggested no gender-based differences in reverse remodeling effects of SV; though statistically insignificant, LA (38.51±8.23 to 37.3±5.92 mm) and RV (27.10±5.74 to 26.42±2.81 mm) diameters were observed to reduce only in men. Conclusion: Our study maintained that earlier commencement of SV in parallel with conventional heart failure therapy results in a significant amount of improvement in LVEF, LVEDD, LVESD, and sPAP in HFrEF patients irrespective of their gender. Simultaneously, SV alleviates the heart failure-related morbidity through rapid functional status (NYHA Class) recovery.

Aims: To compare the impact of covid-19 infection and its associated factors among various domains of quality of life (general health (GH), physical health (PH), mental health, and pain). To determine the variation and it’s contributing factors to the quality of life (QoL). To identify the most common persisting symptoms after covid-19 infection. Study Design: Cross-sectional community based online survey. Place and Duration of Study: Community-based online survey done for a period of 6 months (March 2021- September 2021) among patients who recovered from covid-19. Methodology: A validated self-made questionnaire with informed consent was used to gather information on the patient’s demographics (age, gender, educational qualification, occupation, marital status, and risk factors) covid-19 details (vaccination, severity, and hospitalization details), persisting symptoms, andHealth Related Quality of Life (HRQoL). The HRQoL questions with scored options were framed under four domains general health, physical health, mental health, and pain. A convenient sample of 120 participants was included in our study. Results: The median and inter-quartile ranges were used to describe the HRQoL score. For normal data, Multiple Linear Regression (MLR) was used to investigate the relationship between the dependent and independent variables.MLR results demonstrated that risk factors, severity, and length of hospital stay were negatively associated with QoL. For non-normal data, the Kruskal Wallis test (KWT) and Mann Whitney U (MWU) test were used to compare the effect of covid-19 and its associated factors among various domains of HRQoL. KWT and MWT showed that the ability to perform physical activity was highly impaired in most post-covid patients. Cough, myalgia, arthralgia, and headache were the significant persisting symptoms of covid-19, reported by our participants. IBM SPSS software version 28.0 was used for statistical analysis. Conclusion: We conclude that health care intervention is needed to manage persisting symptoms and to improve HRQoL.

Background: Choerospondias axillaris CA, known as lapsi, is a plant with constituents having therapeutic properties. All plant parts including stem, bark, root, leaves, and fruit have medicinal virtues and have had a role in Ethno-medicine since ancient times. Objective:  The present study was designed to investigate the antihyperlipidemic activity of dried powder of Choerospondias axillaris fruits in Wistar albino rats. Methods: The anti-hyperlipidemic effect of methanolic extract of the fruit of Choerospondias axillaris (CA) was tested in a high-fat diet-induced hyperlipidemic rat model. Here, chronic hyperlipidemia was induced by feeding a high-fat diet for 21 days to rats. During the experiment, the rat’s body weight was monitored. At the end of the study, animals among whole groups have been sacrificed and biochemical parameters such as; serum Total Cholesterol, Triglycerides, Low-Density Lipoprotein Cholesterol (LDL-C), Very Low-Density Lipoprotein Cholesterol (VLDL-C), and increase of serum High-Density Lipoprotein Cholesterol (HDL-C) were analysed. Results: The observed extract of Choerospondias axillaris was proven to be safe in the toxicity findings. Treatment with methanolic extract of CA (200 and 400 mg/kg, p.o) significantly reduced the hyperlipidemia i.e., the decline in levels of serum Total Cholesterol, Triglycerides, Low-Density Lipoprotein Cholesterol (LDL-C), Very Low-Density Lipoprotein Cholesterol (VLDL-C), and High-Density Lipoprotein Cholesterol (HDL-C) when compared to vehicle control and standard drug Atorvastatin (10 mg/kg). The result indicates that methanolic extract of the whole plant of Choerospondias axillaris possessed significant antihyperlipidemic activity. Conclusion: After all the investigation it was found that oral administration of Choerospondias axillaris fruit extract at a low dose of 300mg/kg and a high dose of 600mg/kg against the high-fat diet-induced hyperlipidemia and it was found that a high dose was more effective as compared to low dose. The drug was able to suppress the raised parameters.

Objective: The Fast-track surgery for transurethral holmium laser prostatectomy a perioperative nursing research study. Methods: We performed a retrospective analysis of transurethral holmium laser enucleation of the prostate in 89 patients with bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) who were admitted to and treated at our hospital between 2018 and 2019. Measures such as early postoperative feeding and early catheter removal, adequate preoperative preparation, psychological counseling, intraoperative warming, unobstructed lavage, ensuring postoperative sleep, indwelling analgesic pump, and prevention and treatment of postoperative complications, as well as a successful job in postoperative health guidance and discharge guidance, were all implemented, and the extubation was performed, during the perioperative period in which advanced fast track surgery was used. Results: All 89 patients who underwent holmium laser enucleation of the prostate made a full recovery, with only one experiencing post-operative recurrent hyphema, five experiencing post-operative urinary tract infection, and ten experiencing transient and urge urinary incontinence; all were discharged after conservative treatment. Conclusion: Using fast track surgery as a guide for perioperative care of HoLEP surgeries might lessen the number of issues that arise after surgery and help patients get back to normal quicker.

Introduction: Congestive Heart failure (CHF) is a cardiovascular disease harming the physical, social, psychological, emotional, and well-being status of an individual. The interference due to symptoms and signs of heart failure affects QoL (QoL) and leads to depression among the majority of the patients. Objective: To assess the QoL and depression among CHF patients in Pakistan. Methodology: A descriptive cross-sectional study design was used to assess the QoLand depression among CHF patients in Pakistan. The study population included CHF patients greater than 18 years old, both genders visiting public and private Health Care Facilities located in twin cities of Pakistan. QoL was assessed by using SF 36 and KCCQ while HADS (hospital anxiety and depression scale) was used to evaluate the Depression among 382 CHF patients selected using the convenience sampling technique. Data was entered in SPSS version 21 and statistically analyzed. Results: The results highlighted that use of SF-36 showed the lowest scores for QoL in the domain of role physical (8.82, ± 8.23) followed by the domain of role emotional (10.17, ± 8.6) whereas the highest scores were observed in the domain of mental health (67.26, ± 15.67). On the other hand, the results reported that the use of KCCQ-12 highlighted that the lowest scores for QoL were observed in all the domains of QoL i.e. physical limitations (39.98, ± 31.93), symptoms (73.42, ± 27.94), social limitations (43.21, ± 27.78) and QoL (43.32, ± 23.38). Conclusion: The current study concluded that CHF patients had poor QoL and severe depression. Several domains of QoL among CHF patients were compromised including physical limitations, emotional limitations, social functioning, and pain. For the general symptoms scale, shortness of breath and limitation in sleeping posture are the most commonly affected leading to compromised quality of life. Interventions must be designed with a focus on patient counseling tailored to the needs for improving QoL and minimizing depression.

Aims: To evaluate the efficacy of metronidazole monotherapy and modified therapy with metronidazole + nifuroxazidefor the for treatment of a mild form of Clostridium difficile infection (CDI). Study Design: A prospective, randomized, controlled clinical trial. Place and Duration of Study: University of Applied Sciences Tuzla in the period from June 2018 to June 2019. Methodology: Sixty patients were included in the study, divided into two groups. One group received standard therapy (metronidazole) for the treatment of a mild form of CDI, while the other group was treated with modified therapy (metronidazole + nifuroxazide). Subjects with a developed clinical picture and a positive toxin test for Clostridium difficile were surveyed on the day of admission, then on the 4^th, 10^th, 14^th and 30^th days from the start of therapy. The goal of the research was to determine the impact of the modified therapy protocol on the number of stools and the presence of pain compared to standard therapy. Results: The modified therapy with metronidazole + nifuroxazide showed better pharmacological efficacy in the treatment of CDI compared to the standard therapy with metronidazole alone. The group of subjects who were treated with modified therapy reported a significantly lower number of stools (P=.001) and the absence of pain at the first and second check-ups. Conclusion: Nifuroxazide and metronidazole represent a combination of drugs that reduce the number of stools in the shortest possible time and result in the absence of abdominal pain in patients diagnosed with a mild form of CDI.