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Abstract Introduction In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists’ resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic. Methods A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS. Results A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = − 0.33; p

Hypertriglyceridemia is an independent risk factor of coronary heart disease (as established through various previously conducted studies) and it's rising incidence is creating a need for the immediate attention of it's management. Instead of focusing on the controversies involving the toxicity caused due to the long-term use of statin therapy in conventional mode of treatment, opting for a safer alternative system of treatment seems important. Five cases of diagnosed HTG, with triglyceride levels above 200 were treated with homoeopathic medicine - Fucus vesiculosus, in mother tincture form. The primary outcome measure was to evaluate the reduction in the blood triglyceride levels. All the five cases showed a reduction in triglyceride levels to normal range within 4 months of starting the treatment with the Fucus vesiculosus mother tincture. Also, it was observed that the borderline cholesterol levels and high LDL levels in 2 cases were found to reduce to normal. Treatment involving Fucus vesiculosus in cases diagnosed with HTG showed significant reduction in triglyceride levels along with other parameters of lipid profile. Further authentication of results with significant sample sizes may be taken up.

Abstract Data on comprehensive population-based surveillance of antimicrobial resistance is lacking. In low- and middle-income countries, the challenges are high due to weak laboratory capacity, poor health systems governance, lack of health information systems, and limited resources. Developing countries struggle with political and social dilemma, and bear a high health and economic burden of communicable diseases. Available data are fragmented and lack representativeness which limits their use to advice health policy makers and orientate the efficient allocation of funding and financial resources on programs to mitigate resistance. Low-quality data means soaring rates of antimicrobial resistance and the inability to track and map the spread of resistance, detect early outbreaks, and set national health policy to tackle resistance. Here, we review the barriers and limitations of conducting effective antimicrobial resistance surveillance, and we highlight multiple incremental approaches that may offer opportunities to strengthen population-based surveillance if tailored to the context of each country.

Background: Open-flap debridement therapy often leads to frequent pain postoperatively. It has been reported that open-flap debridement causes pain in 79% of patients. The preemptive approach focuses on preventing post-operative analgesic flare and blocking the occurrence of hyperalgesic states. This study aimed to compare the preemptive analgesia of oral celecoxib with oral acetaminophen after surgical open-flap debridement. Materials and Methods: A randomised, double-blinded, placebo-controlled research was conducted to study the patients presenting with an open-flap debridement under local anaesthesia. A total of forty patients were randomised to receive open-flap debridement, and either celecoxib or acetaminophen was prescribed. Visual analogue scale (VAS) pain score was noted every 2, 4, 6, 8, 10 12 and 20 h post-surgery. Consumption of analgesics was also recorded postoperatively. Results: The average age and weight of the patients in the celecoxib group were 35.85 ± 8.32 and 54.75 ± 8.90 kg, respectively. The average age and weight of the patients in the acetaminophen group were 36.8 ± 8.71 and 53.15 ± 9.90 kg, respectively. The mean VAS pain score at 4 h was 2.6 ± 1.14 and 4.9 ± 1.20 for celecoxib and acetaminophen groups, respectively. The mean post-operative analgesic drug consumption in the celecoxib group was 0.60 ± 0.87 and 1.30 ± 0.80 in the acetaminophen group. Conclusion: Celecoxib shows a significant preemptive analgesic effect, thereby reducing the use of post-surgical analgesics after open-flap debridement. Hence, pre-surgical single dose of celecoxib can be used to minimise the post-operative analgesic use.

Background: This is the first study showing the co-relationship of apelin among chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). CP has an anti-inflammatory and anti-glycaemic role in our system. In the future, a localised therapeutic dose of apelin can be used to lower the severity of periodontal disease by reducing the inflammation. The objective of the present study is to investigate the levels of serum apelin from patients with CP, CP + T2DM, and healthy individuals. Materials and Methods: This study included 180 individuals that were equally divided into three groups. Group A consisted of healthy individuals, Group B with CP, and Group C with CP + T2DM. Probing pocket depth (PPD) and serum Apelin (AP) were measured. Serum apelin expression was determined using enzyme-linked immunosorbent assay. Statistical analysis was performed using SPSS software. Results: The highest apelin was in CP + T2DM group (24.0 ± 3.78 ng/dl) followed by CP (15.4 ± 2.01 ng/dl) and healthy individuals (7.6 ± 1.18 ng/dl). There was a significant increase in serum apelin (P ≤ 0.05) in Group C individuals. Similarly, PPD was significantly increased in individuals with CP + T2DM. Conclusion: Expression of significant apelin in patients with CP and T2DM suggests a possible role for these adipokines in inflammation and glucose level regulation. In the future, it may be used as a therapeutic agent in curing periodontitis.

Being a fast-growing city with a high rate of urbanization and agricultural development, the city of Najran, situated in the southwest of the Kingdom of Saudi Arabia, has witnessed a series of earth fissuring events and some other geo-environmental hazards in recent times. These fissures have posed a significant threat to inhabitants and infrastructure in the area. A few studies suggest that excessive groundwater withdrawal is responsible for fissuring activities. Because of the intensity of this geo-hazard, this article presupposes that groundwater extraction alone cannot be responsible for the magnitude of fissuring activity in the area and discusses other severe factors that could be responsible for the earth fissures. The study proposes that the cause of the problem is multifaceted and synergistic, and outlines threatening factors that can inherently trigger more fissures in the region, based on the geologic history of the area and a critical review of investigative studies conducted in the area and beyond. Predicated on the region's structural history, some undiscovered elements that can potentially cause fissuring in the region were identified and discussed. Some of these include the pre-existence of a fault system, a crack from the bedrock ridge, the existence of paleochannels, the collapsibility of loess, the tectonic (earthquake) history of the area, and differential compaction due to heterogeneity. The use of a metaheuristic and a combined application integrating other optimization algorithms can be utilized to determine optimum hyperparameters and present their statistical importance, thereby improving accuracy and dependability in fissure prediction in Najran. Reliable models would primarily be used to monitor active fissures and identify key factors utilizing spatial information, subsidence, groundwater-related data sets, etc. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pain is a universal phenomenon and usually under treated and its intensity varies widely among patients. Spinal anaesthesia with opioid and local anaesthetics to prolong postoperative analgesia is common practice in recent years. Buprenorphine is an agonist - antagonist opioid. Intrathecal buprenorphine (30-150 μg) along with local anaesthetics is safe and known to increase the postoperative analgesia without affecting sensory or motor blockade and with lesser side effects. Aim: To compare the anaesthetic characteristics and its side effects in subarachnoid block with bupivacaine 0.5% heavy and varying dose of buprenorphine (90 μg and 120 μg). Materials and Methods: This randomised control study was conducted in the Jhalawar Medical College, Jhalawar, Rajasthan, India, from March 2019 to November 2019. The study included 90 patients belonging to American Society of Anaesthesiologists (ASA) class I and II of either sex age between 18 to 60 years posted for elective lower limb orthopaedic surgeries. The patients were divided into three groups; group A which included a patient count of 30 received plain hyperbaric bupivacaine 0.5% (2.5mL) with 0.5 mL saline. Group B which included 30 patients, receive plain hyperbaric bupivacaine 0.5% (2.5 mL) along with buprenorphine 90 μg diluted in 0.5 mL saline. Group C with a patient count of 30 received hyperbaric bupivacaine 0.5% (2.5 mL) with buprenorphine 120 μg mixed with 0.5 mL saline. Analgesic characteristics, haemodynamic parameters, side effects, sedation scores by Ramsay sedation score and pain scores by Visual Analogue Score (VAS) (0-10) were measured postoperatively till 24 hours. Statistical analyses of data were done by one Way Analysis of Variance (ANOVA) test and chisquare test where p-value less than 0.05 was considered to be a statistically significant value. Results: The onset time of sensory blockade (group A: 5.14±1.34, group B: 4.54±1.10, group C: 4.50±1.18 in minutes), time of onset of motor blockade (group A: 10.10±1.00, group B: 9.43±1.30, group C: 9.21±1.49 in minutes) and maximum level of sensory block at T6 level (group A: n-01/30, group B: n-04/30, group C: n-04/30) were comparable between the three groups and were not statistically significant. Sensory recovery time was significantly (p<0.0001) delayed in group B and C (178.9±7.18 min and 189.23±7.4), while in group A it was 152.86±8.9 min. Duration of postoperative analgesia was significantly (p<0.0001) prolonged in group C (group A 165.53±8.5, group B 391.49±19.8, group C 493.23±18 in minutes). Side-effects like Postoperative Nausea and Vomiting (PONV) and sedation were increased with dose of buprenorphine but easily treatable and not significant (p>0.05). Conclusion: A higher dose of buprenorphine shows to provide an adequate and longer postoperative analgesia without any major side effects. [ABSTRACT FROM AUTHOR]