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Background Pakistan is among 3 countries endemic for wild poliovirus type 1 (WPV1) circulation that are still struggling for eradication of poliomyelitis. Active clinical and environmental surveillance with meticulous laboratory investigations provide insights into poliovirus transmission patterns and genomic diversity to inform decisions for strategic operations required to achieve eradication. Methods We analyzed epidemiological and virological data to comprehend the current epidemiological status of WPV1 in Pakistan during 2015–2017. Stool specimens of patients with acute flaccid paralysis (AFP) and sewage samples collected from 60 environmental sites were tested. Viral culturing, intratypic differentiation by real-time polymerase chain reaction, and nucleic acid sequencing of the VP1 region of the poliovirus genome to determine genetic relatedness among WPV1 strains were applied. Results Poliovirus isolates were grouped into 11 distinct clusters, which had ≥95% nucleotide homology in the VP1 coding region. Most of the poliovirus burden was shared by 3 major reservoirs: Karachi, Peshawar, and Quetta block (64.2% in 2015, 75.4% in 2016, and 76.7% in 2017). Conclusions Environmental surveillance reveals importations and pockets of unimmunized children that dictate intensive target mop-up campaigns to contain poliovirus transmission. A decrease in the number of orphan isolates reflects effective combination of AFP and environmental surveillance in Pakistan. The genetic data reflect sustained transmission within reservoir areas, further expanded by periodic importations to areas of high immunity reflected by immediate termination of imported viruses. Improved immunization coverage with high-quality surveillance is vital for global certification of polio eradication. [ABSTRACT FROM AUTHOR]

The microbial and chemical analysis of illicit drug samples from different areas of Pakistan i.e. Quetta, Karachi, Lahore and Islamabad was conducted in a cross-sectional study at National Institute of Health, Islamabad. The drug samples were confiscated by Anti Narcotics Force (ANF), Pakistan. Microbial analysis was done by estimating bioburden which revealed the presence of gram negative and positive bacteria's, fungus, Streptococcus, Staphylococcus species. Trypton soya agar was used for total aerobic count, MacConkey agar for gram-negative bacteria, Sabouraud dextrose agar for fungus and Vogel-Johnson agar for Streptococcus and Staphylococcus species. Colour tests were applied to identify the drug samples. Qualitative and quantitative analysis of suspected samples of Heroin, morphine, cocaine and acetic anhydride was made by employing different chromatographic techniques i.e. Thin-layer chromatography (TLC) and High-performance liquid chromatography (HPLC). The samples were found to be adulterated with paracetamol, diazepam and Dextromethorphen. Acetic anhydride was adulterated with hydrochloric acid (HCl). There is lack of information providing structured advice on responses to the consequences of illicit drug adulteration. Robust and rehearsed interventions and communication strategies would provide a basis for response for a wide variety of organisations. Research into the usefulness of media warnings about adulteration of illicit drugs is required. [ABSTRACT FROM AUTHOR]

Objective: To analyze pharmacotherapy provided in the hospital for MI indications and outcomes and to assess the protocols that are practiced for MI patients against the AHA and NICE guidelines. Methods: This study was conducted from 23rd July 2022 to 13th December 2022 in Cardiology ward of Lady Reading Hospital (LRH), Peshawar, Khyber Pakhtunkhwa, Pakistan. Patients of Myocardial Infarction (n = 240) admitted to hospital during the said period were included in this work. Results: The results showed that around 77% (185) of male patients suffered from MI as compared to 23% (55) of female patients. In our study only 68% of the patients were kept on aspirin and clopidogrel simultaneously, rest were either only administered aspirin or clopidogrel. The p-value for anti-coagulant and beta-blocker usage was found to be significant as it came out to be less than 0.001 whereas the use of ACE inhibitors was around 0.67, which stated that it was the least important. Conclusion: MI is as emergency that needs the patients follow up and monitoring and their treatment is administered to the latest and most advanced guidelines whether they are AHA or NICE guidelines. For this a thorough study was conducted on admitted patients in cardiac ward with MI and the drugs data was tabulated. Then studied the different internationally accepted guidelines that are followed by the most advanced hospital in the world ranging from Europe to America. The data collected showed that the tertiary care hospital of Peshawar do not follow the latest new guidelines. The practicing doctors administered the drugs that were correct almost half decade ago but now new guidelines have overtaken them which leads to improved patients morbidity and decreased mortality. [ABSTRACT FROM AUTHOR]