RESUMEN
Non-celiac gluten sensitivity [NCGS] is a wheat associated disorder diagnosed by exclusion diagnosis. This review was conducted to collect current information about NCGS, clinical and pathologic manifestations, and problems faced by health professionals. It also highlights the obstacles faced when adopting a gluten-free diet. A search of international literature was conducted through PubMed and Google Scholar till September 2017. The heterogeneous groups of patients affected by NCGS are composed of a number of subgroups, and each demonstrates different clinical and pathological manifestations. The presence of certain underlying factors can be utilised to identify susceptible individuals, namely, incidence of food allergies in infancy, anti-gliadin IgG-antibodies, activation test for flow cytometric basophils, atopy, and increased intraepithelial duodenal eosinophil presence. There is urgent need for reliable biomarkers to decisively diagnose and differentiate NCGS from related disorders. Patients willing to adopt gluten-free products have to choose from products which have high fat and sugar content
RESUMEN
Clinical pharmacists should be increasingly important members of the healthcare team in developing countries such as Pakistan. Survey of literature was conducted to identify the determinants of clinical pharmacy in Pakistan. Lack of trained human capital, shortage of resources, patient overburden, inefficient pharmacy education curriculum, and limited job opportunities are some of the determinants of clinical pharmacy profession in developing countries. The underutilization of clinical pharmacists paves the way for an increased incidence of medication errors, adverse drug events, irrational prescribing, and suboptimal therapeutic outcomes. Integration mapping is an important framework for providing guidelines in protocol planning for improvement in a profession. A step by step change is required to promote the growth of clinical pharmacy profession in Pakistan