Consumption of proton pump inhibitors in outpatients of Gastroenterology Clinics in Khyber Pakhtunkhwa: evidence of inexpedient use.

Introduction: Proton pump inhibitors (PPIs) are effective drugs used for multiple gastrointestinal complications. They are commonly used in both hospitalised and outpatients. However, little is known about its utilisation pattern in ambulatory patients. Aim: To evaluate the inexpedient continuous use of PPIs in patients with respect to treatment duration. Material and methods: A cross-sectional observational study was conducted from January 2018 to November 2019 in Khyber Pakhtunkhwa, Pakistan. Regular proton pump inhibitor users were identified through patient histories. Results: During the study period, 171 patients were included using a non-probability consecutive sampling technique, who were using regular proton pump inhibitors for a longer duration, i.e. from 3 months to 15 years. The highest proportion (42.8%) were using PPI regularly from 3 months to 1 year followed by 22.9% for 1-2 years, 12.0% for 2-3 years, 7.8% for 3-4 years, 4.2% for 4-5 years, and 10.24% for > 5 years. Omeprazole and esomeprazole were the most commonly used drugs, with 71.1% and 23.5% prevalence, respectively. A total of 33.73% of patients had continued PPI use on their own after initially being prescribed by the physician. Conclusions: It can be deduced that PPIs are used in outpatients beyond standard treatment guidelines. The inexpedient continuous use of proton pump inhibitors is of concern due to the risk of developing adverse effects. Therefore, patient counselling and periodic monitoring must be carried out to prevent the irrational use of PPIs.

Artificial intelligence and social media on academic performance and mental well-being: Student perceptions of positive impact in the age of smart learning.

The advancement of artificial intelligence (AI) and the ubiquity of social media have become transformative agents in contemporary educational ecosystems. The spotlight of this inquiry focuses on the nexus between AI and social media usage in relation to academic performance and mental well-being, and the role of smart learning in facilitating these relationships. Using partial least squares-structural equation modeling (PLS-SEM) on a sample of 401 Chinese university students. The study results reveal that both AI and social media have a positive impact on academic performance and mental well-being among university students. Furthermore, smart learning serves as a positive mediating variable, amplifying the beneficial effects of AI and social media on both academic performance and mental well-being. These revelations contribute to the discourse on technology-enhanced education, showing that embracing AI and social media can have a positive impact on student performance and well-being.

Questionnaire-Based Study of 392 Women in Abbottabad, Pakistan, to Evaluate the Types of Cosmetic Products Purchased Between December 2018 and March 2019 and Their Associated Adverse Events.

BACKGROUND Cosmetics are applied topically to enhance appearance and are commonly used by women of all ages. Cosmetics contain many chemical agents, but the incidence of adverse reactions is low, possibly due to underreporting. This questionnaire-based study included 392 women to evaluate information on the types of cosmetics purchased between December 2018 and March 2019, their use by the women surveyed, and their associated adverse events. MATERIAL AND METHODS A cross-sectional study was conducted among 392 women in Abbottabad, Pakistan, using a pre-structured and validated questionnaire to evaluate information on the types of cosmetics, their use, and their associated adverse events. Part 1 of the study collected information about demographics. Part 2 contained a total of 11 items, and collected the frequency of use of cosmetic on skin and hair care products. Part 3 consisted of 4 items and collected information about problems encountered due to the use of cosmetics. RESULTS In the winter season, 47.7% (n=187) of women preferred chemical-based cosmetic products, while 30.9% (n=121) preferred Ayurvedic products. Among commonly used cosmetic products, 26.9% (n=106) of women used foundations. The most frequently used skin care product was face wash 39.5% (n=155). The most prevalent adverse events related to cosmetics were pimples (19.9%, n=78), redness (17.6%, n=69), and eye discomfort (15.8%, n=62). Furthermore, 51.3% (n=201) strongly agreed that cosmetics aid in getting a whiter complexion. CONCLUSIONS The survey concluded that most women preferred cosmetics with a chemical base, which are associated with rashes, redness, and acne. It is important to encourage cosmetovigilance and awareness campaigns among cosmetic product sellers and users.

Effects of long-term proton pump inhibitor use on sexual hormones and sexual and reproductive health in female patients.

PURPOSE: Proton pump inhibitors (PPIs) are widely used to treat a range of gastrointestinal diseases around the world. Long-term use of PPIs has been associated to a variety of undesirable effects. Although short-term therapy has been shown to have little or no effect on endocrine hormone in women, however, its long-term safety has received little attention. We aimed at evaluating long-term use of PPIs and its effects on female reproductive hormones as well as related clinical consequences. METHODS: A cross-sectional study was conducted in two outpatient gastroenterology clinics in the province of Khyber Pakhtunkhwa. This study included female patients who had been using PPIs on a regular basis for 3 months or more. RESULTS: In total of 101 participants, patients with sexual complaints have significantly altered levels of prolactin (p = 0.05), estrogen (p < 0.001) and progesterone (p = 0.001) than patient without sexual complaints. The frequency of amenorrhea (p < 0.001), cyclic disturbances (p < 0.001), breast augmentation (p = 0.001) and painful breast (p = 0.004) were statistically significant in patients with raised serum prolactin values. Serum values of Sex hormone binding globulin SHBG (p < 0.001), estradiol (p = 0.002) and total testosterone (p < 0.001) were significantly altered between normal prolactin and hyperprolactinemic patients. CONCLUSION: These findings suggest that long-term PPI use may cause endocrine hormone disturbances leading to sexual difficulties in women.

From industrialization to dehumanization: understanding the deriving forces of environment and implications for sustainable development.

Environment has detrimental effects on economic activity and human survival. Climate change is increasingly conducive to natural disasters, epidemics, social conflicts, food security, financial shocks, economic hardships, and life subsistence. In pursuit of this issue, this study empirically investigates the effects in outcome variable CO2 provoked by independent variables governance, technological innovation, renewable energy, economic growth, and economic policy uncertainty in APEC economies. The APEC region accounts for 60% of global emissions, 62% of world GDP, 48% of global trade and contribute 8.7% renewable energy annually. A dynamic panel PMG-ARDL model is applied under the assumption of maximum likelihood estimation with DH causality and CS-ARDL for the period of 1996-2020. Our empirical results confirm that governance, technology innovation, and transitional energy have significant and positive effect to mitigate CO2 emissions. The region needs to design policy mechanisms supportive to promote institutional quality, enhances transparency, ensure political stability and rule of law. It develops the infrastructure that ensures the adaptation of technology innovations, promotes green growth, improves energy efficiency, and implements carbon pricing mechanism. Economic policy uncertainty has insignificant and positive effects on environmental degradation. The findings show that governance, technological development, and transitional energy have an essential role to mitigate CO2 emissions and achieve sustainable development. Moreover, this study will be helpful in understanding the implications of SDGs and achieving specific targets such as (SDG-7: Clean energy sources) and (SDG-8: Sustainable development goal) based on the largest set of emitters APEC.

The Impact of Contemporary Antiretroviral Drugs on Atherosclerosis and Its Complications in People Living With HIV: A Systematic Review.

With the advent of modern antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has been modified into a chronic manageable condition, prolonging the lifespan of people living with HIV (PLHIV). This has resulted in an increased non-AIDS-related morbidity in the HIV-infected population. Our aim is to study the role of contemporary ART in tackling the risk of atherosclerosis and cardiovascular disease (CVD) in PLHIV. We searched through the databases of PubMed, PubMed Central, and Cochrane Library for pertinent articles using the medical subject headings (MeSH) "HIV infection", "Atherosclerosis", and "Antiretroviral agents". The articles published in the past five years were retrieved, screened for relevance, and assessed for quality before being included in the review. This review was performed following the PRISMA 2020 guidelines. The results indicate that the incidence of dyslipidemia with integrase strand transfer inhibitors (INSTIs) is greater than with non-nucleoside reverse transcriptase inhibitors (NNRTIs) and lesser than with protease inhibitors (PIs). INSTIs are indispensably associated with weight gain and obesity. High triglyceride (TG) and oxidized low-density lipoproteins to low-density lipoproteins (oxLDL/LDL) ratio levels and low high-density lipoprotein (HDL) levels are seen in patients taking PIs. A higher incidence of hypertension and metabolic syndrome (MetS) was noticed with INSTIs compared to NNRTIs. PI intake for >5 years increases the risk of subclinical atherosclerosis. Increased risk of myocardial infarction with INSTIs was observed in a study, while another study reported decreased risk. HIV infection independently increases the risk for atherosclerosis and CVD. Although contemporary ART decreases this enhanced risk, it inherently increases the risk for abnormal lipid profile, MetS, weight gain, and obesity. Further research into the risk of atherosclerosis and CVD with newer ART drugs is essential for decoding the underlying mechanisms and preventing adverse cardiac outcomes in PLHIV.

Multiband antenna design with enhanced radiations using characteristic mode analysis.

In this research, a multiband patch antenna design based on the superposition of multiple modes at the same resonant frequency is presented. The concept of the contribution of lower order modes (LOMs) with the higher order dominant modes (HODMs) is investigated using characteristic mode analysis (CMA). In order to provide similar broadside radiations in three bands, the radiating capability of the LOMs is enhanced in the resonant frequencies of HODMs. These HODMs when excited alone provide null in the broadside radiations of the antenna. Using a single feed, enhancement in the broadside radiations of the antenna is achieved with the superposition of multiple modes at the same resonant frequency. Based on the proposed concept two antennas have been designed and fabricated. The antenna provides stable and enhanced radiations. simulated and measured results are in good agreement. These antennas find application in many applications including communication systems, base station antennas, 5G communications, satellite communication etc.

Investigation of CeO2 nanoparticles on the performance enhancement of InsulatingOils.

Integrating nanotechnology in dielectric fluid significantly inhibits losses and boosts overall dielectric fluid performance. There has been research done on the effects of introducing various nanoparticles, such as titania, alumina, silica nanodiamonds, etc. In this paper, a novel nanoparticle, Ceria (CeO2), has been used, and its properties were examined using the FTIR (Fourier Transform Infrared) spectrum, the XRD (X-ray Diffraction) spectrum, the SEM (Scanning Electron Microscopy), and the TEM (Transmission Electron Microscopy). This paper illustrates an efficient dielectric fluid prepared by the successful dispersion of Cerium Oxide (CeO2) nanoparticles in various concentrations into four commercial oils, namely mineral oil, rapeseed oil, synthetic ester oil, and soybean oil, to enhance and improve their dielectric characteristics. The performance investigation emphasises breakdown strength enhancement and other dielectric properties of the colloidal solution comprising different nanoparticle (NP) concentrations. Various commercial oils are used as a base in nano-oil to diversify their applicability as dielectric fluids by measuring the correlation in dielectric parameters and statistically assessing their applicability with normal and Weibull distributions. The obtained experimental data sets were analyzed using the Statistics and Machine Learning Toolbox in MATLAB. The aging measurement has been done only on mineral oil, and results were matched using a predictive model of statistics and the Machine Learning Toolbox in MATLAB. Well-dispersed CeO2 NPs in the insulating oils lead to a significant increase in AC breakdown strength. The effect of ageing on the dielectric properties of nano oils yields better results than conventionally aged oil. It has been observed that the breakdown voltage is enhanced by up to 30% for mineral oil at an optimal concentration of 0.01 g/L, 9% for synthetic ester oil at 0.03 g/L, 18% for rapeseed oil at 0.02 g/L, and 19% for soybean oil at 0.03 g/L nanoparticle concentration. Following the dispersion of CeO2 nanoparticles, the dielectric constant of all insulating oils has also significantly improved. The overall experimental results are promising and show the potential of the CeO2 NPs-based nano oil as an efficient and highly performing dielectric oil for different power applications.

Potential drug-drug interactions in patients presenting with osteoarthritis to community orthopaedic clinics of Abbottabad, Khyber Pakhtunkhwa: A cross-sectional study.

OBJECTIVES: Osteoarthritis (OA) causes long-term pain and disorders of lower extremities. Paracetamol is the drug of choice; however, NSAIDs, opioids and steroids are frequently employed in the symptomatic relief of OA. The prescribing of multiple analgesics leads to potential drug-drug interactions (pDDIs). The primary objective of this study was to identify the prevalence and predictors of pDDIs in OA. MATERIALS AND METHODS: A total of three hundred and eighty-six patients, either newly diagnosed or with a history of OA, were enrolled for this cross-sectional study. Data regarding patients' demographics, clinical characteristics and prescribed medications were recorded from the prescriptions and examined for the pDDIs using Medscape multidrug interaction checker. RESULTS: Among 386, most patients were females (53.4%). The most prevalent diagnoses were knee OA (39.7%) and unspecified OA (31.3%). Paracetamol and topical NSAIDs were underprescribed whereas an oral NSAID, Diclofenac, was the most frequently used drug in OA. Total of 109 pDDIs were found in 386 prescriptions, of which 63.3% DDIs were categorised as moderate, followed by minor (34.9%) and major (1.8%). CONCLUSIONS: This study finds a prevalence of DDIs and polypharmacy among the OA patients. Collaborative efforts among healthcare providers, pharmacists, and patients themselves are essential to optimize medication regimens and minimize the polypharmacy including the associated risks as well as DDIs.

From COVID to conflict: Understanding the deriving forces of environment and implications for natural resources.

In the contemporary world, the importance of natural resources is increasing day by day especially due to extraordinary circumstances, i.e., COVID-19 and global conflicts. The abundance of natural resource is considered competitive advantage and crucial for sustainable development. However, the role of natural resources can be questionable especially if its impact on the economy is negative. Sustainable use of natural resources is currently the biggest challenge for governance. Following these footprints, the study aims to revisit a novel perspective of natural resources in the context of global conflicts using data from Asian economies for the period of 1996-2020. In this pursuit, this study investigates how governance balances macroeconomic variables with sustainable development to account for effective climate change adaptation, mitigation efforts and integral to control conflicts. The second-generation test of CIPS and CADF are used to deal with cross-sectional dependence issues and Westerlund cointegration to estimate long-run relationships. Furthermore, the long-run coefficients are estimated by the PMG estimator using dynamic panel ARDL approach. The findings confirm that surpassing the threshold level of governance is essential to promote environmental quality and preservation of natural resources. The region needs to promote steward policy for resources. This can take the form of nationalizing resource assets, increasing taxes and royalties on resource extraction to ensure sustainable development. The handlers need to design polices supportive to renewable energy consumption, endorse IT based industry solution, encourage high-tech inward FDI, promote green financing and support sustainable development.

Glucagon-like peptide 1 receptor agonists in end-staged kidney disease and kidney transplantation: A narrative review.

AIMS: Glucagon-like peptide 1 receptor agonists (GLP-1RA) improve glycemic control and promote weight loss in type 2 diabetes (DM2) and obesity. We identified studies describing the metabolic benefits of GLP-1RA in end-staged kidney disease (ESKD) and kidney transplantation. DATA SYNTHESIS: We searched for randomized controlled trials (RCTs) and observational studies that investigated the metabolic benefits of GLP-1RA in ESKD and kidney transplantation. We summarized the effect of GLP-1RA on measures of obesity and glycemic control, examined adverse events, and explored adherence with therapy. In small RCTs of patients with DM2 on dialysis, liraglutide for up to 12 weeks lowered HbA1c by 0.8%, reduced time in hyperglycemia by ∼2%, lowered blood glucose by 2 mmol/L and reduced weight by 1-2 kg, compared with placebo. In prospective studies inclusive of ESKD, 12 months of semaglutide reduced HbA1c by 0.8%, and contributed to weight losses of 8 kg. In retrospective cohort studies in DM2 and kidney transplantation, 12 months of GLP-1RA lowered HbA1c by 2%, and fasting glucose by ∼3 mmol/L compared with non-use, and in some reports, weight losses of up to 4 kg were described. Gastrointestinal (GI) side effects were most commonly reported, with hypoglycemia described with GLP-1RA in hemodialysis, particularly in those using insulin. CONCLUSIONS: GLP-1RA are growing in popularity in those with DM2 and obesity. In small RCTs and observational cohort studies modest glycemic and weight benefits have been described in ESKD and transplantation, but GI side effects may limit adherence. Larger and longer term studies of GLP-1RA remain important.

Long-Term Proton Pump Inhibitor Therapy and its Effect on Endocrine Hormones in Selected Patient Population.

Proton pump inhibitors (PPI) are commonly prescribed medications for a variety of gastrointestinal disorders around the globe. Long-term utilization of proton pump inhibitors is linked with different adverse events. Although, short-term therapy has been demonstrated to have little or no impact on endocrine hormones in men, yet its safety with long-term use has poorly been studied. We aimed to evaluate the impacts of long-term utilization of proton pump inhibitors on male reproductive hormones and its clinical outcomes. A cross-sectional study was performed in two out-patients gastroenterology clinics in Khyber Pakhtunkhwa province. Male patients who were using PPIs regularly for≥3 months were enrolled in this study. Among 65 enrolled participants, patients with sexual complaints have significant variations in mean serum levels of prolactin (p<0.001), sex hormone binding globulins (p=0.043), total testosterone (p<0.001) and progesterone (p=0.001) as compared to patients without sexual complaints. Significantly high values of prolactin mean ranks were observed in patient with sexual complaints (p<0.001). There were statistically significant correlations of serum levels of sex hormone binding globulins (p=0.003), total testosterone (p=0.008) and progesterone (p<0.001) with serum prolactin levels. Similarly, statistically significant variation was observed for decreased libido (p=0.001), erectile dysfunction (p=0.001) and decreased semen mass ((p<0.001) between normal and hyperprolactinemic PPI users. Highly significant differences were observed in serum sex hormone binding globulins (p<0.001), total testosterone (p<0.001) and progesterone (p<0.001) values in normal and hyperprolactinemic groups. In conclusion, long-term utilization of PPI may induce endocrine hormone disruption with subsequent sexual complications.

Innovations in the synthesis of graphene nanostructures for bio and gas sensors.

Sensors play a significant role in modern technologies and devices used in industries, hospitals, healthcare, nanotechnology, astronomy, and meteorology. Sensors based upon nanostructured materials have gained special attention due to their high sensitivity, precision accuracy, and feasibility. This review discusses the fabrication of graphene-based biosensors and gas sensors, which have highly efficient performance. Significant developments in the synthesis routes to fabricate graphene-based materials with improved structural and surface properties have boosted their utilization in sensing applications. The higher surface area, better conductivity, tunable structure, and atom-thick morphology of these hybrid materials have made them highly desirable for the fabrication of flexible and stable sensors. Many publications have reported various modification approaches to improve the selectivity of these materials. In the current work, a compact and informative review focusing on the most recent developments in graphene-based biosensors and gas sensors has been designed and delivered. The research community has provided a complete critical analysis of the most robust case studies from the latest fabrication routes to the most complex challenges. Some significant ideas and solutions have been proposed to overcome the limitations regarding the field of biosensors and hazardous gas sensors.

Which Is Better? Rate Versus Rhythm Control in Atrial Fibrillation: A Systematic Review.

Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity and mortality. The optimal approach to managing AF, specifically rate control versus rhythm control, remains a topic of debate in clinical practice. This systematic review aims to compare the rate control and rhythm control strategies based on their clinical outcomes, quality of life, and adverse events associated with them. A comprehensive search was conducted using PubMed, Google Scholar, Science Direct, Research Gate, MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, and Embase (Excerpta Medica dataBASE) databases. A total of 1657 research papers were identified through the search strategy, and after applying the eligibility criteria, 28 studies were selected for the analysis. The studies encompassed a range of methodologies, including randomized controlled trials, observational studies, and meta-analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for study selection, data extraction, and analysis. The outcomes of interest included all: cause mortality, stroke, bleeding events, cardiovascular hospitalizations, quality of life, and adverse effects of treatment. Data were synthesized and presented in tables, charts, and forest plots for meta-analysis where appropriate. The results indicate that both rate control and rhythm control strategies have their own merits and limitations, with the outcomes varying based on patient characteristics and comorbidities. While rhythm control strategies may lead to better symptom control and improved quality of life, rate control strategies may be associated with lower risks of adverse events and complications. This systematic review provides a comprehensive overview of the current evidence regarding rate and rhythm control strategies in AF management, offering insights for clinical decision-making and highlighting the need for individualized treatment approaches.

Anodic SnO2 Nanoporous Structure Decorated with Cu2O Nanoparticles for Sensitive Detection of Creatinine: Experimental and DFT Study.

Advanced anodic SnO2 nanoporous structures decorated with Cu2O nanoparticles (NPs) were employed for creatinine detection. Anodization of electropolished Sn sheets in 0.3 M aqueous oxalic acid electrolyte under continuous stirring produced complete open top, crack-free, and smooth SnO2 nanoporous structures. Structural analyses confirm the high purity of rutile SnO2 with successful functionalization of Cu2O NPs. Morphological studies revealed the formation of self-organized and highly-ordered SnO2 nanopores, homogeneously decorated with Cu2O NPs. The average diameter of nanopores is ∼35 nm, while the average Cu2O particle size is ∼23 nm. Density functional theory results showed that SnO2@Cu2O hybrid nanostructures are energetically favorable for creatinine detection. The hybrid nanostructure electrode exhibited an ultra-high sensitivity of around 24343 µA mM-1 cm-2 with an extremely lower detection limit of ∼0.0023 µM, a fast response time (less than 2 s), and wide linear detection ranges of 2.5-45 µM and 100 µM to 15 mM toward creatinine. This is ascribed to the creation of highly active surface sites as a result of Cu2O NP functionalization, SnO2 band gap diminution, and the formation of heterojunction and Cu(1)/Cu(ll)-creatinine complexes through secondary amines which occur in the creatinine structure. The real-time analysis of creatinine in blood serum by the fabricated electrode evinces the practicability and accuracy of the biosensor with reference to the commercially existing creatinine sensor. The proposed biosensor demonstrated excellent stability, reproducibility, and selectivity, which reflects that the SnO2@Cu2O nanostructure is a promising candidate for the non-enzymatic detection of creatinine.

Modeling aquifer storage and recovery in the eastern district of the United Arab Emirates using MODFLOW.

The Emirate of Abu Dhabi has relied on groundwater as a source of fresh water for several decades, which has resulted in the deterioration of non-renewable groundwater aquifers. This has led to the installation of desalination plants for fresh water supply. This research aims to increase strategic water reserves in the eastern district of Abu Dhabi by analyzing the best locations for aquifer storage and recovery (ASR). The ASR technology offers an opportunity to store large volumes of water for later beneficial use. This study explores an option of using excess desalination water for ASR recharge in the eastern district Al Ain region of Abu Dhabi. A limiting factor in the application of the ASR technology is the lack of suitable sites. Detailed hydrogeological and operational knowledge of the studied areas helped in identifying potential sites for ASR based on a scoring system. Determining best locations for managed aquifer recharge is a crucial design step. Five scenarios were studied at Al-Khrair and Al-Shuwaib sites in Al Ain region. Results show that a wider distribution of injection wells with intervals more than 1200 m is more suitable to overcome the excessive head buildup. Based on the adopted criteria, Al-Khrair was the best site for recharge followed by Al-Shuwaib. Al-Khrair site can be recharged at 64,000 m3 d-1 for seven years, while Al-Shuwaib site can be recharged at 64,000 m3 d-1 for only two years.

Assessment of antibiotic storage practices, knowledge, and awareness related to antibiotic uses and antibiotic resistance among household members in post-conflict areas of Pakistan: Bi-central study.

Background: The storage of antimicrobials at home is frequently in-practice in various developing countries, resulting an irrational use, antibiotic resistance, and toxicities. This condition may worsen more in conflict zones where health facilities are limited. This study aimed to determine the storage and use of leftover antibiotics among households (HHs) along with knowledge and awareness about antibiotics and antibiotic resistance (ABR). Methods: A descriptive cross-sectional study design was employed. Members of HHs were invited to participate in the survey while using a convenient sampling technique. The data were obtained using a validated questionnaire and analyzed through SPSS. Results: A total of 96 HHs were randomly selected from two districts (n = 50, n = 46), with most of the participants being men between the ages of 18 and 28 (n = 45, 46.9%) years. The majority of HHs (n = 32, 33.3%) had six to eight total family members, with one to two chronic diseases (n = 63, 65.6%), individual families (n = 60, 62.5%), and with (n = 35, 36.5%) LRTIs (lower respiratory tract infections). The HHs were aware of the word "antibiotic" (n = 59, 61.5%) and gave correct replies to amoxicillin as an antibiotic (n = 42, 43.8%); on the other hand, HHs also thought of paracetamol as an antibiotic (n = 45, 47.9%). They identified the most common brands of antibiotics easily, and a majority of them (n = 69, 71.9%) had never heard of ABR before and had lower levels of awareness. The most stored antibiotic at home (n=38, 39.6%) was azithromycin (J01FA10). In addition, they had multiple needless (1-2, n = 62, 64.6%; 3-4, n = 29, 30.2%) and antibiotics in their houses. Age had a strong association (p = 0.017, H = 12) affected the mean knowledge scores related to antibiotic use. Association of education levels (p = 0.001, H = 52.8) and occupation (p = 0.04, H = 10) with proper antibiotics use were found to be significant. However, family members with more than one chronic illness (p = 0.09, H = 0.8) showed a significant relationship with their awareness of antibiotics. Conclusion: Participants generally stored various antibiotics of different classes in their homes. Lack of knowledge related to the appropriate usage of antibiotics, use of leftover antibiotics, and awareness related to ABR were unknown to the participants.

A review of synthesis, fabrication, and emerging biomedical applications of metal-organic frameworks.

The overwhelming potential of porous coordination polymers (PCP), also known as Metal-Organic Frameworks (MOFs), especially their nanostructures for various biomedical applications, have made these materials worth investigating for more applications and uses. MOFs unique structure has enabled them for most applications, particularly in biomedical and healthcare. A number of very informative review papers are available on the biomedical applications of MOFs for the reader's convenience. However, many of those reviews focus mainly on drug delivery applications, and no significant work has been reported on other MOFs for biomedical applications. This review aims to present a compact and highly informative global assessment of the recent developments in biomedical applications (excluding drug-delivery) of MOFs along with critical analysis. Researchers have recently adopted both synthetic and post-synthetic routes for the fabrication and modification of MOFs that have been discussed and analyzed. A critical review of the latest reports on the significant and exotic area of bio-sensing capabilities and applications of MOFs has been given in this study. In addition, other essential applications of MOFs, including photothermal therapy, photodynamic therapy, and antimicrobial activities, are also included. These recently grown emergent techniques and cancer treatment options have gained attention and require further investigations to achieve fruitful outcomes. MOF's role in these applications has been thoroughly discussed, along with future challenges and valuable suggestions for the research community that will help meet future demands.

Utilization of social media in floods assessment using data mining techniques.

Floods are among the devastating types of disasters in terms of human life, social and financial losses. Authoritative data from flood gauges are scarce in arid regions because of the specific type of dry climate that dysfunctions these measuring devices. Hence, social media data could be a useful tool in this case, where a wealth of information is available online. This study investigates the reliability of flood related data quality collected from social media, particularly for an arid region where the usage of flow gauges is limited. The data (text, images and videos) of social media, related to a flood event, was analyzed using the Machine Learning approach. For this reason, digital data (758 images and 1413 video frames) was converted into numeric values through ResNet50 model using the VGG-16 architecture. Numeric data of images, videos and text was further classified using different Machine Learning algorithms. Receiver operating characteristics (ROC) curve and area under curve (AUC) methods were used to evaluate and compare the performance of the developed machine learning algorithms. This novel approach of studying the quality of social media data could be a reliable alternative in the absence of real-time flow gauges data. A flash flood that occurred in the United Arab Emirates (UAE) from March 7-11, 2016 was selected as the focus of this study. Random forest showed the highest accuracy of 80.18% among the five other classifiers for images and videos. Precipitation/rainfall data were used to validate social media data, which showed a significant relationship between rainfall and the number of posts. The validity of the machine learning models was assessed using the area under the curve, precision-recall curve, root mean square error, and kappa statistics to confirm the validity and accuracy of the model. The data quality of YouTube videos was found to have the highest accuracy followed by Facebook, Flickr, Twitter, and Instagram. These results showed that social media data could be used when gauge data is unavailable.

Exploring the factors and barriers of healthcare professionals in tertiary care hospitals toward pharmacovigilance: a multicenter study from Khyber Pakhtunkhwa, Pakistan.

BACKGROUND: Spontaneous Adverse drug reactions (ADRs) reporting is a cornerstone for a successful pharmacovigilance program as under-reporting of ADRs remains a major issue around the globe. The current study aimed to assess the knowledge attitude and practices of health care professionals regarding pharmacovigilance along with barriers and factors to encourage ADR reporting at tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan. METHODS: A questionnaire-based cross-sectional survey was conducted, using the convenience sampling method to collect the data from doctors, nurses, and pharmacists working in seven tertiary care hospitals from seven districts of Khyber-Pakhtunkhwa province, Pakistan, between July 2019 and March 2020. RESULTS: During the study, a total of 830 questionnaires were distributed, out of which 669 were returned (response rate 80.6%). Overall, Healthcare professionals exhibited poor knowledge (79.5%) about ADR reporting and pharmacovigilance however, 73.5% of pharmacists were more knowledgeable as compared to 18.7% doctors and 13.8% nurses (p < .001). Moreover, poor reporting practices were displayed by 95.6% doctors, 94.4% nurses, 94.4 and 75.5% pharmacists (p < .001). However, the majority of healthcare professionals showed an overall positive attitude (94%) toward ADR reporting. The most frequently cited barriers were unavailability of reporting forms (92.5%), absence of a professional environment to discuss ADRs (82.5%), and lack of training (81.8%) whereas, most common factors to encourage ADR reporting were obligatory reporting (85.9%) and provision of ADR management guidelines and training (84.3%). A significant relation was found between the healthcare professionals and their professional status with the overall knowledge, attitude, and practice (KAP) scores (p < .001) whereas a medium, positive correlation was found between the knowledge and practice of pharmacovigilance and ADR reporting by the healthcare professionals (r = 0.321, n = 669, p < .001). CONCLUSION: There is an overall lack of knowledge and poor reporting practices among health care professionals on ADR reporting and pharmacovigilance. Hence the study suggests that strategies should be devised by all the stakeholders to properly educate and train the healthcare professionals in this area to enhance overall patient safety and safe use of medicines.