The current study aims to assess the beliefs of the general public in Pakistan towards conspiracy theories, acceptance, willingness to pay, and preference for the COVID-19 vaccine. A cross-sectional study was conducted through an online self-administered questionnaire during January 2021. The Chi-square test or Fisher exact test was utilized for statistical data analysis. A total of 2158 respondents completed the questionnaire, among them 1192 (55.2%) were male with 23.87 (SD: ±6.23) years as mean age. The conspiracy beliefs circulating regarding the COVID-19 vaccine were believed by 9.3% to 28.4% of the study participants. Among them, 1040 (48.2%) agreed to vaccinate on its availability while 934 (43.3%) reported the Chinese vaccine as their preference. The conspiracy beliefs of the participants were significantly associated with acceptance of the COVID-19 vaccine. The existence of conspiracy beliefs and low vaccine acceptance among the general population is a serious threat to successful COVID-19 vaccination.

The present research is based on the fabrication preparation of CS/PVA/GG blended hydrogel with nontoxic tetra orthosilicate (TEOS) for sustained paracetamol release. Different TEOS percentages were used because of their nontoxic behavior to study newly designed hydrogels’ crosslinking and physicochemical properties. These hydrogels were characterized using Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and wetting to determine the functional, surface morphology, hydrophilic, or hydrophobic properties. The swelling analysis in different media, degradation in PBS, and drug release kinetics were conducted to observe their response against corresponding media. The FTIR analysis confirmed the components added and crosslinking between them, and surface morphology confirmed different surface and wetting behavior due to different crosslinking. In various solvents, including water, buffer, and electrolyte solutions, the swelling behaviour of hydrogel was investigated and observed that TEOS amount caused less hydrogel swelling. In acidic pH, hydrogels swell the most, while they swell the least at pH 7 or higher. These hydrogels are pH-sensitive and appropriate for controlled drug release. These hydrogels demonstrated that, as the ionic concentration was increased, swelling decreased due to decreased osmotic pressure in various electrolyte solutions. The antimicrobial analysis revealed that these hydrogels are highly antibacterial against Gram-positive (Staphylococcus aureus and Bacillus cereus) and Gram negative (Pseudomonas aeruginosa and Escherichia coli) bacterial strains. The drug release mechanism was 98% in phosphate buffer saline (PBS) media at pH 7.4 in 140 min. To analyze drug release behaviour, the drug release kinetics was assessed against different mathematical models (such as zero and first order, Higuchi, Baker–Lonsdale, Hixson, and Peppas). It was found that hydrogel (CPG2) follows the Peppas model with the highest value of regression (R2 = 0.98509). Hence, from the results, these hydrogels could be a potential biomaterial for wound dressing in biomedical applications.

Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a class of oral hypoglycemics that improve glycemic control by increasing the urinary excretion of glucose. They gained widespread popularity because they not only showed improved glycemic control but also had a favorable effect on weight loss, blood pressure, and cardiovascular mortality. One of their rare side effects is euglycemic diabetic ketoacidosis (eDKA) although the diagnosis is sometimes difficult to make due to near-normal glucose levels. We present a case of eDKA in a patient who presented with confusion, acute kidney injury (AKI), and metabolic acidosis after having an influenza-like illness with a minimally elevated blood glucose of 187 mg/dL. She had already stopped taking dapagliflozin (an SGLT-2 inhibitor) two weeks before the presentation. She was initially treated as sepsis and required hemodialysis. Later on, metabolic acidosis was attributed to eDKA from dapagliflozin, which resolved after the administration of intravenous insulin. Her eDKA developed while she had already stopped dapagliflozin two weeks ago, which makes this an interesting case finding. It is one of those rare cases where dapagliflozin led to a delayed complication of eDKA.

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Background: Most of the medicinal plants are available as wild or weeds in the world including Pakistan. It was reported by many researchers that Pakistan is rich with medicinal flora based upon the surveys conducted in the Northern areas but still there are some areas other than Northern parts in Pakistan that has not been studied so far. There is a need to explore the medicinal flora from neglected area where most of the people still rely on local medicinal plants to cure their diseases by means of indigenous knowledge. District Gujrat is among those area that has not been explored to study the medicinal flora.Methods: Surveys were conducted to collect the indigenous knowledge and medicinal significance of seasonal weeds in Gujrat, Punjab, Pakistan in winter 2018 and summer 2019. Information collected through questionnaire and interviews.Results: Weeds have much importance among local inhabitants to cure many diseases as respiratory disorders, kidney and liver disorders, muscle and skeletal disorders, ear, nose and throat problems, dermatological disorders, fever, diabetes, cancer etc. The plant parts and its percentage used by local inhabitants were leaves (58%), fruits (36%), seeds (25%), whole plant (34%), roots (32%), milky latex (1%), flowers (8%) and stem (3%). The most important families were Asteraceae, Poaceae, Fabaceae, Polygonaceae and Solanaceae. Cichorium intybus L. (Asteraceae) had 100% Fidelity Level (FL) value as liver tonic and blood purifier. Highest 0.76 Informant Consensus Factor (ICF) values were noted against stomach, gastric, intestinal and digestive problems. Achyranthes aspera L. (Amaranthaceae) showed the highest Fidelity Level (FL) values that was 93% used gastrointestinal disorders and menstrual pain.Conclusions: It was concluded that the area of Gujrat, Punjab, Pakistan is a rich source of important medicinal weeds that needs to be utilized for useful medicinal purpose. There is need to create awareness among the farmers and local people about the efficacy of weeds.

AIm:To describe the effect of high dose progesterone (HDP) alone, or in combination with folic acid (FA), on occurrence of neural tube defects (NTDs) in chick embryo. mAterIAl and methOds: 60 Fertile, specific eggs of Fyoumi species of chick were selected at zero hr of incubation. They were incubated at 37.5 ºC and 75% relative humidity until the embryos reached stage eight of development. At this stage the eggs were divided into four groups consisting of 15 eggs/group. The 1st group was incubated without any operation. The 2nd group was injected with physiological saline. The 3rd and 4th groups were injected with HDP (20x physiologic dose of progesterone) and HDP with supplement of 5 micrograms/embryo of FA, respectively. After 48 hrs of incubation, all embryos were reviewed for the presence of NTDs under light microscopy.results: None of the eggs in the control, and saline injection groups showed NTDs, whereas 75 % (9/12) of the embryos in the 3rd group, and 58.3 % (7/12) of the chick embryos in 4th group showed NTDs. COnClusIOn: Exogenous progesterone at levels twenty times above its physiologic range in chick embryos causes NTDs. FA supplementation decreases the frequency of NTDs but does not abolish them.KeywOrds: Neural tube defects, Progesterone, Folic acid, Chick embryo, Neural tube closure ÖZ AmAÇ: Yalnızca Progesteron ve progesterona ilave olarak Folik asit ile ile kombine edilmiş uygulamanın civciv embiryosunda nöral tüp defekti oluşumu üzerine olan etkisi. yÖntem ve GereÇ: Çalışmada, inkübasyonun 0. saatinde 60 fertil Fyoumi türü civciv embiryosu kullanıldı.Tüm embiryolar gelişimlerinin 8. evresine kadar, 37,5 ºC ve 75 % nemli ortamda inkübasyona tabi tutuldu. Bu evrede embiryolar 15'erli 4 gruba ayrıldı. Birinci grup herhangi bir işleme maruz bırakılmaksızın inkübasyona tabi tutuldu. İkinci gruba serum fizyolojik injeksiyonu yapıldı. Üçüncü gruba yüksek doz progesteron (fizyolojik dozun 20 katı), dördüncü gruba yüksek doz progesterona ek olarak 5 mikrogram folik asit injeksiyonu yapıldı. Bu işlemlerden sonraki 48 saat boyunca inkübe edilen embriyolar ışık mikroskobunda nöral tüp defekti gelişimi açısından incelemeye alındı.BulGulAr: Kontrol grubunda ve serum fizyolojik injeksiyonu yapılan grupta nöral tüp defekti saptanmazken, 3. grupta % 75 oranında (9/12), 4. grupta ise % 58,3 (7/12) oranında nöral tüp defekti geliştiği görüldü.sOnuÇ: Fizyolojik dozun 20 katında uygulanan progesteron civciv embriyolarında nöral tüp defekti oluşumuna neden olmaktadır. Folik asit desteği nöral tüp defekti oluşum sıklığını azaltsa da defektin görülmesini tam olarak ortadan kaldıramamaktadır.

Immune checkpoint inhibitors (ICIs) are an evolving class of drugs for the treatment of various cancers; for example, their use is recommended as a second-line chemotherapy for non-small cell lung cancer. With the expanding use of ICIs, we are discovering their unique side effects, called immune-related adverse events (irAEs), which can impair gastrointestinal, hepatic, dermatological, endocrine and other systems. Nivolumab is an ICI that blocks the human programmed death receptor-1 (PD-1) on T cells to prevent the interaction between the receptor, PD-1, and human programmed death ligand-1 expressed on tumour cells. Here, we report a case of a 65-year-old woman with recurrent lung adenocarcinoma who was treated with nivolumab and developed immune-related adrenalitis, which was managed with hydrocortisone and fludrocortisone. This case highlights the importance of understanding the irAEs of ICIs to allow prompt recognition and management of life-threatening complications of the treatment.

Introduction Bilateral globus pallidus lesions have been characteristically thought to be associated with global cerebral hypoperfusion and hypoxic changes. One of the important causative factors that need to be considered is the opiate drug abuse. Case presentation We present a case of a 50-year-old male who came to the hospital after being found down for 3 hours. He was found to have weakness of right upper and lower extremity. MRI showed bilateral globus pallidus infarcts. He later admitted to inhalation of heroin. Over the next few days, weakness started to improve and he was eventually discharged to rehabilitation. This case is a unique presentation of bilateral globus pallidus lesions after a one-time inhalation of heroin. Conclusion We, therefore, advocate that inhaled heroin should be considered as one of the causes of bilateral globus pallidus lesions, in addition to IV heroin and cocaine and physicians should be aware of the possibility of alternate forms of heroin abuse in such patients.