Coronavirus disease 2019 (COVID-19), the respiratory illness caused by severe acute respiratory syndrome coronavirus 2, has affected hundreds of thousands of people. We aim to report the distribution of cases, prevalence, and clinical, radiological, and laboratory signs and outcomes of COVID-19 in paediatric patients. Moreover, we intend to evaluate neonatal clinical outcomes. Hence, our age range of interest is 0 to 19 years. Methods: A systematic literature review was conducted using the Medline database to identify papers published between 1 December 2019 and 9 April 2020 on COVID-19. Results: The search identified 27 relevant scientific papers and letters. The review showed that the prevalence of COVID-19 in the paediatric population accounts for a small percentage of patients, whose clinical signs and symptoms are often milder than those of adults. Despite better prognosis and low mortality in children, the disease can progress to severe pneumonia in some cases, especially in the presence of co-morbidities. Children are likely to become a hidden source of infection because of their

Globally, the prevalence of chronic, noncommunicable diseases is increasing at an alarming rate and diabetes is one of them. If diabetes is not controlled then a lot of complication like coronary artery disease, cerebrovascular disease, peripheral vascular disease, retinopathy, nephropathy and neuropathy arise in diabetic patients and causes morbidity and/or mortality. Diabetes is increasing at an epidemic form and in near future the largest increases will take place in the regions dominated by developing economies. So, it will be a great social and economical burden to developing countries as well as the developed. But if we be aware about our diet and lifestyle and take proper medication we may prevent and reduce the prevalence of diabetes. Oral medicine plays an important role in management of diabetes. But most of the oral drugs are costly and have a lot of side effects. For this it is also necessary to take medicines with fewer or no side effects. And antidiabetic medicinal plants may play an important role in this case. In this article we have tried to describe how diet and lifestyle with using medicinal plants may help to prevent or maintain diabetes and help to reduce the mortality and morbidity due to diabetes or complication related to it.

IntroductionStudies have shown that electronic cigarettes have gained immense popularity and their use has increased dramatically all over the world. However, little is known about the knowledge and attitudes towards e-cigarettes in third world countries such as Pakistan. The aim of this study was to determine the perceptions of teenagers in Karachi regarding e-cigarettes and whether the differences in said perceptions were affected by gender and level of education.MethodsWe conducted a cross-sectional study in January 2017 using convenience sampling and interviewed 441 young individuals, aged 13 to 19 years, to determine their knowledge, attitudes, and practices regarding e-cigarettes. The participants were questioned about their knowledge and its source. Attitudes were judged using four and five-point Likert scales while questions regarding practices focused on single and current use. Chi-square and Mann-Whitney tests were applied to compare the knowledge, attitudes, and practices of teenagers with gender and level of schooling.ResultsThe majority of participants knew what e-cigarettes were (n=277, 68.7%) but did not know about their contents (n=225, 55.8%) and had learned about them from either friends or the internet (n=245, 60.%). Almost half of them (n=190, 47.2%) believed that the reason for e-cigarette use was either peer pressure or to quit smoking conventional cigarettes. An overwhelming majority also stated that; it was either easy or very easy to obtain e-cigarettes (n=277, 68.7%), they would not try smoking e-cigarettes even if a good friend of theirs recommended them (n=287, 71.2%), they were not current e-cigarette smokers (n=370, 91.8%) and they would never promote e-cigarette use (n=371, 92.1%). Statistically significant differences were found with males knowing more about e-cigarettes (p=0.006) and being more common to either have smoked (p <0.001) or be current e-cigarette smokers (p <0.001). Furthermore, middle school students were more likely to have negative attitudes towards e-cigarettes believing they were more harmful (p=0.003) and more addictive (p <0.001) than conventional cigarettes.ConclusionMany people were aware of what electronic cigarettes are but still, it was evident that there was the lack of proper knowledge along with negative attitudes towards e-cigarette use among teenagers in Pakistan due to cultural and social stigmas and lack of advertising. Males and females had considerable differences in their opinions regarding e-cigarette use owing to such social practices being considered taboo by females and males having greater freedom due to patriarchal, familial and cultural systems.

Introduction: Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blockers (ARBs) are taken as the first treatment option for hypertensive patients. The various global trials have suggested that ACEIs and ARBs may increase risk of lung cancer; however, the results are contradictory and there is no local study available. This study is conducted to compare the incidence of lung cancers in patients on ACEIs and ARBs.Methods: This retrospective study, conducted in a major cardiology unit of a tertiary care hospital in Pakistan, included patients diagnosed with hypertension, between 2005 and 2010, who were prescribed either ACEIs or ARBs. During the period of 2005 to 2010, 47,823 naïve hypertensive patients were reported in the outpatient department of the cardiology unit. Of which, 22,241 were prescribed ACEI and 25,582 were prescribed ARBs. After sorting patient data based on our inclusion criteria, n = 14,891 participants were included in the ACEI group and n = 19,112 participants were included in the ARB group.Results: The incidence of lung cancer in the ACEI and ARB group was n = 165 and n = 160, respectively. In this study, the overall incidence rates of lung cancer in the ACEI and ARB cohorts were 12.2 and 16.6 per 10,000 person-years, respectively. The hazard ratio was 1.32 (95% confidence interval: 1.06-1.64; p-value: 0.01). Conclusion:In this study, the incidence of lung cancer was relatively more among people using ACEIs than ARBs. Hence, patients undergoing long-term treatment with ACEIs need regular follow-up and proper scanning to avoid grave complications.

Introduction: Recent research has observed the ability of coronavirus disease 2019 to spread in the brain from the respiratory system. The associated neurological disorder includes encephalopathies, inflammatory syndromes, stroke, peripheral neuropathies, and various other central nervous system disorders. This study aims to highlight the long-term neurological sequelae in patients with COVID-19 disease.Methods: This long-term study was carried out in the COVID-19 unit of a tertiary care hospital in Pakistan from July 2020 to July 2021. After obtaining informed consent, we enrolled 1000 patients who recovered from COVID-19 and were discharged. The participants were followed up after 30 and 90 days.Results: At the time of enrollment, there were 602 (60.2%) males and 398 (39.8%) females. The most common neurological symptom on 30-day follow-up was headache (8.8%), followed by insomnia. The most common neurological symptom on day 90 follow-up was insomnia (5.07%), followed by an altered sense of smell (3.3%).Conclusion: COVID-19 tends to produce a wide range of neurological symptoms, ranging from headache to anosmia to increased risk of stroke, that complicates clinical management. Potential neurologic effects and drug interactions have been reported secondary to the medications used to treat COVID-19. In light of the aforementioned facts, COVID-19 could potentially have a long-term effect on the brain. Therefore, it is important that the clinicians must be aware of the potential neurologic complications. Lastly, proper followup is recommended that would aid in timely recognition and management of the neurological disorder.