Heavy metal pollution is a severe environmental problem. Remediation of contaminated soils can be accomplished using environmental materials that are low cost and environmentally friendly. We evaluated the individual and combination effects of humic acid (HA), super absorbent polymer (SAP), zeolite (ZE), and fly ash composites (FC) on immobilization of lead (Pb) and cadmium (Cd) in contaminated soils. We also investigated long-term practical approaches for remediation of heavy metal pollution in soil. The biochemical and morphological properties of maize (Zea mays L.) were selected as biomarkers to assess the effects of environmental materials on heavy metal immobilization. The results showed that addition of test materials to soil effectively reduced heavy metal accumulation in maize foliage, improving chlorophyll levels, plant growth, and antioxidant enzyme activity. The test materials reduced heavy metal injury to maize throughout the growth period. A synergistic effect from combinations of different materials on immobilization of Pb and Cd was determined based on the reduction of morphological and biochemical injuries to maize. The combination of zeolite and humic acid was especially effective. Treatment with a combination of HA + SAP + ZE + FC was superior for remediation of soils contaminated with high levels of Pb and Cd.
Pharmacoeconomics is the branch of health-economics where cost and outcomes are compared for patient’s treatment therapies and services in a health care system. Hypertension is one of the most common serious medical conditions in Pakistan and throughout the world. A large number of antihypertensive medications alone or in combinations are being prescribed. Pharmaco-economic studies are helpful in prescribing the most appropriate medication with required outcomes at minimum cost. Objective of study was to assess the prescription trends and cost-effectiveness among different classes of antihypertensive medications prescribed at different clinical setups of Hyderabad, Pakistan. A Prospective observational study was carried out at cardiac OPD of Liaquat University Hospital, Hyderabad from April 2018 to April 2019. According to inclusion and exclusion criteria, 400 prescriptions containing antihypertensive Drugs were collected via purposive sampling technique for pharmacoeconomic analysis during the study period. In Government setting, Monotherapy (83%) was more frequent than combination therapy (17%). The most frequent and the most cost-effective monotherapy was Enalapril maleate 5 mg having cost/day 4 Rs. In combination therapies, Lisinopril 20 mg + HTZ 12.5 mg was the most frequent. Spironolactone 50 mg + furosemide 40 mg was found to be the most cost-effective combination with cost/day 5 Rs. In private settings, the trends of antihypertensive monotherapy (75.5%) were more frequent than combination therapy (24.5%). The most frequent monotherapy was Telmisartan 40 mg while the most frequent antihypertensive combination was Amlodipine besylat 10 mg + Valsartan 160 mg. Metoprolol tartarate 100 mg and lisinopril 5 mg were cost-effective monotherapies with cost/day 5 Rs each and the combination of candesartancelexetil 16 mg + HTZ 12.5 mg was the most cost-effective. It is concluded from the current study that the prescription trends of antihypertensive medications were relatively cost-effective at Government setting but overall, the antihypertensive treatment cost was high which puts a substantial economic burden on patients.
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