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Overuse disorders of tendons, or tendinopathies, present a challenge to sports physicians, surgeons, and other health care professionals dealing with athletes. The Achilles, patellar, and supraspinatus tendons are particularly vulnerable to injury and often difficult to manage successfully. Inflammation was believed central to the pathologic process, but histopathologic evidence has confirmed the failed healing response nature of these conditions. Excessive or inappropriate loading of the musculotendinous unit is believed to be central to the disease process, although the exact mechanism by which this occurs remains uncertain. Additionally, the location of the lesion (for example, the midtendon or osteotendinous junction) has become increasingly recognized as influencing both the pathologic process and subsequent management. The mechanical, vascular, neural, and other theories that seek to explain the pathologic process are explored in this article. Recent developments in the no operative management of chronic tendon disorders are reviewed, as is the rationale for surgical intervention. Recent surgical advances, including minimally invasive tendon surgery, are reviewed. Potential future management strategies, such as stem cell therapy, growth factor treatment, and gene transfer, are also discussed.

The purpose of this study was to investigate perception of pharmacist and prescriber regarding traditional role of community pharmacist. Questionnaire based, cross sectional study was conducted which comprised of 428 participants from Quetta, Pakistan. Majority (n=242, 56.5%) of respondents were prescribers while (n=186, 43.5%) were pharmacists with experience of 1 – 4 years (n=174, 40.7%). Overall the majority (n= 386, 90.2%) of the participants had positive perception regarding traditional dispensing and traditional counselling (n=314, 73.4%) role of community pharmacist. Concerning the prescribers, majority (n=200, 82.6%) had positive perception regarding traditional dispensing role and traditional counselling role (n=132, 524.5%) while concerning pharmacists, majority (n=186, 100%) had positive perception regarding the traditional dispensing role and traditional counselling (n=182, 97.8%) role of community pharmacist. This study concluded that both prescribers and pharmacists had positive perception regarding traditional role of community pharmacist, and it is recommended that further studies should be conducted regarding extended and clinical role of community pharmacist.

Ethnopharmacological relevance: Erythrina variegata (Fabaceae) is widely used as a tranquilizer and/or sedative in Traditional system of medicine. Aim of study: The present study was aimed to investigate anxiolytic effects of methanolic extract of leaves of Erythrina variegata. Materials and methods: The anxiolytic activity of methanolic extract of Erythrina variegata leaves at doses (100 and 200 mg/kg; p.o) was studied by elevated plus maze model and Rota rod test in rats. Results: In elevated plus maze test, methanolic extract of Erythrina variegata produced significant reduction in onset of anxiety and the effect was comparable to that produced by diazepam. In the Rota rod test in rats, Erythrina variegata (200 mg/kg) showed significant muscle relaxant property. The effect of the extract was comparable to that of the standard drug diazepam (1 mg/kg). The results of the present study specified that the methanolic extract of Erythrina variegata leaves keeps significant anxiolytic like activity. Conclusion: The results recommended that chronic administration of the methanolic extract of the leaves of Erythrina variegata exerts an anxiolytic-like effect on rats, and it may serve as a new approach for the treatment of anxiety.

Objective: The aim of this clinical review was to have an in-depth knowledge of the antibiotics being used to treat lower respiratory tract infections which are most likely to occur in the pediatric population of different age groups. Methods: This study analyzed 43 articles which were studied and identified according to the research criteria. The required data has been searched using research gate, ncbi, Medscape, Mayo Clinic, WebMD. Results: The findings included different levels of effectiveness in the 5 generations of cephalosporin’s as some killed certain bacteria’s better than others and are relatively short acting with half-life of about 30-120 minutes when compared to penicillin. For example, first generation cephalosporin’s were quite active against gram positive bacteria when compared to gram negative bacteria however, the efficacy was reduced due to resistance. It was discussed regarding second generations that they are effective against both gram negative and gram-positive bacteria and are resistant to B-lactamase more than the first generations, therefore have a high anti-bacterial activity. As far as the third and fourth generations were concerned, they were able to penetrate the blood-brain barrier and were frequently designed for bacterial meningitis which were caused by susceptible pathogens. Fifth generations have a similar mechanism of action as that of the 3rd generations and can treat resistant staphylococcus aureus and streptococcus species which are resistant to penicillin antibiotics. On the other hand, Carbapenems (penetrates bacterial cell wall of micro-organisms and inhibits cell wall synthesis) and aminoglycosides (inhibits protein synthesis by binding to bacterial ribosomes and inducing misreading of the of the genetic code) are one of the most highly efficacious as they prevent severe and high risk bacterial infections although, rare incidents of toxicity and life threatening side effects have been reported when taken aminoglycosides. Conclusion: Penicillin is the safest to treat and prevent the lower respiratory tract infections in the pediatric population as they have minor side effects such as headache, nausea compared to other antibiotics.

Background: Second-hand smoking (SHS) has been strongly associated with poor health outcomes, higher risk of lung cancer in adults, increased frequency of respiratory disease in children. This study was aimed to estimate the prevalence of exposure, investigate the possible associated risk factors and to assess the knowledge and awareness towards SHS. Method: A cross-sectional study was conducted and data’s pertaining to socio-demographic characteristics, sources of exposure, respiratory symptoms and awareness were collected using a self-administered questionnaire and evaluated. Results: Nearly 72.98% participants reported that maximum exposure to second-hand smoke were in Estirah (social club) followed by Internet cafe (35.48%), Park (22.98%), Shopping malls (22.18%), Playground (19.76%), College (8.87%) and Restaurants (7.26%). Parental smoking had a major risk of exposure inside the home (30.24%) and friends outside (28.63%) the home. The risk of SHS was less common with people who had adequate knowledge and also with educated parents. A significant association was found between SHS exposure and chronic phlegm (42.74%), dyspnoea (41.13%) chronic cough (27.96%), wheezing (23.79%). The knowledge and awareness among people on SHS were adequate though the practices were poor. 76.21% of the parents reported that SHS exposure made their child’s health worse and 72.58% opted for smoke-free public places while 26.21% participants allowed visitors to smoke in their house. Conclusion: Hence, it is very important to develop and propagate effective measures to promote smoke-free homes and public places. Health education programs should also address the more complex problem of motivating people to change their attitudes.