Characterizing cutaneous leishmaniasis in a conflict-affected region: a study from North Waziristan, Pakistan.

Background/aim: Cutaneous leishmaniasis is an emerging tropical disease that remains a serious public health issue in Pakistan, particularly in North Waziristan. The current research was carried out to investigate the presence of cutaneous leishmaniasis in this region. Materials and methods: This prospective observational study was conducted from October 2018 to December 2020 at District Head Quarter Hospital Miranshah in North Waziristan with the collaboration of the Pathology Department of Gomal Medical College Dera Ismail Khan, Khyber Pakhtunkhwa. Needle aspirates were used for the microscopic Giemsa-stained slides. SPSS was used for data analysis. Results: Of the 5406 clinically-suspected cases, 2603(48.2%) were positive by microscopic examination. Of these 2603 patients, 1474 (57%) were male and 1129 (43%) were female. Most of the lesions were on the face, followed by upper and lower limbs. The 5-10-year age group had the highest percentage of 1167 (45%). A single lesion affected 96.6% of the patients, while 2.7% had double lesions and 0.7% had triple lesions. A high number of cutaneous leishmaniasis were seen from April to August, while the lowest number was seen November to December. Conclusion: This study provides extensive information in relation to the existence of cutaneous leishmaniasis in the North Waziristan district of Pakistan, as well as the detailed demographic features of those affected by the disease.

Haematological outcomes in progression of malaria: A cohort study from district Dera Ismail Khan, Pakistan.

Malaria is the second highest reported disease from public health sector which affects about 4 million people each year in Pakistan. The study sought to evaluate the haematological changes in malarial patients in order to find any relation of these changes with malarial pathogenesis. This cross sectional descriptive study was designed at the pathology department of Gomal Medical College, Dera Ismail Khan during March 2015 to February 2017. Blood samples were collected from 400 malaria microscopy positive in EDTA tubes for the analysis of haematological parameters like Total leucocyte count, Haemoglobin, Platelets, Mean Cell Volume, Mean Cell Haemoglobin and Mean Cell Haemoglobin Concentration. Out of the 400 cases of malaria, 366 (91.5%) were Plasmodium vivax, 24 (6.0%) were Plasmodium falciparum and 10 (2.5%) were co-infection of Plasmodium vivax and Plasmodium falciparum infection. Anaemia was seen in 148 (37%) of cases; thrombocytopenia was 316(79%) and 60 (15%) cases had leucopenia. This study shows that malarial patients exhibited important changes in haematological parameters like thrombocytopenia; anaemia and leucopenia are significant predictors of malaria infection. When used in combination with other clinical and microscopy methods, these parameters could improve the diagnosis and treatment of malaria.

Pharmacokinetic evaluation of quetiapine fumarate controlled release hybrid hydrogel: a healthier treatment of schizophrenia.

The current study aimed to rationally develop and characterize pH-sensitive controlled release hydrogels by graft polymerization of gelatin (Gel) and hydroxypropyl methyl cellulose (HPMC) in the presence of glutaraldehyde (GA) using quetiapine fumarate for the treatment of schizophrenia. The prepared hydrogels discs were subjected to various physicochemical studies including: swelling, diffusion, porosity, sol-gel analysis, Fourier transform infrared spectroscopy, differential scanning calorimetry, and scanning electron microscopy. Three different pH values (1.2, 6.8 and 7.4) were used to determine shape, transition, and controlled release behavior of prepared hydrogels. Various kinetic models including zero order, first order, Higuchi model and Power Law equation were applied on drug release data. The optimized hydrogels were subjected to in vivo studies using albino rabbits. Swelling and release results were found to be insignificant (p < .05) evidencing that there was no significant difference in swelling and drug release rate of hydrogels in different pH mediums. Swelling, porosity, gel-fraction, and drug released (%) were found to be dependent on concentrations of Gel, HPMC, and GA. Kinetic models revealed that QTP-F release followed non-Fickian diffusion. In-vivo studies contributed significantly higher plasma QTP-F concentration (Cmax), time for maximum plasma concentration (Tmax), area under the curve (AUC0-inf) and half-life (t1/2) as 18.32 ± 0.50 µg/ml, 8.00 ± 0.01 hrs, 6021.2 ± 5.09 µg.hrs/ml and 10.06 ± 0.43 hrs, respectively, for test-hydrogels when compared to reference market brand (Qusel® 200 mg, Hilton Pharma, Karachi, Pakistan) QTP-F tablets. It might be concluded that QTP-F loaded pH-sensitive hydrogels were developed successfully with reduced dosing frequency for schizophrenia.