Introduction: Caffeine is considered one of the most common stimulants that improve alertness and prevents sleepiness in many people. It is one of the most common consumed psychoactive substances in the world. Sometimes patients report failing of feeling numbness after local anesthesia administration due to excessive consumption of coffee, thus, they request a higher dose of local anesthesia during treatment. To this day, no previous study reported a direct association between caffeine intake and local anesthesia failure. Aim: This study aims to review published articles that discussed the effect of caffeine administration and consumption on anesthetic efficacy. Materials and Methods: A literature search was performed from multiple databases including PubMed, Web of Science, Cochrane, and Google Scholar. The most eligible articles were included using specific keywords. The literature search was limited to full-text English articles, which were screened for eligibility by two reviewers. Results and Discussion: Four studies were included in our study, these studies demonstrated that caffeine administration following general anesthesia can significantly accelerate recovery. However, the effect of caffeine consumption on local anesthesia efficacy was not yet completely proven. Conclusion: Caffeine consumption can speed up post-general anesthesia recovery. However, the effect of caffeine consumption on local anesthesia efficacy is still controversial and further investigation and clinical trials are required.

Human monkeypox is a zoonotic orthopoxvirus disease with a presentation similar to the smallpox. The frequency and geographical spread of human monkeypox cases have increased recently in most countries of world. The disease is endemic in Democratic Republic of the Congo, Central and West Africa, but presently spread to other nations of the world including India that too when the whole world is facing the Covid -19 pandemic. In this article the author focus on the various parameters related to the monkeypox, present status and the stigmatization.

Rosuvastatin belongs to the HMG-CoA reductase inhibitor class of drugs (statins). The main aim of the present study was to formulate and evaluate time-controlled pulsatile release Rosuvastatin press-coated tablets. The core tablets were formulated by the Direct compression method. Coated tablets were formulated by the Press-coating technique. The drug delivery system was designed to deliver the drug at a specific time for the patient suffering from Hyperlipidemia. The core tablets containing Rosuvastatin, anhydrous lactose, and different ratios of super disintegrants like croscarmellose sodium, and sodium starch glycolate, among six core tablets were formulated, and they were evaluated for post-compression parameters like Weight variation, Thickness, Hardness, Friability, Disintegration, and In-vitro drug release profile, then the core was optimized by using different ratios of polymers such as Eudragit-S100, Eudragit-L100, and HPMC K4M, Ethyl Cellulose (1:2, 2:1 ratios). Totally four coating compositions were fixed and coated to core tablets by press-coating method, then they were evaluated for post-compression parameters like Weight variation, Hardness, Thickness, and In-vitro drug release studies were performed in 0.1 N HCl for 2 hrs, pH 6.8 phosphate buffer for 6 hrs and pH 7.4 phosphate buffer from the dissolution data the coat containing Eudragit-S100, Eudragit-L100 (2:1) combination shown best profile for pulsatile release of Rosuvastatin. The 10 hrs of lag time for the drug release and the drug release were depending on the effects of the composition of the polymers used.

Based on 2030 vision of the Kingdom of Saudi Arabia (KSA), improving the quality of preventive and therapeutic health care services is one of the targets that set out by the National Transformation Program (NTP). Clinical Audit (CA) is one of the great tools of quality improvement worldwide. Although a CA program was initiated just a while ago in Saudi Arabia, in this short duration the maturity of this practice in this country is evident in various documentations. However, it is still a long path to go in this practice as many health professionals are not yet mindful about the positive implications and benefits of this concept. In this consideration, this article was attempted to highlight the concepts, broad principles of and the mandatory stages in implementing CA practice to a success. Apart from that the leadership role in materializing CA, the barriers to its success, as well as, the pattern of CA practice in Saudi Arabian health care system in achieving its maturity have also been outlined.

Background: Worldwide, head and neck cancer (HNC) was the 6th most common cancer in 2020 in all ages and both sexes. In Bangladesh, lip and oral cavity cancer was the 2nd most common cancer in 2020. Up to 60% of HNC patients presents with locally advanced disease. Aim and Objective: To determine treatment Interruption and hospital admission in head and neck cancer patients during concurrent chemoradiotherapy with or without prophylactic nasogastric tube feeding. Materials and Method: A quasi-experimental study was performed in Radiation Oncology Department of National Institute of Cancer Research & Hospital from 1st January 2020 to 31st December 2020. A total number of 68 Patients (34 patients in each arm) was included in this study according to inclusion and exclusion criteria by purposive Sampling technique. All patients in Arm A and Arm B were planned for total 66 Gray in 33 daily fractions, 2 Gray per fraction, 1 fraction per day, 5 fractions per week over 6½ weeks and inj. Cisplatin 40mg/m² was given intravenously 2 hours before radiotherapy on 1st day and then weekly. All the information’s were recorded in a pre-tested and semi-structured questionnaire. The analysis was done by using independent sample t test for continuous variables and chi-square test for categorical variables and data were presented in tables and graphs. Results: In this study, mean age was 52.5 ± 8.5 years and male: female ratio was 4.2: 1 among all patients. The Incidence of treatment interruption was significantly lower in Arm A compared with Arm B (29.4% in Arm A and 70.6% in Arm B, p-value < 0.05). There were fewer patients who required hospitalization in Arm A (23.5% in Arm A and 55.9% in Arm B) and length of hospital stay was less too (5.3 ± 1.7 in Arm A and 10.0 ± 1.9 in Arm B, p value <0.05). There were no significant differences in treatment response and toxicities between the two groups. Conclusion: Prophylactic nasogastric tube feeding at the beginning of CCRT in head and cancer patients is beneficial in terms of preventing treatment break and reducing hospital admission.

Background: Basis of recurring chest radiography and admission to sanatorium started at some stage in World War 2, for the prognosis of pulmonary tuberculosis in asymptomatic sufferers/soldiers of battle. Meanwhile the declining incidence of Tuberculosis and discovery of recent screening exams result in decrease in chest radiographs screening method. Chest radiographs account for majority of clinical expenditures international. Objective: The objective of this study is to determine the prevalence of chest radiographs PA view in general population of Mirpur Azad Kashmir. Methodology: This cross-sectional study was performed in District Mirpur. The data has been collected from patients at radiology department of DHQ Hospital Mirpur. The study duration was three months after the approval of supervisors. Total 180 patients participated in this study. This included males and females. Convenient sampling technique was used for the collection of data during October 2021-December 2021. Conclusion: In our study mostly patients came with symptoms if cough and according to radiographic findings must patient have cardiomegaly. It is concluded that all patients with the symptoms of SOB ,cough and fever must not have chest infection there could be another cause of these symptoms .Most patients were with cardiomegaly so prevalence if cardiomegaly is higher than chest infections like TB and other infections.

Guaifenesin is an expectorant and belongs to BCS class I which exhibits high solubility and high permeability. Guaifenesin has a half-life of 1 hour; in order to increase its duration of action gastroretentive tablets are formulated. Guaifenesin shows poor flow properties so the method opted for the preparation of this tablets is Top spray granulation. In which HPMC K100LV/HPMC E6LV/HPMC K100M/HPMC K15MPCR is used as swelling matrix polymer, Povidone is used as binder, Magnesium stearate is used as lubricant and MCC is used as diluent. Tablets are evaluated for floating lag time, total floating time, thickness, hardness, friability and invitro drug release studies were performed. The optimized formulation showed less floating lag time, sufficient floating time and with maximum drug release of 88.9% at the end of 12 hours.