Propranolol is a nonselective ß adrenergic receptor antagonist with equal affinity for ß1 and ß2 adrenergic receptors, lacks intrinsic sympathomimetic activity, and does not block a receptors. Propranolol is absorbed following oral administration and consists in two enantiomers, the (-) enantiomer is the active form and is cleared from the body more slowly than the inactive (+) enantiomer. Much of propranolol is metabolized in the liver and the metabolites of propranolol are 4-hydroxypropranolol, 5-hydroxypropanolol, N-desisopropranol, and propranolol ß-D-glucuronide. The oral dose of propranolol hydrochloride is 250 to 750 µg/kg thrice-daily in infants and in children it is 200 to 500 µg/kg thrice-daily or 4 times-daily. Propranolol has been found efficacy and safe in infants and children but may induce adverse-effects. The elimination half-life of propranolol is about 15 hours in term and preterm infants and the distribution volume of propranolol is larger than the water volume. Propranolol interacts with drugs. Halofenate, phenytoin, phenobarbitone, rifampicin, and ethanol which affect the clearance of propranolol, and chlorpromazine and cimetidine inhibit the metabolism of propranolol. The prophylaxis, treatment, and trials with propranolol have been extensively studied in infants and children. Propranolol crosses the human placenta but it does not equilibrate between the maternal and foetal compartment and migrates into the beast-milk. The aim of this study is to review the published of propranolol dosing, efficacy and safety, effects, adverse-effects, metabolism, pharmacokinetics, interaction with drugs, prophylaxis, treatment and trials in infants and children and propranolol transfer across the human placenta and migration into the beast-milk.

Introduction: The application of and effective fiscal policy for the smoking control in the health context begins understanding the smoking impact over the health market equilibrium. Objective: To describe the basic relation between the health market equilibrium and the application of a fiscal policy for the appropriate smoking control. Materials and methods: Was made a descriptive research about the basic relation between the health market equilibrium and the application of a fiscal policy for the appropriate smoking control. As teoric methods were used the descriptive, the comparative and the historic – logic. As empiric method was used the bibliographic research. The graphs were designed by Microsoft Excel 2007. Results: Society would be better without smoking and fiscal authorities must acknowledge it and take decision agree to that fact. These authorities need induce to smokers to reduce the tobacco consumption. For that fiscal authorities need understand the main causes from the tobacco consumption beginning and keeping. Conclusion: Tobacco consumption intensity growing carries to increase the price equilibrium from this market and much patients leave from this market because of smoking impact. That’s why the fiscal authorities must use the fiscal policies carrying the population to a context with lowest smoking impact over the health services market.

Cancer is not only the challenging disease but the treatment is so the same. Chemotherapy is the treatment plan that is included as an essential treatment which increases the chances to live in serious cancer stages and their types but chemotherapy induced cardiac dysfunction is the life-threatening complications leading to electrophysiological dysfunctions presented at Electrocardiogram. Studies have presented that Chemotherapy is the cause around 5% of cardiac-toxicities and near 4% the reason of cardiac death in cancer. This study aims to review the literature behind the effect of chemotherapy on the electrocardiogram and its alterations see at various stages and types of cancer. The research literature was extracted the data from Google scholars, PubMed, Medline, and Cochrane. Various alterations on ECG parameters that were QTc prolongation, abnormal ventricular repolarization, increased heart rate, QRS complex abnormalities and the severity to the disease was seen in the increased in stage of cancer as early the cardiac toxicity was noticed and delayed in early cancer diagnosis.

Datura metel (Solanaceae) from south Lebanon. The different parts of this plant contain the tropane alkaloids atropine (AT) and scopolamine (SC), which are naturally muscarinic receptor antagonists. A method has been developed for the extraction and HPLC-UV analysis of the AT and SC in different parts of D. metel, namely seeds, capsule, leaf, and stem. This analytical method was validated and gave a good detection response with linearity over a dynamic range of 0.03-0.17 mg?mL-1 and recovery in the range of 93.9–108.76%. Limit of detection (LOD) and limit of quantification (LOQ) values were 32 and 98 µg.mL-1 for atropine and 31 and 93 µg.mL-1 for scopolamine, allowing a reliable quantitation of the target alkaloids. The solvent system Methanol/acetonitrile was the better choice for extracting tropane alkaloids from different Datura parts. Capsule parts of the plant accumulate the highest amount of scopolamine, while seeds accumulate the higher amount of atropine. Briefly, the order of scopolamine concentrations in Datura metel parts, from Lebanon, was in capsules ? seeds ? leaves ? stems and for atropine, the concentrations were in seeds ? capsules ? stems ? leaves.

Background: There is an evident change in the colorectal cancer demographic over the period. This change is more marked in the age distribution and location of the tumor. It has practical implications, in regards to develop cancer awareness programs and screening protocols. Keeping in view that Pakistan is one of the countries with a high number of the young population this study is carried out to make a comparative analysis of this trend in our population. Material and methods: Colorectal cancer patients presented in Sindh Institute of urology and transplantation from January 2011 till December 2020 was reviewed retrospectively. All patients were divided into two groups, Group A young age population and Group B old age population. Subgroup analysis of study period was performed to check the progressive change in the trend of stage and clinical characteristics of colorectal cancer patients. Data reviewed from the patient’s files and collected as per Proforma requirement. Result: Total of 612 patients with colorectal cancer presented between 2011 till 2020.Among these patients 243 (39.7%) presented between January 2011 till December 2015. Patients age 50 years and younger were 410 (66.8%). Results showed a statistically significant association between and patient’s age and location of tumor such that left-sided colonic cancer and rectal cancer were more common in the young population. Subgroup analysis according to the study period showed that there is a change in the trend of disease presentation. Right-sided colonic cancer presentation decreased in the younger population over the period while simultaneously left-sided colonic cancer and rectal cancer presentation increased. Conclusion: The incidence of left-sided colonic and rectal cancer has been increased in the younger population over the specified period while there was no association between right-sided colon cancer and age noticed.