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Mohammad Zobair Wardak,1 Ahmad Farid Daanish,2 Ershad Ahmad Mushkani,2 Mohammad Asif Atiq2 1Internal Medicine Specialist, Darussalam Hospital, Kabul, Afghanistan; 2Department of Pharmacology, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Mohammad Asif Atiq, Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel +93777378141, Email masifatiq@gmail.comIntroduction: Previous studies have reported an association between certain medical conditions, such as hypertension and diabetes, and severe COVID-19.Objective: To determine the prevalence of hypertension and diabetes among severe COVID-19 patients who were admitted to the only specialized center for COVID-19 in Kabul, Afghan-Japan Hospital Kabul, Afghanistan.Methods: A cross-sectional design was utilized, including 202 patients, admitted to Afghan-Japan Hospital during the first six months of 2022. Medical records of patients tested positive for COVID-19 via Polymerase chain reaction (PCR) with oxygen saturation levels below 90% at the time of admission were included in the study. Age, sex, and the presence of hypertension and diabetes were the studied variables. Descriptive statistics were used for analysis.Results: The median age of the patients were 63 (IQR=54.75– 75) years. Males and females each accounting for 50% of the total, and the majority of the patients (50.5%) were in the age group 60– 79. Of 202 patients, 143 (70.8%) had hypertension, 42 (20.8%) had diabetes, 147 patients (72.77%) had at least one of these comorbidities. Fifty-five patients (27.22%) were without diabetes and without hypertension. The prevalence of hypertension and diabetes was higher among female, ie, 57.1% and 54.5% respectively. Patients in the 40– 59 year old group had the highest rate of hypertension (75.6%). The highest prevalence of diabetes was seen in the 60– 79 year old group.Conclusion: The study found a higher prevalence of hypertension in severe COVID-19 cases compared to global reports and the general adult population in Afghanistan. The relationship between hypertension and COVID-19 risk needs further investigation. The prevalence of diabetes was also higher, consistent with findings from other countries.Keywords: severe COVID-19, comorbidity, hypertension, diabetes

Mohammad Zobair Wardak,1 Ahmad Farid Daanish,2 Ershad Ahmad Mushkani,2 Mohammad Asif Atiq2 1Internal Medicine Specialist, Darussalam Hospital, Kabul, Afghanistan; 2Department of Pharmacology, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Mohammad Asif Atiq, Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel +93777378141, Email masifatiq@gmail.com

Ershad Ahmad Mushkani,1 Fahima Hamidy,2 Tawfiq Ahmad,3 Mohammad Asef Adelyar4 1Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan; 2Department of Nursing Skills, Aliabad Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan; 3Department of Ophthalmology, Shahr Ara Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan; 4Department of Abdominal Surgery, Aliabad Teaching Hospital, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Ershad Ahmad Mushkani, Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel +93-744600222, Email ershadahmad2605@gmail.comObjective: Evaluation of the techniques of respiratory inhaler use among stable inpatients with COPD in Ali Abad Teaching Hospital.Methods: This cross-sectional study was conducted between April 2020 and October 2022 at the cardiopulmonary department of Ali-Abad Teaching Hospital. Participants were requested to demonstrate how to use their prescribed inhalation devices. The inhaler’s accuracy was evaluated using checklists that had been previously established and included key procedures.Results: We studied 318 patients performing a total of 398 inhalation maneuvers with five different IDs. Across all studied inhalation maneuvers, the maximum number of misuses was observed in those using the Respimat (97.7%), and the minimum number of misuses was observed in those using the Accuhaler (58.8%). For the pMDI, the steps “take a deep breath after activating the inhaler” and “hold the breath a few seconds” were most frequently inaccurately performed. Regarding the pMDI with spacer, the steps “exhale fully” were most commonly carried out in mistake. For the Respimat, the steps “hold the breath a few seconds after inhalation activation” and “exhale fully” were most frequently inaccurately performed. According to gender, the misuse was less in females for all studied inhalers (p< 0.05). Higher proportion of literate participant correctly used all types of inhalers as compared to the illiterate patients (p< 0.05). According to the findings of this study, the majority of patients (77.6%) lacked knowledge of proper inhaler technique.Conclusion: The misuse rates were high for all studied inhalers; however, among studied inhalers, the Accuhaler had the greatest proportion of correct inhalation techniques. In order to ensure proper inhaler technique, patients should be educated before receiving inhaler medicines. Therefore, it is crucial for doctors, nurses, and other healthcare professionals to comprehend the problems with the performance and proper usage of these inhaler devices.Keywords: COPD, misuse, inhaler

Ahmad Farid Daanish, Ershad Ahmad Mushkani Department of Pharmacology, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Ershad Ahmad Mushkani, Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel +93-74460022, Email ershadahmad2605@gmail.comObjective: To compare the prevalence of self-medication among first- and fifth-year medical students at Kabul University of Medical Sciences.Methods: A cross-sectional study was conducted with the participation of all first- and fifth-year medical students by using a short, self-administered questionnaire. The prevalence of self-medication was estimated in the entire study population and also in those who had used medicines in the preceding one week.Results: Of the total 302 students, the prevalence of medicine use was 38%. The prevalence of self-medication in all study population was 25.16%, whereas in those who had used medicines was 64.9%. Prescription-only medicines consisted of 59.2% of self-medication. The practice of self-medication and the use of prescription-only medicines were more prevalent among students in their fifth year and among males. While the prevalence of medicine use was the same among males and females, it differed between students in the fifth and first year. Paracetamol, anti-infectives, and non-steroidal anti-inflammatory drugs (NSAIDs) were more frequently used medicines.Conclusion: The use of medicines, self-medication and the use of prescription-only medicines were more prevalent among fifth-year students compared to those in the first-year. This apparently reflects the effect of medical education and training. More specific studies are required to address the issue in more detail and to facilitate interventions. The estimation of the prevalence of self-medication by using a short acceptable recall period, confined in those who had used medicines, seems to be more reasonable and accurate than by using a longer recall period in the entire study population. The prevalence of prescription-only medicines in self-medication could also be a useful indicator.Keywords: self-medication, medical students, medicine use, prescription-only medicines