Do general practitioners know what they are prescribing?

Across-sectional study was conducted to explore general practitioners' [GPs] knowledge regarding the major therapeutic use and adverse effects of drug[s] they prescribe. Three drugs namely tablet Montelukast Sodium, tablet Somatriptan and inhaler Fluticasone Propionate were selected from the list of drugs approved by the Ministry of Health in Pakistan. GPs who had prescribed at least one of the three were inquired about the cost, therapeutic use and one common adverse effect. For each question, one correct option and three distracting options were given. Two hundred and ninety four responses of 131 GPs were included in the final analysis. The correct options for therapeutic use and adverse effect were identified by 61.2% [n = 180] and 40.8% [n = 120] respectively. A statistically significant [p < 0.01] deficit of knowledge regarding adverse effects was observed for those GPs who identified pharmaceutical advertisements as their primary source of information for new drugs and those who were less experienced

Hemoglobin status of pregnant women visiting tertiary care hospitals of Pakistan

To determine the status of haemoglobin levels in pregnant women who visited tertiary care hospitals of various cities in Pakistan for their antenatal care from January 1 to April 30, 2007. This was a descriptive cross-sectional multi-centre study This study was conducted at the Aga Khan University Hospital [AKUH], Karachi, Civil Hospital, Karachi [CHK] and Nawabshah Medical College Hospital [NMCH], Nawabshah. Copies of medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected from January 1 to April 30, 2007. Reports or results of hemoglobin concentrations were also obtained from the patients. A total of 1709 pregnant women were recruited. Majority 1145[67%] were from the age group of 25 to 34 years and 1555[91%] had some degree of anemia. The number of women with moderate to severe anemia [hemoglobin levels < 8 or 8-9.9 gm/dl, respectively] was significantly higher in CHK and NMCH compared to AKUH [p < 0.001]. Whereas mild anemia [hemoglobin levels 10-10.9gm/dl] or normal hemoglobin levels was significantly higher at AKUH [p < 0.001]. Moderate anemia [hemoglobin levels of 8-9.9gm/dl] was statistically more frequent in second and third trimester, while mild anemia [hemoglobin levels of 10-10.9gm/dl] was more in first trimester of pregnancy. The distribution of severe anemia however; was not different is the three trimesters. About 90-92% subjects received iron/vitamin/mineral supplements irrespective of the hemoglobin status of the woman. Prevalence and severity of anemia in pregnant subjects attending the tertiary care hospitals of Pakistan is exceptionally high. Current findings highlight the anemia in pregnancy as a priority area of concern

Prescription of new drugs by general practitioners in Pakistan: an exploration into information sources, prescription influences and general attitudes

In Pakistan, an average of 2000 brands are approved for marketing by the Government of Pakistan annually. However, there is a dearth of studies on the topic of sources of information used by physicians regarding new drugs and important factors, which lead to actual prescription of these drugs. To explore the common sources of information concerning new drugs for the General Practitioners [GPs] and to study different factors influencing their prescription. The study design was cross-sectional descriptive. Licensed GPs registered with Pakistan Medical and Dental Council working in both institutional and independent settings included. A total of 124 GPs from 5 districts of Pakistan namely Karachi, Lahore, Hyderabad, Multan, Larkana and other smaller towns participated in the study. They were interviewed with the help of a Questionnaire. Potential sources of information and influential factors regarding prescription derived from a thorough review of literature were listed in the Questionnaire. Representatives from pharmaceutical companies [82%] represented the most common source of information about new drugs followed by Pharma guide [51.6%] and medical journals [41.8%]. When asked about the factors which influenced them to start prescribing new drugs, 75.2% listed pharmaceutical representatives as being an influencing factor. This was followed by good reputation of pharmaceutical company [64.5%] and drug samples given by the respective companies [45.5%]. The results of our study establish pharmaceutical representatives and pharmaceutical advertisements as the major source of information regarding new drugs for GPs in Pakistan followed by Pharma guides, medical colleagues and medical journals

Endothelial dysfunction underlying the increased contractility in aorta from older rats

Aging is associated with marked changes in the cardiovascular system and is one of the most important independent risk factors for cardiovascular diseases. The purpose of this study was to elucidate whether smaller increases in age influences the vascular contractile effect of various stimuli in rat thoracic aorta. An additional aim was evaluate the contribution of vascular smooth muscle and endothelium in case there is an altered behavior of the contractility of the aorta in various age groups. Open rings of male Wistar rats of 7, 11 and 15 weeks were used in this study. The experiments were done in both endothelium-denuded as well as endothelium-intact preparations. Isometric contraction was measured by a force-displacement transducer. KC1-induced contraction was not different in endothelium-denuded preparations from the three groups of animals, however, phenylephrine [PE], PGF[2 alpha] and endothelin-1 [ET-1] produced an exaggerated contractile response in aorta from 15 week animals. Carbachol relaxed the contraction produced by PE in a concentration-dependent manner; however, the magnitude of relaxation was more marked in 7 week animals compared to that in 11 or 15 week rats. Our study shows for the first time that even a modest increase in age from 7 to 15 weeks produces changes in VSM as well endothelial cells resulting in exaggerated contractile response to agonists

Effects of changes in PH the contractility of vascular smooth muscle

Hydrogen ion concentration [H+] is an important regulator of many cellular functions including contractility of the vascular smooth muscle cells. In many physiological and pathological states, changes in pH may have profound effects on the contractility of blood vessels and thus on the peripheral vascular resistance and blood pressure. Therefore, it is necessary to understand the likely outcome of the situations in the conditions, where pH changes are frequent. In this review, the mechanisms involved in the contractile responses of vascular tissues to pH changes are discussed