Out of pocket [OOP] cost of treating hypertension in Karachi, Pakistan

Pakistan is categorized to below to middle income countries where two third of the national annual health expenditure is in the form of out of pocket [OOP] cost. A prevalence based study was conducted to determine the OOP cost treatment of hypertension in Karachi by interviewing 350 hypertensive patients aged >30 years through a validated questionnaire. Hypertension [HTN] was classified into stage 1 and stage 2 and was found to be common in females [53.42%] than males [46.57%]. The total costs of stage 1and stage 2 HTN were calculated to be217869.7PKR and17545457.6 PKR respectively. The average treatment cost of stage 1 was observed to be significantly lower [p=0.006] than the cost of stage 2 HTN. Moreover; the cost of antihypertensive drugs, physician fees and laboratory tests were considerably different however; no variation was seen in cost of transport and loss of productivity through absenteeism from work. Overall, the present study indicates that the antihypertensive treatment has imposed a high burden on the pocket of common man and this is a major reason for treatment non-adherence. Consequently, it increases the risks of cardiovascular events, morbidity and mortality. Therefore, effective strategic planning is need of time to reduce OOP cost for better control on hypertension in Pakistan

need of instituting public health education programs in Karachi

Objective: To determine the awareness, need, role, and the effectiveness of the health education programs in improvement of well being of the community/citizens. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted, from Aug to Dec 2015 at the four districts of Karachi city

Material and Methods: The instrument of the study was a questionnaire, including basic demographic information of the participants and other 20 items related to need and role of health education programs in control of diseases. A total 250 participants were selected through stratified random sampling design from residential areas of North, South, East and West districts of Karachi. Participants failed to answer item one of the questionnaire were excluded from the study. The data was then analyzed and expressed in percentages and graphs

Results: Total 189 residents were continued the participation belonging to the age group between 18-65 years. Majority of the respondents [96.82%] were in favor of organizing health education activities. About 75.13% believed that such programs have pronounced effect in management of diseases. Furthermore, participants [51.32%] were willing to attend health seminars/symposiums and workshops to be aware to their medical problems. It was also found that they have basic concept of immunization and harmful effects of smoking on health

Conclusion: Over all the residents of Karachi were well aware to the health education and its role in improvement of disease status. Residents showed positive response for participation in health education activities to manage their illness or medical problems. However, the present study involves a smaller population subjects. Authors highly recommended the institution of health education programs in hospitals and community to make the people and environment healthy

Quality surveillance of immediate release aceclofenac tablets (100 mg) available in local market

Aceclofenac is considered to be an effective drug that has been widely prescribed for multir pjedical complaints globally. Owing to high demand many generic counterpart of aceclofenac tablets are now available in the commercial market. The aim of the present work is to evaluate and compare the quality attributes of various national/local brands of aceclofenac immediate release tablets [l00mg] with the standard multi-national brand available in Pakistan. Physico-chemical evaluation was performed by determining the average tablet weight, thickness

Sensitivity pattern of ceftriaxone against different clinical isolates

Emerging resistance against broad-spectrum antibiotics for standard empiric therapy is a global concern. Ceftriaxone [broad spectrum, third generation cephalosporin] is widely used in tertiary care settings to treat severe bacterial infections usually non-responsive to other antibiotics. The aim of the study is to evaluate the current sensitivity pattern of ceftriaxone [30micro g/disk] among different clinical isolates. For this purpose, three hundred clinical isolates including Escherichia coli [25%], Staphylococcus aureus [30%], Salmonella typhi [17%] and Klebsiella pneumoniae [20%] were collected from different pathological laboratories of Karachi, Pakistan. The in-vitro sensitivity of different Gram positive and Gram-negative bacteria was determined by disk-diffusion technique using 0.5 McFarland standard. Results showed that ceftriaxone was highly sensitive against Escherichia coli [90%] and least sensitive against Klebsiella pneumoniae [65%]. It is concluded that the sensitivity of ceftriaxone is progressively decreasing in comparison with past studies creating an alarming situation. Therefore, continuous surveillance is required to determine the current resistance status of clinical pathogens and for effective anti-microbial therapy

Prevalence of tension type headache in undergraduate students

Tension Type Headache [TTH] is one of the most frequent types of headaches, noted in adults. The major reasons leading to TTH are Socio-economic crises, breakup of relationship, failures in life and academic pressures among other. The aim of this study is to determine the prevalence of TIH in undergraduate students of Pharmacy. Two hundred and eighty five students were randomly selected from different universities who were provided with a questionnaire, to evaluate the intensity of stress during their study. The prevalence of TIH was found to be 57.6% in a population, being 44.8% among females and 16.8% among males. Students used self-medication for relief as they were not satisfied with their educational system as well as examination pattern. Majority of them wished to change the pattern of examination from subjective to objective types of question. It was concluded that the academic pressure is one of the major leading causes of TTH and therefore, it was suggested that the professional educational system should be modified to minimize the risk of TTH, with a view produce more healthy and confident graduates

Food-drug interactions

The effect of drug on a person may be different than expected because that drug interacts with another drug the person is taking [drug-drug interaction], food, beverages, dietary supplements the person is consuming [drug-nutrient/ food interaction] or another disease the person has [drug-disease interaction]. A drug interaction is a situation in which a substance affects the activity of a drug, i.e. the effects are increased or decreased, or they produce a new effect that neither produces on its own. These interactions may occur out of accidental misuse or due to lack of knowledge about the active ingredients involved in the relevant substances. Regarding food-drug interactions physicians and pharmacists recognize that some foods and drugs, when taken simultaneously, can alter the body's ability to utilize a particular food or drug, or cause serious side effects. Clinically significant drug interactions, which pose potential harm to the patient, may result from changes in pharmaceutical, pharmacokinetic, or pharmacodynamic properties. Some may be taken advantage of, to the benefit of patients, but more commonly drug interactions result in adverse drug events. Therefore it is advisable for patients to follow the physician and doctors instructions to obtain maximum benefits with least food-drug interactions. The literature survey was conducted by extracting data from different review and original articles on general or specific drug interactions with food. This review gives information about various interactions between different foods and drugs and will help physicians and pharmacists prescribe drugs cautiously with only suitable food supplement to get maximum benefit for the patient

Analgesic prescribing in developing countries

Prescription writing is the key part in healthcare provision. This study aims to find out the current prescribing practice for the analgesics in tertiary health care centers situated in Karachi. Cross sectional, random sampling method was used to collect 1000 medicine chart of patients from different hospitals in the metropolitan city of Karachi from July to December 2008.These charts were reviewed to get information about patients' demography, reason for hospitalization, medications, number of analgesics. Different variables were determined in this study including the gender and age group of majority patients taking analgesics with their prescribing frequency, combination analgesics and different prescription errors. Results are expressed in frequency and percentage. 1000 medicine charts were reviewed. Five thousands eight hundreds and ninety one drugs were prescribed out of which 1,084 were analgesics [18.4%], 821[75.7%] were non opioids and were 263 [24.26%] opioids. Analgesics were more prescribed to females [N=564; 56.4%] than males [N=436; 43.6%]. The most prevalent age groups was between 11 to 30 years [N=263; 26.3%] and 31 to 70 years [N=200; 20%]. Paracetamol was the most frequently prescribed analgesic [N=340; 34%] followed by opioids [N=263; 26.3%], acetic acid NSAIDs? derivatives [198; 19.8%], aspirin [175; 17.5%], propionic acid NSAIDs derivatives [N=56; 5.6%] and fenamic acid NSAIDs derivatives [N=52; 5.2%]. Paracetamol and aspirin were commonly prescribed in combination with other analgesics. The most common prescription errors were omission of weight of patient [N=174; 17.4%] and strength of tablet [N=136; 13.6%], wrong dosage form [N=l16; 11.6%] and omission of route of administration [N=104; 10.4%]

overview of clinical pharmacology of ibuprofen

Ibuprofen was the first member of Propionic acid derivatives introduced in 1969. It is a popular domestic and over the counter analgesic and antipyretic for adults and children. Ibuprofen has been rated as the safest conventional NSAID by spontaneous adverse drug reaction reporting systems in the UK. This article summarizes the main pharmacological effects, therapeutical applications and adverse drug reactions, drug-drug interactions and food drug interactions of ibuprofen that have been reported especially during the last 10 years

In vitro susceptibility test of different clinical isolates against ceftriaxone

Because of the prevailing penicillin resistance in microorganisms, broad spectrum cephalosporins are used empirically specially in developing countries. The aim of this study is to determine the susceptibility pattern of different gram positive and gram negative pathogens against third generation cephalosporin-ceftriaxone to explore the existing effectiveness of this antibiotic. 180 clinical isolates of different gram positive and gram negative pathogens including P.mirabilis, S. typhi P.aeruginosa, E. coli, S. aureus and Klebsiella were collected from blood and urine samples of in-patients. 30 isolates of all species were tested against each of six brands of ceftriaxone using in vitro sensitivity tests by disc diffusion method [NCCLS criteria]. The susceptibility limit was >/= 21 mm zone of inhibition, while moderately susceptible was considered at 20-14 mm, and those isolates which showed>13 mm or no zone of inhibition were resistant to this antibacterial drug. Ceftriaxone was found most effective against S. aureus. While 96.1% of the isolates showed susceptibility towards ceftriaxone, followed by E. coli [95%], P. aeruginosa [92.7%], K. pneumonia [89.4%] and S. typhi [87.2%]. P. mirabilis showed lowest susceptibility amongst all the test organisms [83.8%]. Ceftriaxone can be used as a drug of choice in infections caused by S. aureus, E. coli, P. aurigenosa, K. pneumonia and S. typhi. However, it should be used with other antimicrobial agents in order to increase its effectiveness against P. mirabilis

Formulation development and optimization of Ibuprofen tablets by direct compression method

Ibuprofen is widely used as a prescription and non-prescription medicine. The aim of study is to prepare Ibuprofen tablets [200mg] using direct compression technique which is now days considered a cost effective and simple method of manufacturing. It is considered as an appropriate method for hygroscopic and thermolabile substances. In order to obtain the best, optimized product, nine different formulations were developed. Diluent [X1], disintegrant [X2] and lubricant [X3] were taken as independent variables. Weight variation [Y1], thickness [Y2], length and width [Y3], hardness [Y4], friability [Y5], disintegration [Y6], dissolution [Y7] and pharmaceutical assay [Y8] were studied as response variables. The results of all nine formulations were found within the acceptable limits conforming to those given in official compendia. However, F-6 was selected as an optimized product on the basis of high dissolution [99.05%] and Assay [100.04%]. The variation of weight among the tablets of F-6 was least which showed best ratio of excipients in the formulation. Optimization has proven as an effective tool in product development. This is because no clear relationship exists between the variables