Hypertensive patients' readiness to use of mobile phones and other information technological modes for improvingtheir compliance to doctors' advice in Karachi

To determine the use of information technology [IT] and electronic media for improving compliance rate to doctors' advice in hypertensive patients in Karachi. Total 400 persons [200 males and 200 females] were randomly selected in six districts of Karachi. Data was collected through a pretested questionnaire. Following was sample criteria: age above 15 years, living in Karachi and ambulatory. Persons admitted in a hospital, individuals who were doing some physical activity during survey e.g. exercise, labor work etc., individual in stressed condition, non-cooperative individuals - not willing to get BP checked and fill questionnaire, and pregnant women were excluded. Those who did not sign the consent form were also excluded. SPSS was used for data analysis and descriptive statistics was employed for sensitivity analysis. For healthcare awareness, people look for health programs on radio and TV channels. Short Message Service [SMS] and phone are highly appreciated by patients for reminders. To increase compliance to doctors' advice, less educated people prefer phone calls over SMS whereas educated individuals favor SMS. Although price of medicine has not emerged as a major contributing factor for non-compliance, discount on medicinal products is highly appreciated by the patients. The study concludes that there is a widespread awareness of high blood pressure in the sample population of Karachi e.g. 72.5%. People consider reminder message system i.e. Calls and Short Messaging Service [SMS] would help them in improving compliance to doctors' advice

Current trends in treatment of hypertension in Karachi and cost minimization possibilities

This study finds out drug usage trends in Stage I Hypertensive Patients without any compelling indications in Karachi, deviations of current practices from evidence based antihypertensive therapeutic guidelines and looks for cost minimization opportunities. In the present study conducted during June 2012 to August 2012, two sets were used. Randomized stratified independent surveys were conducted in doctors and general population - including patients, using pretested questionnaires. Sample sizes for doctors and general population were 100 and 400 respectively. Statistical analysis was conducted on Statistical Package for Social Science [SPSS]. Financial impact was also analyzed. On the basis of patients' doctors1 feedback, Beta Blockers,and Angiotensin Converting Enzyme Inhibitors were used more frequently than other drugs. Thiazides and low-priced generics were hardly prescribed. Beta blockers were prescribed widely and considered cost effective.This trend increases cost by two to ten times. Feedbacks showed that therapeutic guidelines were not followed by the doctors practicing in the community and hospitals in Karachi. Thiazide diuretics were hardly used. Beta blockers were widely prescribed. High priced market leaders or expensive branded generics were commonly prescribed. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines

Pathological threat of developing resistance against broad spectrum antibiotics

The objectives of the study were to describe the recent sensitivity pattern against Escherichia coli and Staphylococcus aureus in relation to ciprofloxacin and cefepime as to maintain the effectiveness of the treatment regimen. Furthermore the resistance of these organisms was explored to estimate the impending burden of resistant infections. During the present study 50 isolates of Staphylococcus aureus and 50 isolates of Escherichia coli have been collected from Dr. Ziauddin Hospital Laboratory and Imam Clinic laboratory. The study was done in the department of Pharmaceuticals, Faculty of Pharmacy, Karachi University. The sensitivity pattern of these isolates to ciprofloxacin and cefepime was determined by using Disc Diffusion Method. Data was analyzed by using National Committee for Clinical laboratory Standard [NCCLS]. Data indicated that the clinical isolate of Eschericia coli has exhibited 58% sensitivity, 42% resistance to Cefepime. Where as Staphylococcus aureus has shown 54% sensitivity, 46% resistance to Cefepime. The clinical isolates of Eschericia coli has exhibited 36% sensitivity, 64% resistance to ciprofloxacin, where as Staphylococcus aureus, has shown 44% sensitivity, 56% resistance to Ciprofloxacin. The prescribed drugs must not be used frequently otherwise resistance threat against the relevant microorganism would be increased at an alarming level

Pharmacokinetic study of cephradine in Pakistani healthy male volunteers

To observe and discuss the difference in the pharmacokinetics of Cephradine in Pakistani population with the reported data of other ethnic origins. A Single group pharmacokinetic study was conducted having six healthy male volunteers of 20-24 years of age. Blood samples were collected at appropriate times up to 7 hours. Plasma concentrations of Cephradine was determined by HPLC technique and pharmacokinetic parameters were determined by both compartmental and noncompartmental methods using Kinetica ver 4.4.1 and Winnonlin ver 5.01. Peak plasma concentration was 11.49 +/- 1.73 microg/ml achieved at 0.76 +/- 0.12 hr, after the administration of 250 mg Cephradine to fasting volunteers. Area under the serum concentration-time curve was found to be 16.4 +/- 1.71 microg.hr/ml. Absorption, distribution, disposition and elimination half lives were calculated as 0.183 +/- 0.038hr, 0.248 +/- 0.143 hr, 2.126 +/- 0.341 hr and 0.441 +/- 0.193 hr respectively where as the volume of central compartment and total body clearance were found to be 9.65 +/- 3.78 L and 15.4 +/- 1.89 L/hr. The plasma concentration time curves showed the absorption rate constant was 3.968 +/- 0.05 hr-1, disposition rate constant was 0.333 +/- 0.05 hr-1, distribution rate constant was 3.64 +/- 2.18 hr-1 and elimination rate constant was 1.738 +/- 0.468 hr-1. The value of micro-constants i.e. K12 [central to peripheral compartment] and K21 [peripheral to central compartment] were found to be 1.529 +/- 1.499 hr-1 and 0.704 +/- 0.44 hr-1 respectively, where as MRT and AUMC were calculated as 2.04 +/- 0.09 hr and 35.92 +/- 1.86 hr[2]x micro g/mL. The findings showed that the results of Pakistani subjects are slightly different when compared with the reported data of other ethnic origin

Incidence rate and distribution of paediatric nosocomial infections

The mechanism of action of Nosocomial infection as in any other infectious disease is dependent on host, agent and environment factors. Risk factors for the host are age, nutritional status and co-existing disorders. The organism's intrinsic virulence as well as its ability to colonize and survive within institutions influence nosocomial infections. Diagnostic procedures, medical devices, medical and surgical treatments are risk factors in the hospital environment. Unlike the adults, children are the more susceptible subjects of such kind of infections especially the neonates. Neonatal intensive therapy units usually have a prevalence of about 20% and superimposed by virulent and usually antibiotic resistant strains because of following reasons: o Children that are admitted usually have weak immune system, so they may acquire the colonization of any type of organism. o Ill babies require more handling hence the spread via contact. In describing the incidence rate and distribution of nosocomial infections in children, for implementation and improving infection control measures, one hundred and twenty four isolates of Pseudomonas aeruginosa/Pseudomonas species, Staphylococcus aureus [MRSA/MSSA] and Klebsiella specie, were collected from a pediatric hospital setting in Karachi. The results showed more than 24% [124 isolates of 513 cultures that were suspected of acquiring nosocomial infection] incidence percentage rate. Nosocomial infections are caused in children in a developing country due to the lack of sanitation, monitoring and implementation of infection control procedures. Common sources of such infections were the water supply, poor ward/operation theatre hygienic conditions and utensils

Paediatric nosocomial infections: resistance pattern of clinical isolaten

Hospital acquired infections are transmitted to patients by hospital personnel and other patients, or they may arise from patient's own endogenous flora. Children are one of the most susceptible subjects associated in the hospitalacquired infections and have a higher prevalence rate for infections. This problem is at its extremes in developing countries like Pakistan where in most of cases the severity depends on the hygienic conditions of the Hospitals and lack or lapse of infection control measures. To have a surveillance type of data in this regard, one hundred and twenty four isolates of Pseudomonas aeruginosa/Pseudomonas species, Staphylococcus aureus [MRSA/MSSA] and Klebsiella species, that are commonest among the nosocomial infection causing organisms, were collected from pediatric hospital settings in Karachi. A study of incidence and resistance pattern by Kirby Baur disc diffusion method, with selected antimicrobials, was carried out. These isolates were resistant against most antimicrobials tested. Drugs like mmipenem, meropenem, amikacin, vancomycin [especially in MRSA or BRSA], Fucidic acid [for burns and other infections] and some of the 3rd generation cephalosporins were found quite effective