ABSTRACT
Objective: The antimicrobial drugs especially Quinolones are the top most therapeutics class of drug prescribed in some country like Pakistan in primary and tertiary care hospitals and clinics. The objective of the study was to assess the irrational prescribing practice of quinolones in tertiary care setups of Karachi. Methodology: A prospective observational study was conducted for the period of 04 months from November 2019-February 2020, in Public and Private Sector Tertiary Care setups of Karachi. Data was collected from surgical, medical and emergency wards on the basis of World Health Organization prescribing pattern, to evaluate the prescriptions based on Culture sensitivity tests (CST), empirical, targeted, and/or prophylactic therapies. Results: Out of total 1000 patients 41.6% patients were from Public and 58.4% were from Private Sector Tertiary Care Hospital. 13.7% of the patients from Public and 24.8% from Private Sector Tertiary Hospitals were prescribed Quinolones after performing their Culture Sensitivity Test. However, 79.8% of the patients were prescribed Quinolones without Culture Sensitivity Test. 36.4% patients were prescribed with empirical therapy, 20.2% with De-Escalation therapy, while 43.4% were prescribed with prophylactic therapy of quinolones. Conclusion: Study concluded that some serious efforts are required to avoid the irrational prescribing practice and promote the rational prescribing practice of antibiotics particularly for Quinolones.
ABSTRACT
Background: Anxiety involved panic attacks either having or not having social fear, social anxiety disorder, generalized anxiety disorder as well as separation anxiety disorder is known to be marked mental diseases. It is related to high medical cost and a significant load of disease. Agaricus blazei Murill (AbM) is a mushroom and possesses immunemodulating and antimicrobial effects both in-vivo and in-vitro and as well as it has been used to treat cancer, hepatitis, dermatitis, and hyperlipidemia traditionally. Method: In this experiment evaluation of anxiolytic effect of AbM on mice has been done by using Elevated Plus Maze test, open field test and motor co-ordination test by rotarod. Mice (Mus musculus) weighing 22-25 grams, were divided into 4 groups (n=6). Oral administration of hydro-alcoholic extract of AbM was utilized in 2 doses i.e. 136.5 mg/kg and 273 mg/kg. Group, I received vehicle (distilled water 10 ml/kg), p.o. Group II received standard (diazepam 1 mg/kg), i.p. Group III and IV orally received hydro-alcoholic extract of AbM (136.5 mg/kg and 273 mg/kg, respectively). Result: In Elevated Plus Maze test, oral administration of hydro-alcoholic extract of AbM (136.5 mg/kg and 273 mg/kg, respectively) exhibited significant (p<0.01) elevation in the percentage of number of open arm entries (48.0 ± 1.1% and 48.93 ± 2.1% respectively) and time spent in open arm (14.92 ± 1.9% and 84.17 ± 2.4%). Conclusion: Hence it is concluded that hydro-alcoholic extract of AbM can be a new therapeutic agent to treat anxiety.
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Objective: In this study, we assessed the laxative effects of Prunus amygdalus oil (PAO) in constipation model of mice. Method: The animals were divided into 6 groups and Prunus amygdalus oil was orally administered in two dose-strengths (3.0 ml/kg/day and 6.0 ml/kg/day) in mice. Group one was administered with Lactulose (30 ml/kg/day) as standard. Understandings of the possible mechanism of laxative action 2 groups of animals were pretreated with atropine (10 ml/kg/day) that moderately inhibit the laxative activity of Prunus amygdalus oil. Results: Results of our study revealed that treatment of PAO was effective in increasing the fecal number and fecal weight and this increase was very close to standard drug Lactulose, which indicate the laxative activity of oil. Those groups of animals which were previously administered with atropine partially inhibit the laxative activity of Prunus amygdalus oil, specifying that laxative action is mainly facilitated through muscarinic receptors activation and indicated the occurrence of Acetylcholine like component. Conclusion: Our study results revealed the laxative activity of PAO mediated mainly with the cholinergic pathway. This study provides a basis for beneficial use of Prunus amygdalus oil in constipation.
ABSTRACT
Severe or pertinent hepatic toxicity interferes with antituberculotic chemotherapy resulting in dose reductions, treatment delays or cessation of therapy. Hepatic toxicity by antituberculotic agents is due to anaphylactic reactions (acetylaor phenotype polymorphism) and is relative to the cumulative dose intensity. Risk of hepatic toxicity is higher in the elderly and alcoholic patients. Patients with previous hepatic diseases such as hepatitis and comorbidities i.e. HIV infections, malnutrition and renal damages are prone to an added risk of hepatic toxicity. This review consolidates the pattern of hepatic adverse effects associated with each component of the antimyobacterial regimen e.g. isoniazid, rifampicin and pyrazinamaide. Higher propensities of hepatic adverse effects are associated with the first line agents, intensified by the incorporation of second line antibiotics, primarily metabolized in the liver. In conclusion the hepatic biomarkers should be monitored in the patient under a tuberculosis treatment plan as well as purposefully assessed during follow-up visits of the patients.