ABSTRACT
The extent and nature of irrational prescribing of drugs has not been explored in Pakistan A pilot study was therefore undertaken in three major teaching hospitals located in the twin cities of Rawalpindi/Islamabad. Six hundred and one prescriptions from medical, paediatrics and psychiatry units of these hospitals were analyzed to study the prescribing pattern. The mean number of drugs per prescription was found to be 2.97. Only 23.6% drugs were prescribed by their generic names. About 80% of the prescribed drugs were from the National Essential Drug List of Pakistan. Use of injectable preparations was 17.1%. Antimicrobials constituted 20.4% of the drugs prescribed, frequently for cases of acute respiratory infections and gastroenteritis. The average cost of treatment per day was Rupees 26.10 in the outdoors and Rs. 88.36 in indoors. Treatment did not correlate to the diagnosis in 24.6% of the cases. Doses of drugs were inappropriate in 30.6% prescriptions. Duration of treatment was not specified on a vast majority (73.4%) of the prescriptions. The data highlights the need for educational, managerial and regulatory interventions to rationalize the drug use in Pakistan.
Subject(s)
Drug Utilization , Hospitals, Teaching , Practice Patterns, Physicians' , Humans , Pakistan , Retrospective StudiesABSTRACT
A rapid, sensitive and specific high-performance liquid chromatographic method was developed for the determination of serum levels of retinol in humans. A direct serum injection technique after deproteinisation was used to avoid lengthy pretreatment steps which can result in degradation of retinol during analysis. The column used was CLC-ODS, the mobile phase was acetonitrile-water and detection wavelength was 328 nm. Deterioration in column performance was not observed even after injection of 300 samples. The lower detection limit was 10 micrograms/l. On analyzing a serum pool six times, a C.V. of 0.7% was obtained. The method is quantitative, reproducible, rapid and highly accurate for routine analysis.
Subject(s)
Chromatography, High Pressure Liquid/methods , Vitamin A/blood , Child, Preschool , Female , Humans , Infant , Male , Reproducibility of ResultsABSTRACT
PIP: Sterols, steroidal sapogenins, steroidal alkaloids and alkaloidal amines derived from plant sources provide the starting materials for steroid production. Sarmentogenin (III) a cardiac glycoside, was first used, but the source was limited. Hecogenin (IV), a saponin (Agave sislana), was manufactured to cortisone by the process of Spensley et al. Introduction of an oxygen atom at carbon 11 by microbiological means gave a new series of starting compounds, among them, diosgenin (V) which converts to progesterone, to 11 hydroxyprogesterone by fermentation, cortisone, hydrocortisone and delta compounds. Reviews on the development, physiological and biochemical aspects of oral contraceptives were mentioned. A steroid with activity equivalent to progesterone was made by Ehrenstein in a 12-step synthesis from a cardiac aglycone strophanthidin. Estradiol converted to 19-nor testosterone by Birch and Mukherji provided a breakthrough in production of 19-nor steroids and led to production of 19-nor progesterone (VI) with a higher activity than progesterone. 19-nor-17alpha-ethynyltestosterone (VIII), its acetate derivative, and a related compound (I) account for 80% of consumption of oral contraceptives in the United States. Reviews of nor-steroids by Colton and Kilmstra, and of the chemical developments leading to currently used steroid contraceptives by Djerassi are mentioned.^ieng
