Farnaz Malik

Pakistani pharmacy students' perception about complementary and alternative medicine.

Objectives. To assess Pakistani pharmacy students’ perceptions of complementary and alternative medicine (CAM), the frequency with which they use CAM, and barriers to use of CAM. Method. A CAM health belief questionnaire was administered to 595 students enrolled in a 5-year doctor of pharmacy program (PharmD) in Pakistan. Results. Attitudes of students towards CAM were positive. Lack of evidence supporting CAM practices was considered to be the major barrier toward more students using CAM. A majority of students (79%) agreed that clinical care should integrate conventional medicine and CAM practices. Many CAM-based therapies, such as dietary supplements, massage, herbal medicines, and homoeopathic medicines were used by the students. Significant gender differences in attitude were observed, with male students having more conservative attitudes toward CAM use. A high percentage of students desired more training in CAM. Conclusions. Pakistani students exhibited positive attitudes about the value of CAM and most felt that CAM should be included in the PharmD curriculum.

Assessment of antibiotic prescribing behavior of consultants of different localities of Pakistan

The objective of study was to evaluate the pattern and practice of consultants especially antimicrobials in the allopathic health sector in Pakistan to assess the magnitude of the problem and suggesting corrective measures. A cross-sectional survey in various cities of Pakistan was conducted which was developed in line with WHO and has so far been implemented in 12 developing countries. A total of 4923 prescriptions of 197 consultants were collected and analyzed. Drugs dispensed were 480142; average number of drugs per prescription for all disciplines was 3.13±1.5. The number of encounters with antibiotics in medicine department was 20.17% of the total antibiotic while ophthalmology had no encounter with injectables. Cost of 23.79% of prescriptions was below Rs.100 and 4.9% above 500 rupees. Therapeutic categories of the drugs prescribed were 14.6% antimicrobial followed by 12.5% cardiovascular or renal drugs. The age of the patient, severity of disease, socio-economic status, previous experience of treating similar patients were important factors that determined choice of drugs. EDL was not available in most of the facilities. Around 80% drugs were prescribed by brand name. The drugs prescribed from the essential list were around 30%. Concern of losing patients to others practitioners was considered among the top three factors by only 18% of providers. Age of the patient, severity of disease, socio-economic factors were important factors that determined choice of drugs. Prescribing and dispensing practices are inappropriate and irrational in Pakistan like many developing countries. Managerial and regulatory interventions are proposed to improve the rational use of drugs.

Prescribing of bisphosphonates and antibiotics in Pakistan: challenges and opportunities for the future

The management of patients with osteoporosis and the rational use of antibiotics are growing concerns in Pakistan. The first step is to assess utilisation patterns, prescribing behaviour and the potential rationale among a range of medicines including bisphosphonates and antibiotics, and subsequently use the findings to suggest potential future policies for all key stakeholders to improve patient care in the future.

Phyto-chemical analysis, anti-allergic and anti- inflammatory activity of Mentha arvensis in animals

Allergic diseases are fairly common in all parts of the world and involve all ethnic groups with bronchial asthma, allergic rhinitis, conjunctivitis and eczema being the commonest manifestations. Despite our efforts, their incidence is on an escalating path. The use of herbal remedies and standardized extracts for treatment of allergy and other diseases has been gaining momentum in recent years. The qualitative and quantitative determination of phyto-chemicals and assessment of the anti-allergic and antiinflammatory activities using aqueous and organic extracts of different plant parts (root, stem and leaves) of Mentha arvensis in animals showed that all parts of M. arvensis (specifically, leaves) are rich source of secondary phytoconstituents, which impart their therapeutic effects against allergic and inflammatory diseases. These results support the claim about the use of this herb in folk medicines.

Enzymatic saccharification and lactic acid production from banana pseudo-stem through optimized pretreatment at lowest catalyst concentration.

This work estimates the potential of banana pseudo-stem with high cellulosic content 42.2-63 %, for the production of fermentable sugars for lactic acid production through statistically optimized pretreatment method. To evaluate the catalyzed pretreatment efficiency of banana pseudo stem based on the enzymatic digestibility, Response Surface Methodology (RSM) was employed for the optimization of pretreatment temperature and time using lowest concentrations of H2SO4, NaOH, NaOH catalyzed Na2S and Na2SO3 that seemed to be significant variables with P<0.05. High F and R2 values and low p-value for hydrolysis yield indicated the model predictability. The optimized condition for NaOH was determined to be conc. 1 %, temperature 130 oC for 2.6 hr; Na2S; conc. 1 %, temperature 130 oC for 2.29 hr; Na2SO3; conc. 1 %, temperature 130 oC for 2.41 hr and H2SO4; conc. 1 %, temperature 129.45 oC for 2.18 hr, produced 84.91 %, 85.23 %, 81.2 % and 76.02 % hydrolysis yield, respectively. Sulphuric acid provided 33+1 gL-1 reducing sugars in pretreatment step along with 38+0.5 gL-1 during enzymatic hydrolysis. Separate hydrolysis and fermentation of resulting sugars showed that the conversion of glucans into lactic acid reached 92 % of the theoretical yield of glucose.

Alternative and Traditional Medicines Systems in Pakistan: History, Regulation, Trends, Usefulness, Challenges, Prospects and Limitations

Over the last few decades, there has been a considerable interest worldwide in Traditional medicine/Complementary and Alternative Medicine (TCAM) particularly in herbal products. The World Health Organization also advocates the important role of alternative and traditional medicines in preventive, promotive and curative health, especially in developing countries and encourages member states to support traditional medicines to and plan for, formulation of policies with appropriate regulations (WHO, 2001).

Prevalence of Vitamin D deficiency in Pakistan and implications for the future

ABSTRACT Background and aims: vitamin D deficiency (25-hydroxyvitamin D) affects over one billion people worldwide. Vitamin D deficiency results in progression of osteoporosis as well as other conditions. Previous studies have shown high rates of vitamin D deficiency in Pakistan despite appreciable levels of sunshine. However, none have assessed vitamin D deficiency across all age groups, genders, incomes, and locations to guide future strategies. Methods: Questionnaire and blood sampling among 4830 randomly selected citizens. Results: High levels of deficiency among all age groups, genders, income levels, and locations. Amongst the selected citizens, 53.5% had vitamin D deficiency, 31.2% had insufficient vitamin D, and only 15.3% normal vitamin D. Conclusion: High rates of vitamin D deficiency in Pakistan despite high levels of sunshine and previous Food Acts asking for food fortification with vitamin D. Public health strategies are needed to address high deficiency rates, including food fortification, i.e. nurture, alongside increasing exposure to sunlight, i.e. nature. This will involve all key stakeholder groups.

Hepatoprotective effects of Justicia adhatoda L. against carbon tetrachloride (CCl 4 ) induced liver injury in Swiss albino mice

) induced liver damage in Swiss albino mice. Liver injury was assessed by estimation of biochemical parameters which includes liver function tests and supplemented by histopathological examination of liver. Aqueous, ethanolic and methanolic extracts of different concentrations were given orally and activities of these extracts were compared with standard drug (silymarin). The results showed that

Seroepidemiological surveillance of antitetanus antibodies in Pakistani childbearing women: A population based survey

Maternal and Neonatal Tetanus is a severe, often fatal ailment characterized by sweeping augmented strictness and convulsive spasms of skeletal muscles. Vaccination is the most steadfast method of forbearance against this disease and has inculcated to lessen mortalities. The present study was carried out with a view to assess the serum levels of tetanus antitoxins in randomly selected rural and urban women to find out the effect of age, number of pregnancy, parity and number of injections at the time of delivery. The study was cross-sectional in design and hospital-based. The gold standard mouse neutralization assay was employed despite being costly and cumbersome. Antibody titre of each sample was determined by seroneutralization method. 1504 women, randomly selected from various hospitals of age 15 to 40 years, 1064 (0.000) were vaccinated, which are significant while 440 were unvaccinated women and taken as control. The 65% (p = 0.000) women had antibody titre higher than protective level which is significant, 28% equal to protective level and 6.7% below protective level. Average antibody titre of 3rd trimester was higher than 2nd trimester (p = 0.000) which is significant. Immunization awareness and practice was higher in 30 years in women (63%) of both rural and urban areas but practice was comparatively higher in urban (74%) than rural area (67%). These finding shows that tetanus vaccination in our population is generally effective and cannot be protected by herd immunity, as tetanus is not communicable disease. Key words: Antitetanus antibodies, seroneutralization, childbearing age, Pakistan. INTRODUCTION Tetanus caused by Clostridium tetani , is a vaccine-preventable, global infectious disease with significant morbidity and mortality. The global status of serological immunity against tetanus varies between countries as a result of different national vaccination policies and methods, and the criteria used for determination of serum levels of tetanus antitoxin. Protective immunity was noted

Sero-surveillance of measles amongst vaccinated and non-vaccinated children: An age stratified population based survey in Pakistan

Measles is one of the most contagious human diseases; it remains a leading cause of death among young children and its elimination is one of the major global public health priorities. It is estimated that in year 2008 approximately 100,000 deaths in children aged less than 5 years was attributable to measles. The increase in measles vaccination coverage in the developing world has produced significant changes in the epidemiology of the infection. The present age stratified cross sectional survey was conducted in Islamabad, Pakistan and its adjoining areas during January to June, 2009 to determine the measles protective titre in children of 1 to 15 years. 927 blood samples of children were collected to ascertain the measles antibodies by ELISA assay. 588 were males and 339 were female (p = 0.001). Measles IgG antibodies sero-positive ratio in children among examined population was 741 (79.9%), sero-negative 174 (18.77%) (p = 0.001). Out of 174 seronegative children, 135 (14.5%) were vaccinated while 39 (4.20%) children were non-vaccinated. The children were divided into three groups, that is, 1 to 5 years (pre school age), 6 to 10 years (primary school group) and 11 to 15 years (secondary school going children). Sero-positive antibodies percentage increased age. Measles IgG antibodies ratio is higher in male children as compared to female. Sero-surveillances should be conducted at regional and provincial levels to assess the actual level of protective titre throughout the country and to evaluate the country’s vaccination program. The routine coverage of immunization should also increase from 80 to 100%.