Fatima Zehra

Isolation and structure of cucurbitacin Q1

Abstract Cucurbitacin Q1, a compound isolated from the fruit of Cucumis prophetarum , has been shown to be the pure trans component of cucurbitacin Q.

The cost of poliomyelitis: Lack of cost-of-illness studies on poliomyelitis rehabilitation in Pakistan

182 Archives of Pharmacy Practice  Vol. 7  Issue 4  Oct‐Dec 2016 restore them to a functional life. Usually, LT results in excellent shortand medium-term outcomes although rarely long-term. Those patients are lucky who come walking back through the doors of the Intensive Care Unit to offer thanks to doctors and their near and dear ones. For others with permanently failing organ systems, life-sustaining interventions do not work out while new complications keep arising, and recovery looks impossible. Patients often think of the irony, what kind of living is this? Perhaps need to be tolerated only if recovery being the final reward. Patients need to undergo LT provided they find a suitable donor match in time and only if they are ready to take on the added cost of follow-up care. For patients of age <40 LT is a life saving procedure. However, for the underprivileged looking at the current cost of procedure and treatment, LT looks unaffordable.

Epidemiology of primary amoebic meningoencephalitis-related deaths due to Naegleria fowleri infections from freshwater in Pakistan: An analysis of 8-year dataset

Objective: This study was aimed at gathering all the data related to Naegleria fowleri resulted primary amoebic meningoencephalitis (PAM) deaths in Pakistan and present it in a dataset, conduct statistical analysis to report any significant finding and present it as a base for future investigations on the subject. Materials and Methods: A retrospective 6-month study was designed which gathered data related to N. fowleri resulted PAM spread in Pakistan from 2008 to 2015. The study adhered to STROBE recommendations for observational cross-sectional studies. Results: The mean (X) age of the patients was 29.47 years (standard deviation [SD]: 13.95), and adults between 26 and 45 years were most affected (n = 24, 24.5%). The mean (X) survival days after onset of symptoms till death was 4.26 (SD: 2.94). Mortality observed from 2008 till 2015 was 98 (n = 98, 100%). The majority of deaths occur in southern city of Karachi (n = 94, 95.9%) in temperature range of between 35°C and 39°C (n = 39, 60.2%). An incidence rate of 4.084e + 92 was calculated for Karachi. The chlorination of the municipality water supply of Karachi city was below the WHO recommended level of 0.5 ppm. All deaths belonged to individuals from Muslim community (n = 98, 100%) and without swimming history. Only one individual was reported to have a swimming history. Conclusion: Apart from contaminated municipal water supply, the use of water for ablution directly from ground source is believed to be a major contributing factor to the increasing number of infections; however, this claim could not be statistically verified. This study suggests that concerted efforts by all stakeholders are required if Pakistan needs to bring down the number of Naegleria infection cases. Further research is also immediately required to uncover the role of environmental factors in the rise of Naegleria infection cases.

Dietary Supplement Use Among Students of Pharmacy Colleges in the City of Karachi, Pakistan: Prevalence, Opinions, and Attitudes

ABSTRACT This study was conducted among pharmacy students in Karachi, Pakistan, to document prevalence, opinions and their attitudes toward dietary supplement (DS) use. A cross-sectional study was conducted for a period of four months. The study used a specially formulated dietary supplement questionnaire (DSQ). The prevalence of DS use was reported at 48.2%: 51% in males and 47.3% in females. Physician recommendation was cited by majority of students as reason for DS use (n = 153, 25%). Most of the students used multivitamins (n = 315, 51.5%). The average monthly cost attributed to DS use was reported at PKR 1,396.3 (USD 13.55). For every year increase in age, DS use in students decreased (OR = 0.917). Male students were more likely to recommend DS use (OR = 1.425). The most noteworthy finding was the cautious approach of students as the majority reported DS use only upon recommendation of a physician.

Estimation of the Direct Cost of Poliomyelitis Rehabilitation Treatment to Pakistani Patients: A 53-Year Retrospective Study

BackgroundPakistan is one of the last few countries in which poliomyelitis is endemic. Evidence indicates that out-of-pocket expenditures are a barrier to polio rehabilitation treatment, yet there are no reported figures related to the financial burden of this disease on patients in a recently polio-endemic country.ObjectiveThis study investigated direct costs attributed to rehabilitation treatment of poliomyelitis among Pakistani patients and reported its duration along with the socioeconomic status of poliomyelitis survivors.ConclusionThe cost of poliomyelitis rehabilitation in Pakistan is high; it has an economic effect on the lives of patients and their families. Despite good education, polio survivors in Pakistan appear to have low socioeconomic status, lower chances of employment and marriage, as well as fewer children. Further research is recommended to explore the burden of disease on society, i.e., indirect costs and suffering.

Brand versus generic dispensing trend for ciprofloxacin 500 mg, levofloxacin 500 mg, and moxifloxacin 400 mg (oral dosage forms) among pharmacies of Karachi, Pakistan

Introduction: Pakistan spends 0.7% of its gross domestic product on health. The public sector health-care system provides services to 22% of population thus paving the way for a dominant private sector. Patients in Pakistan mostly pay their medical expenses directly, and 64% of the health expenditures are borne by the household. Expenditure on medicine constitutes 43% of the total household expenditure. Methods: A quantitative cross-sectional study was conducted in Karachi, Pakistan, for a month. It was aimed at gathering response from different pharmacies to understand the brand versus generic dispensing trend of ciprofloxacin 500 mg, levofloxacin 500 mg, and moxifloxacin 400 mg oral dosage forms. The study employed convenience sampling and used a survey checklist. The data gathered was entered in SPSS version 22. Results: The mean price per tablet for ciprofloxacin brand and generic was reported at Pakistani Rupees (PKR) 48.44 and PKR 26.85, respectively. The trend for dispensing ciprofloxacin highlighted a split in the market between brand (51%) and generic (49%). For levofloxacin brand and generic, the price per tablet was reported at PKR 36.50 and PKR 36.15 respectively, and despite same price, the market was dominated by generic levofloxacin (92%). Due to a price difference between brand and generic moxifloxacin, i.e., PKR 129.44 and PKR 71.91, respectively, the market was mostly occupied by the generic form (75%). Conclusion: Pricing mechanism must be revisited, and the authorities should take stern actions against any illegitimate price hike. The surging burden of drug expenditure on poorer sections of the society must be addressed by the government on an urgent basis.

Developing a Research Instrument to Document Awareness, Knowledge, and Attitudes Regarding Breast Cancer and Early Detection Techniques for Pakistani Women: The Breast Cancer Inventory (BCI)

There is a general hesitation in participation among Pakistani women when it comes to giving their responses in surveys related to breast cancer which may be due to the associated stigma and conservatism in society. We felt that no research instrument was able to extract information from the respondents to the extent it was needed for the successful execution of our study. The need to develop a research instrument tailored for Pakistani women was based upon the fact that most Pakistani women come from a conservative background and sometimes view this topic as provocative and believe discussing publicly about it as inappropriate. Existing research instruments exhibited a number of weaknesses during literature review. Therefore, using them may not be able to extract information concretely. A research instrument was, thus, developed exclusively. It was coined as, “breast cancer inventory (BCI)” by a panel of experts for executing a study aimed at documenting awareness, knowledge, and attitudes of Pakistani women regarding breast cancer and early detection techniques. The study is still in the data collection phase. The statistical analysis involved the Kaiser-Meyer-Olkin (KMO) measure and Bartlett’s test for sampling adequacy. In addition, reliability analysis and exploratory factor analysis (EFA) were, also employed. This concept paper focuses on the development, piloting and validation of the BCI. It is the first research instrument which has high acceptability among Pakistani women and is able to extract adequate information from the respondents without causing embarrassment or unease.

Development of Evidence-Based Disease Education Literature for Pakistani Rheumatoid Arthritis Patients

Rheumatoid arthritis affects 0.5% to 1% of the population globally and is one of the most common causes of disability. Patient education plays a key role in improving treatment outcomes. The purpose of this study was to discuss the process involved in designing an evidence-based disease education literature for rheumatoid arthritis patients of Pakistan in Urdu language with culturally relevant illustrations. A study was conducted to develop disease education literature using Delphi consensus, content validity, and patient feedback. A panel of experts comprised of university professors and health care experts, including health practitioners and pharmacists as well as a social scientist, was set up to assess the need. Eight patients were randomly selected and were asked to give their feedback. Their feedback was incorporated in the development process. The entire process was carried out in eight steps. A disease education literature for patients of rheumatoid arthritis was developed and edited in the form of a booklet. The booklet contained evidence-based information that must be provided to patients in both Urdu and English languages with culturally relevant illustrations. The availability of such literature is significant, as it enables the patients to seek knowledge at home at their convenience. This home-based knowledge support is as helpful as any other means of medical care. The developed literature is planned to be used in further studies which will evaluate its impact in improving knowledge of RA patients.