Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client's study.

Antibiotics dispensing without a prescription is an irrational practice and can increase the risk of antibiotic resistance, which is a significant public health concern around the globe. This study was aimed to determine the extent to which antibiotics are supplied without prescription in the community pharmacies (CPs) at Hazara Division from November 2020 to February 2021. The simulated client method (SCM) was used, and the data were gathered, recorded, and analyzed through different statistical methods with descriptive and inferential techniques. The antibiotic dispensing was observed in CPs (90.5%), the most dispensed antibiotics were azithromycin (29.4%) and ciprofloxacin (46.5%) respectively. Furthermore, visited medical stores/ drug outlets, 9.5% of the visited stores denied dispensing of antibiotics because they preferred a referral to visit physicians (23. 9%) and (12.8%) did not had the antibiotics at the time of visits. Antibiotics were more obtainable in retail medical stores (AOR = 8.6, 95 percent Cl: 3.0-24.7; p = 0.001) than in pharmacies. In rural areas antibiotics dispensing was more (p = 0.004) as compared to urban areas. Staff members also had asked about patient's (17.7%) symptoms and drug allergies (12.3% and 3.9%), and (1.5%) they consoled them about their medications. The findings of this study indicate that nonprescription antibiotic sales are very common, despite national rules prohibiting this activity. When the simulated Client requested for any medication to relieve his or her discomfort, many antibiotics were given out without a prescription. Pharmacies/medical stores in Hazara Division selling antibiotics without a prescription are worrying and need immediate action by regulators.

Gelatin-based hydrogels as potential biomaterials for colonic delivery of oxaliplatin.

In present investigation, gelatin-based (AA-co-AMPS) hydrogels were prepared using N, N'-Methylenebisacrylamide (MBA) as a cross-linker and ammonium per sulfate (APS) as an initiator. The successful crosslinking and network formation was confirmed by Fourier transform infrared spectroscopy (FT IR). Differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) investigations proved the higher thermal stability and successful entrapment of oxaliplatin (OXP) in the polymeric network. X-ray diffraction (XRD) confirmed the loss in crystallinity of the drug after loading in the hydrogel. Scanning electron microscopy (SEM) revealed the porous surface of the hydrogel. The newly formed hydrogels were responsive to change in pH. The swelling, drug loading and drug release was increased with increase in concentration of acrylic acid (AA) while gelatin and 2-acrylamido 2-methylpronesulfonic acid (AMPS) were found to act inversely. The in-vitro enzymatic degradation study showed that the blank hydrogels were more stable against the blank PBS than the collagenase and lysozyme. MTT-assay proved that the blank hydrogels were cyto-compatible while free OXP as well as OXP-loaded hydrogels showed dose dependent controlled cytotoxicity against Vero, MCF-7 and HCT-116 cell lines. The preliminary safety evaluation and oral tolerability showed that the hydrogel suspension was biocompatible and well tolerable upto 4000 mg/kg of body weight without causing any hematological or histopathological changes in rabbits.