ABSTRACT
OBJECTIVE: To determine the consonance between medical practitioners and clinical pharmacists about antimicrobial resistance and stewardship in their practices. STUDY DESIGN: Descriptive cross-sectional study. Place and Duration of the Study: Department of Pathology and Department of Pharmacology, Jinnah Sindh Medical University, Karachi, Pakistan, from September 2023 to January 2024. METHODOLOGY: Medicinal and Clinical Pharmacy professionals were included in the study through purposive sampling technique. The study employed a methodological approach using a predesigned questionnaire administered through Google Forms, based on a 4-step scale strategy. Through an extensive literature review, item development, expert validation, and pilot testing, the questionnaire aimed to assess medical practitioners' and pharmacists' knowledge and perceptions regarding antibiotic practices and antimicrobial stewardship (AMS). Following a pilot test involving 30 participants and a Cronbach's alpha analysis yielding a value of 0.7 for internal consistency, minor modifications were implemented before dissemination to the participants. The responses were analysed using descriptive statistics, Chi-square test, and Kappa index. RESULTS: Out of the total 200 participants, 130 responded within the stipulated timeframe, resulting in an overall response rate of 65%. Among the respondents, medical practitioners constituted 60% (n = 78), while clinical pharmacists comprised 42% (n = 52) of the total. The general agreement level between medical practitioners and clinical pharmacists was determined to be 0.39, indicating a fair level of concordance between the two cohorts. CONCLUSION: The present investigation emphasised the agreement level between medical practitioners and pharmacists, the two key components of the AMS programme. Nevertheless, a consistent deficiency in knowledge was observed across both cohorts, underscoring the necessity for a heightened level of consensus among the study participants. KEY WORDS: Antimicrobial stewardship, Antimicrobial resistance, Anti-bacterial agents, Pharmacists.
Subject(s)
Antimicrobial Stewardship , Pharmacists , Humans , Cross-Sectional Studies , Pakistan , Surveys and Questionnaires , Male , Female , Adult , Anti-Bacterial Agents/therapeutic use , Health Knowledge, Attitudes, Practice , Physicians , Attitude of Health Personnel , Middle AgedABSTRACT
An experimental study was conducted using rodents at different doses to evaluate the effect of Phaseolus vulgaris (red beans) on cage crossing, head dip, open field, elevated plus maze, and light and dark apparatus for anxiety and forced swim test for depression. The corticosterone level and histopathological evaluation was also done to correlate the antidepressive impact of the red beans. The study also identified the components responsible for the effect using GCMS. Based on the findings, red beans could be a potential non-pharmacological therapy for mild to moderate depressive patients. The anxiety model was conducted on mice weighing 20-25 gms. Group I was taken as control, group II as 500 mg/kg and group III as administered 1000 mg/kg. The tests were performed on 0th, 7th, 15th, 30th, 45th, and 60th day. The depression model research was conducted on albino rats weighing between 180 and 200 g, divided into four groups: a control group, a 500 mg/kg Phaseolus vulgaris group, a 1000 mg/kg Phaseolus vulgaris group, and a standard group treated with fluoxetine. The forced swimming test was performed on days 0, 7, 15, 30, 45, and 60, after which histopathological evaluations were conducted and blood samples were taken to assess corticosterone levels. GCMS was used to identify the constituents present in red beans, while optical spectroscopy was used to detect minerals and ions. Results showed that both doses of Phaseolus vulgaris possess anxiolytic effect and increased the struggling time of rats in depression model significantly, with the 1000 mg/kg dose showing more significant results than the 500 mg/kg dose. The GCMS results identified the presence of erucic acid, which causes an increase in α-amylase, thus reducing depression. Optical spectroscopy also showed that red beans contain zinc, which may increase BDNF and help in treating depression.
ABSTRACT
Vitamins are an essential component of the human body for growth and maintaining health. All vitamins have a significant role in metabolism, as a prophylactic in preventing various diseases, and maintaining health. Literature studies have predicted the positive impact of vitamin D on sugar level in blood of type 2 diabetes. Vitamin D plays a significant role in treating diabetes mellitus because it helps produce insulin and helps in the growth of beta cells of the pancreas. The present study was conducted for evaluating the impact of oral vitamin D in reducing the hyperglycemic conditions in patients after treatment of 1-6 months duration. 52 type 2 diabetes patients were enrolled in the study. The results showed that Vitamin D supplementation of 16 weeks reduced fasting blood glucose and HbA1C significantly in Vitamin D deficient Type 2 diabetes.
Subject(s)
Diabetes Mellitus, Type 2 , Vitamin D Deficiency , Diabetes Mellitus, Type 2/drug therapy , Dietary Supplements , Humans , Vitamin A , Vitamin D , Vitamin D Deficiency/drug therapy , Vitamins/therapeutic useABSTRACT
Beta vulgaris L. is a vegetable most commonly consumed in salads and has been shown to possess multiple benefits. This research was carried out to observe the effects of Beta vulgaris powder at different doses orally in albino rabbits on liver biochemical parameters and coagulation. The study was carried out on albino rabbits which were divided into three groups designated as Group I (administered distilled water) Group II and III (administered beetroot powder at 500mg/kg and 1000mg/kg dose respectively) orally for 2 month duration. The sample was withdrawn at day 0, 30th and 60th day through cardiac puncture. The results showed that both doses of Beta vulgaris were considered safe for use as all the liver parameters were significantly decreased compared to control. Among both doses 500mg/kg dose was considered safer as it reduced the parameters significantly compared to 1000mg/kg dose. Blood coagulation factors at both the doses showed significant increase which was in reference range. Beta vulgaris is a highly beneficial dietary product with ample amount of flavonoids and anti-oxidant agents which might help in improving the liver function and also play a role in coagulation by increasing both fibrinogen levels and prothrombin time.
Subject(s)
Beta vulgaris/chemistry , Liver Diseases/prevention & control , Liver/drug effects , Protective Agents/pharmacology , Alanine Transaminase/analysis , Animals , Aspartate Aminotransferases/analysis , Blood Coagulation , Dietary Supplements , Dose-Response Relationship, Drug , Fibrinogen/analysis , Fibrinogen/metabolism , Freeze Drying , Liver Function Tests , Plant Roots , Powders , Prothrombin Time , RabbitsABSTRACT
A diet comprising of nutrients that would control hypertension as well as hyperlipidemia would be very beneficial over all. This study aimed to assess the effect of lyophilized beet root powder at different doses on lipid profile and hyperlipidemia model. Albino rabbits weighing 1500-2000gms were taken for both studies. Beetroot powder was administered to animals at 500mg/kg and 1000mg/kg doses and after two month dosing the blood samples were withdrawn and lipid profile was assessed. Next a model of hyperlipidemia was created comprising of albino rabbits that were divided into five groups each containing n=6. Group I was considered as control, Group II was marked as Negative control, Group III was taken as standard, whereas Group IV and V were considered as treated and given different doses of beetroot. Blood samples were drawn at baseline, 45th day and at day 60th of study. Highly significant decrease in lipid profile (Cholesterol, LDL and TGS) and significant increase in HDL was observed by both doses after one month. HDL was increased more at 1000mg/kg dose. The presence of flavonoids and saponins in beetroot is responsible for hypolipidemic effect. From our research we came to the conclusion that beetroot powder reduced the lipid profile and could be beneficial in treatment of cardiovascular disease due to atherosclerosis and obesity.
Subject(s)
Beta vulgaris/chemistry , Dietary Supplements , Hyperlipidemias/drug therapy , Phytotherapy/methods , Plant Roots/chemistry , Animals , Cholesterol/blood , Dose-Response Relationship, Drug , Female , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Male , Rabbits , Triglycerides/bloodABSTRACT
The purpose of this study was to evaluate the anxiolytic and antidepressant activity of ethanolic fruit extract of Pyrus communis (pear), in comparison with escitalopram in rodents (rats and mice). Thirty Wistar rats of about 200-250gm and albino mice of 25-30gm, male gender were divided into three groups each comprising of (n=10) animal respectively. Control group received distilled water, positive control received 10mg escitalopram & treated group received 200mg/kg/day of Pyrus communis ethanolic fruit extract orally for 30 days. They were evaluated by using the open field test, forced swim test (FST), plus maze test, light and dark test, hole poking test, stationary rod test, water maze test & cage crossing activity. Results were expressed as mean ± SD. Data was analyzed by using SPSS software (VERSION 21) one way ANOVA followed by Tukey test was used for post hoc analysis. Our result showed that fruit extract had significant antidepressant-like behavior in FST (p<0.001), open field (p<0.05), cage crossing (p<0.001) , significant anxiolytic activity in light and dark box test, plus-maze activity and significantly enhanced learning in water maze and stationary rod test when compared with control. The Pyrus communis fruit extract showed the anxiolytic and antidepressant-like profile in rats and mice. However, further studies need to be carried out in clinical trials for its use in different neuropsychological disorders.
Subject(s)
Anti-Anxiety Agents/pharmacology , Antidepressive Agents/pharmacology , Behavior, Animal/drug effects , Fruit , Memory/drug effects , Plant Extracts/pharmacology , Pyrus , Animals , Elevated Plus Maze Test , Escitalopram/pharmacology , Learning/drug effects , Mice , Morris Water Maze Test , Open Field Test , RatsABSTRACT
Frequent use of antibiotics has been developed resistance and the use of broad spectrum cephalosporin must be limited in children. The study evaluated the association of prescribing patterns of third generation cephalosporin with diagnosis, age, availability of cultural sensitivity report and gender. It is an observational study that was carried out in the duration of six months in a low socio-economic tertiary care hospital. The data of six hundred and eighty-five (685) patients were collected from the medical records of the tertiary hospital. The cephalosporin are the most prescribed antibiotics in children 118/217 (54.3%) followed by adults 119/403 (29.5%) and teenagers 18/65 (27.6%). Whereas, 75/217 (34.5%), 126/403 (31.2%) and 22/65 (33.8%) were prescribed cephalosporin with combination in patients respectively. The culture sensitivity was performed only in 25% of patients i.e., 173/685, Of 173 culture reports 70 and 91 cases from children and adults respectively. Blood is mostly examined specimen in children and urine in adults. Escherichia coli was highly recovered pathogen in culture sensitivity report. The study concluded broad spectrum cephalosporin antibiotics were highly prescribed in children. The culture sensitivity was performed in limited number of patients. Antibiotics stewardship programme will be implemented to reduce the prescribing of broad spectrum cephalosporin in young patients.
Subject(s)
Cephalosporins/therapeutic use , Gram-Negative Bacterial Infections/drug therapy , Practice Patterns, Physicians'/statistics & numerical data , Adolescent , Adult , Age Factors , Child , Female , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Meningitis/drug therapy , Meningitis/microbiology , Microbial Sensitivity Tests , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/microbiology , Retrospective Studies , Tertiary Care Centers , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiologyABSTRACT
In the detection of coronary heart diseases amongst the non-invasive techniques the role of myocardial perfusion imaging is indexed. The rationale of this study was to compare the different parameters and the association between the exercise MPI and vasodilator MPI in the detection of coronary artery disease (that is prolonged Qt interval with the size of perfusion defects). It was a cross-sectional prospective study with purposive non-probability sampling technique which was conducted in a tertiary care hospital from January 2020 to June 2020 for a period of 6 months. All patients regardless of gender were included in this study and age ranging from 30 to 80 years with comorbidities ranging from diabetes, hypertension and smokers were also included. A total of 100 patients were included in this study out of which 81% were male, 50% were diabetics, 69% were hypertensive, 39% had a history of coronary artery disease, 25% were smokers and 63% had hyperlipidemia. For statistical analysis SPSS 21 was applied and significant association was observed between DTS treadmill score and the perfusion defect in vasodilator MPI, corrected Qt interval and DTS tread mill score and between corrected Qt and size of the perfusion defect (P value < 0.001). It was thus seen that the different components of the noninvasive nuclear stress test tend to co-relate and thus aid in the detection of coronary artery disease increasing the accuracy of results.
Subject(s)
Coronary Artery Disease/physiopathology , Exercise Test/methods , Long QT Syndrome/physiopathology , Myocardial Perfusion Imaging/methods , Vasodilator Agents , Adult , Aged , Aged, 80 and over , Coronary Artery Disease/diagnostic imaging , Dipyridamole , Electrocardiography , Female , Humans , Long QT Syndrome/diagnostic imaging , Male , Middle Aged , Prospective StudiesABSTRACT
COVID-19 has taken over the world as the largest viral outbreak in the past 100 years. With over 13 million confirmed cases and 0.5 million-plus people dead, it has affected the life around us. With Pakistan being amongst the top 15 countries affected by it, the government of Pakistan has started vaccination, issued SOPs on daily life and smart lockdown continues in the country, but a part of this activity developing countries are still facing even greater difficulties in handling this crisis. This paper was designed to evaluate the status of scientific literature available on Covid-19 pandemic and to relate this situation from Pakistan perspective. A detailed review of published literature was conducted from March 2020 to August 2020. Covid-19, pandemic, Pakistan, healthcare setup, psychological impact, educational activities and challenges SOPs were utilized as key vocabulary. Miscellaneous searching tools including, Science Direct, Embase, PubMed, Google Scholar and Covid-19 portal from Government of Pakistan were visited for relevant information. A total of 30 research commentaries, articles, opinions and editorial letters were selected based on the required information. This article discusses the effects of COVID-19 on society and focus on SOPs introduced and their effects on the physical and mental health of the general public.