Country-wise Listing - Pakistan

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S.NO Title & Authors Name page
Assessment of errors and incompleteness of prescriptions in outpatient clinics of public sector hospital in Karachi, Pakistan
Farah Khalid, Syed Muhammad Farid Hasan, Fouzia Hassan, Iyad Naeem Muhammad, Sabahat Jabeen, Madiha Mustaque, Fouzia Israr Ahmed, Adnan Iqbal and Azfar Athar Ishaqui
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Prescribing errors are considered as one of the important source of medication errors which can lead to adverse drug reactions. It can be preventable by limiting the errors in the medications prescribed. In the present study, physician prescriptions of outpatient clinics were evaluated for the completeness of information needed in prescriptions. Around two thousand seven hundred prescriptions were evaluated. An average of five drugs per prescription was prescribed. Medical record number, patient’s height and allergy status of patient was not declared in any of the prescription. Patient’s name (96%), physician contact number (63%), dosage form (83%), strength of drug (71%) and duration of therapy (78%) were mentioned in comparatively good number. A very low number of drugs (10%) were prescribed by generic name. Major drug-drug interactions were found in 18% prescriptions. Omission of essential information from the prescriptions will definitely be the source of medication errors that can be prevented by utilizing services of pharmacists in community pharmacies. 
Stability and sterility of single dose infusion vial of acetaminophen for multiple dosing
Azfar Athar Ishaqui, Syed Baqir Shyum Naqvi, Iyad Naeem Muhammad, Sheikh Abdul Khaliq, Syed Hameez Jawed, Adnan Iqbal.
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Single dose vials are considered to be used for single dose and single patient only. Many infection outbreaks reported previously by using single dose vials for multiple dosing were mainly due to improper handling by health care workers. However, under certain circumstances it is permissible to use single dose vial for multiple dosing. In present study, sterility and stability of 50 acetaminophen single dose vials were analyzed for 24 hours by withdrawing samples at different time intervals after the initial first spiking of vial by using basic aseptic techniques. The sterility was examined by inoculating samples on thioglycolate broth, nutrient agar and Sabouraud’s Dextrose agar but none of the samples found contaminated. The stability was evaluated by UV-visible spectrophotometric method. One way analysis (P-value=0.152) reject the null hypothesis and did not reveal any significant differences among samples at different time intervals. The study concludes the use of the SDV for multidosing provided the prevention of contamination in the system.

Anti-inflammatory activity of Cuscuta Campestris hydro alcoholic extract on anti-inflammatory animal model
Asad Ullah Faiz Ghalib, Muhammad Nadeem, Syed Muzaffar Ali, Prof. Dr. Bakir Shyum Naqvi
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Cuscuta campestris Yunck having common names like Golden Dodder, field Dodder and Bay Parri which is widely distributed in America, Africa, Asia, the Pacific Ocean, South and East America. Cuscuta campestris grows on other plant as a host having antibacterial, parasitic properties and anti-inflammatory due to presence of certain chemicals. The main purpose of research work was to find out the anti-inflammatory activity of plant extract. For evaluation of anti-inflammatory activity of Cuscuta campestris, adult Wistar rats of both sexes weighing between 150-200 g were used. Edema was induced in sub planter region of right hind paw of Wister rats by injecting 0.1 ml of 1% suspension of Carrageenan in normal saline. After establishing animal model, treatment was started by giving the plant extract 100 mg/kg and 200 mg/kg. Control was treated by normal saline. To compare the activity of extract, standard drug (Acetyl Salicylic Acid) was used. The results were documented on 0, 1, 2 and 3 hours after treatment and percentage inhibition was recorded. From the results, it was concluded that; the hydro alcoholic extract (200mg/kg) of plant Cuscuta campestris produced better inhibition of paw edema as compared to standard anti-inflammatory drug available.
Sadia Shakeel, Zeeshan Ahmed Sheikh, Somia Gul, Khan Usmanghani
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The present study was conducted to develop and evaluate the quality control parameters of polyherbal Entoban capsules to reassure the safety and efficacy of developed dosage form. The flow property of powdered extract was evaluated by determining bulk density, tap density, Carr's index, Hausner's ratio and angle of repose. Various physicochemical parameters including weight variation and disintegration time were calculated. Alkaloids, tanning agents and microbial limit of the polyherbal formulation were also evaluated. The powder showed good flow property. Average weight of 20 capsules was between 450 mg and 550 mg (with a mean of 506 mg Plus or Minus 10%). The maximum time for disintegration was 6 min. Both the alkaloids and tanning agents were within the specified limits. The developed formulation was in compliance of the permissible microbial limits. In the present study, the developed Entoban capsules were consistent with identity, quality, and purity specifications. So it can be concluded that developed formulation would provide an opportunity to validate its traditional claim regarding its therapeutic efficacy.
M. Rafiq, Muhammad Hanif, Akhtar Ahmed, Asim Awan, Salman Habib, Amir Awan, Ajaz Rasool, Miandad Zardari
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Prognosis of Hepatocellular carcinoma (HCC) is very poor. Chemotherapeutic agents in allopathic medicines are hardly effective. Long time of survival is possible only in cases of full surgical excision or liver transplantation. Use of herbal medicine in the treatment of liver cancer and other cancers has a long tradition. A total of 30 HCC patients (66% were chronic hepatitis patients) treated with four well known herbal aqueous extracts (viz Bergenia ciliata, Nigella sativa, cassia fistula and Picrorhiza scrophulariflora) in which 17 patients were females and 13 males in age group ranges from 42-72 years. Over all six cases were HBV positive, 11 cases were HCV positive and one case with co-infection HBV and HCV viruses. All others were HBV/HCV negative. All individuals were diagnosed as HCC and further monitored on ultrasound, CT scan and alpha fetoprotein; some of them were confirmed additionally with MRI and tissue biopsy. Their liver function tests and serological tests, to determine the status of HBV and HCV were also performed. Out of 30 confirmed HCC patients 10 showed hundred percent improvements displaying no evidence of mass in liver. Ten patients showed remarkable reduction in their size of tumor/mass and are still on medication. Eight patients were having non compliance who had started treatment but either left in the mid of treatment or lack of follow up while the two patients were passed away. All on medication patients showed remarkable improvement and reduction in the size of tumor. However, no adverse effects were observed. To obtain a convincible data it is proposed to treat all the patients approximately for a minimum period of 5 years.
Sabira Begum, Syed Tahir Ali, Syed Imran Hassan,, Syed Nawazish Ali, Bina S. Siddiqui, Khursheed Ali Khan and Nayyer Mahmood
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The antimicrobial activity of the methanolic extracts from the roots of Raphanus sativus, fruits of Hibiscus esculentus, Citrus maxima and Capsicum annuum, leaves of Psidium guajava and Syzygium cumini was studied using disc diffusion method against various Gram-positive and Gram-negative bacteria at 1000 µg/disc concentration. Significant antimicrobial activity in the extract of leaves of Psidium guajava and Syzygium cumini was observed.
Shazia Alam, Baqir.S.Naqvi, Iyad Naeem Muhammad
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Unstable angina (UA)  and  non ST segment elevation myocardial infarction (NSTEMI) is one of common ischemic sign of acute coronary syndrome (ACS), a serious emergency medical condition and majority of patients admitted with chest pain, affecting citizens at younger ages leading to more death and disability in low- and middle-income countries thereby having a greater economic impact. The study aim was to determine the economic burden of unstable angina in hospitalized patients by analyzing the cost of different health care parameters in public and private hospitals of Karachi. A prospective study was conducted among hospitalized UA/NSTEMI patients from September 2013 to February 2014. Data was analysed and results were obtained with the help of statistical software SPSS version 20.Overall 227 patients of UA/NSTEMI admitted in private and public hospitals. Majority of them were males 66.5% while 33.5% were females presented with chief complaint of chest pain 41.4%. UA found to have 58.1% and NSTEMI 41.9%. Total hospitalization cost has been estimated approximately $ 34485. Factors like accommodation cost, laboratory charges, medicines cost and angiography contributed differently to increase the economic burden as $ 9675 and $ 6002 whereas significant financial load found to be from medicines and angiography $ 6550 and $12247respectively. Despite advances in treatment, unstable angina/ non ST elevation myocardial infarction UA/NSTEMI presents an enormous medical, social, and economic burden on individuals of Karachi.
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Muhammad Haseeb Tariq, Bilal Ghaffar, Tauqeer Ahmed, Abbas Sultan, Muhammad Irfan, Muhammad Junaid Farrukh
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The current study was aimed to evaluate the antibacterial activity of different concentrations of aqueous and non-aqueous extracts of Carica papaya seeds. Dried and grinded papaya seeds (5g), respectively mixed with 95ml of extraction solvent (water, methanol, acetone and ether) for 24 hours were used for this study. Extraction was done by maceration and Soxhlet method. The extract was then decanted and filtered through a Whatman filter paper.  Antimicrobial activities of the each extract were determined using agar well diffusion method using fresh clinical isolates of Escherichia coli and Staphylococcus aureus and their MIC and zone of inhibition were determined. The results were evaluated statistically using paired sample t-test. Aqueous extract of Carica papaya exhibits greater antimicrobial activities against the clinical isolates of Escherichia coli and Staphylococcus aureus as compared to the non-aqueous plant extracts. MIC of aqueous extract against Escherichia coli was 10-3mg/mL, whereas methanolic extracts shows 10-4mg/mL MIC. Similarly MIC of aqueous extract against Staphylococcus aureus was 10-4mg/mL as compared to MIC of methanolic extract 10-6mg/mL. There was statistically significant difference between the zone of inhibition of aqueous extracts of the plant material against Staphylococcus aureus and Escherichia coli (P < 0.001). Preliminary phytochemical analyses reveal that the extracts contain alkaloids, tannins, saponins and phenols. Carica papaya may be used for the treatment of infection caused by Escherichia coli and Staphylococcus aureus.
Ahmad Khan, Jallat Khan, Hafiz Shoaib Sarwar, Kamran Hidayatullah, Amina Riaz, Zanib Chaudhry
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In the present study accelerated testing (6 month) and long term testing (12 month) were carried out on Oral Verapamil Hydrochloride control release tablet in order to assess the physical and chemical stability of Verapamil Hydrochloride tablets. All the formulations were tested for disintegration test, % drug content and % drug release over the entire period of testing. These formulations did not show any significant change in any parameter during 12 month and 6 month of testing at 25+5?C/60+5% RH and at 40+2?C/75+5% RH, respectively. All the results were within the acceptable limits. Shelf lives calculated by software R Gui were found to be 43.452, 43.577 and 43.234 months at 1, 3 and 6 months for F4 in accelerated stability. However shelf lives were 44.112, 41.634, 41.867 and 42.896 months at 1, 3, 6 and 12 months respectively in long term stability.
Somia Gul, Kashifa Khanum and Nusrat Mujtaba
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<div style="text-align: justify">An isocratic reversed phase high-performance liquid chromatographic (RP-HPLC) method has been developed for the simultaneous determination of methylparaben and propylparaben in poly herbal formulation at 254nm. Chromatographic separation was achieved on C18 WP, 100A column (250mm x 4.6 mm, 5 &micro;m) column using mobile phase, methanol: water: acetonitrile (40:40:20 v/v/v) having flow rate of 1.2 mL min -1 at room temperature. Calibration curves were linear over range of 40 &ndash; 60.2 &micro;g mL -1 of methylparaben with a correlation coefficient &plusmn; 0.99 and 7.9 &ndash; 11.9 &micro;g mL -1 of Propylparaben with coefficient correlation &plusmn; 0.99. &nbsp;Method is rapid, accurate, precise and specific for the routine quality control analysis of preservative content in poly herbal oral liquid dosage form.&nbsp;</div>
Fakhsheena Anjum, Sadia Shakeel, Sana Ghayas, Wajiha Iffat
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<div style="text-align: justify">The objective of the present work is to study the awareness and causes of shisha (waterpipe) smoking among adolescents in Karachi, Pakistan. A cross-sectional study was conducted among the youth aged 16-25 years in various shisha bars/cafes of Karachi, based on convenient sampling. A total of 145 respondents i.e. males (n =107, 73.79%) and females (n = 38, 26.2%), participated in the study. More than 40% of the participants started shisha smoking at the age of 16-18 years and around 70% smoked shisha occasionally. One of the interesting and leading facts observed during study that were associated with initiation of shisha smoking were curiosity for shisha smoking (23%), followed by hanging out with friends (21%), pleasure-seeking (18%), peer pressure (13%) and boredom (12%). Among 145 participants who had ever smoked shisha, the majority (61.8%) were current smokers. Majority (59.43%) of respondents thought that shisha is less harmful than cigarettes and contains less nicotine than cigarettes (62.75%). More than 50% agreed that Shisha smoking is an efficient stress-coping strategy and their family knew about this habit. Shisha smoking is quite popular among Pakistani adolescents and awareness regarding its dangers is alarmingly low. Policy makers should play a key role in reducing the spread of shisha smoking.</div>
Anab Fatima, Syed Baqir Naqvi, Iyad Naeem Mohammed, Shaheen Perveen, Iqbal Nasiri and Sheikh Abdul Khaliq
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Various antibiotics whenever given orally along with antacid show significant pharmacokinetic interactions. During the present single dose, cross over, randomized study pharmacokinetic interaction between oral combination of amino penicillin i.e. 250 mg amoxicillin with an antacid(10 ml) containing aluminium, magnesium hydroxide and simethicone were evaluated. The study was conducted on ten healthy male volunteers. The study was performed on Pakistani population and data obtained was used to compare pharmacokinetic parameters of amoxicillin alone and with simultaneous administration of antacid in an open one compartmental model. Initially Physico-chemical test were performed for amoxicillin to check the quality of product. Plasma concentrations of amoxicillin were determined by validated high performance liquid chromatography techniques and pharmacokinetic parameters were estimated for both treatments. The analysis showed significant difference(P< 0.05,SPSS 16.0) when amoxicillin used along with antacid in various pharmacokinetic parameters. The values of mean Cmax of amoxicillin alone and with antacid found to be 8.88±0.09 and 7.84 ± 0.06 µg/ml at Tmax of 2 ±0.00 hrs and 3 ± 0.00 hrs with the values of AUC0-t(AUClast) and AUC 0-∞ were 33.33±0.70 and 37.89±0.70 alone and 36.25±0.43 and 41.64±1.15mg/ with antacid. Likewise significant difference in other pharmacokinetic parameters was observed between treatment groups (the values of Clearance(CL),Vd, absorption, distribution and elimination rate constants, MRT and AUMC).No serious adverse event observed during study period. The study demonstrated that oral absorption of amoxicillin may be affected by the presence of antacid therefore it must be recommended to avoid the combination of amoxicillin and antacid or to make a dose adjustment or close monitoring of patients.
Social Networking Experiences on Facebook pertaining to Accountability and E-Professionalism: A future perspective
Wajiha Iffat, Sadia Shakeel, Saima Naseem, Abdur Rasheed
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The present study was planned to investigate students‘ Facebook activity and opinions regarding accountability and e-professionalism. A cross sectional study was conducted from Oct‘2013 till Jan‘2014. The study population includes the students enrolled in MBBS, BDS and Pharm.D program belonging to different institutes of Karachi. Descriptive statistics were determined to illustrate participant‘s characteristics and their response to the questionnaire items, following a presentation regarding potential e-professionalism issues with Facebook. Logistic regression model was used to evaluate the association of gender, institute and bachelor program of students with their response. It revealed that 84.2% of the students were aware of the privacy settings available in Face book and 81.8% uses them to limit public access to their information. Male students belonging to private sector are more likely aware of privacy settings available in Facebook. It is necessitating for young generation to be more aware of online professionalism for gearing up their careers as healthcare providers.
Evaluation of in vitro antibacterial activity of Mentha Longifolia extracts
Muhammad Ibrar, Hina Nazir, Kosar Tammana, Jehangir Khan, Palwasha, Aiman Zafar, Ume Roman, Imran Aman, Muhammad Akif, Abid Hussain, Azam Hayat, Mujaddad-ur-rehman
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The aim of the current study is to investigate the antibacterial activity of Mentha Longifolia extract against commonly encountered pathogenic bacteria. The principle focus is on naturally occurring substance and their derivatives especially flavonoids present in plants which are reported to possess good antibacterial activity. The extracts were tested for antibacterial activity against different selected bacteria by disk diffusion method. The results showed that the cold water flower extract exhibited a relatively strong antimicrobial activity against both gram positive and gram negative bacteria tested. The ethanolic extract of M. Longifolia also showed good antibacterial activity against both gram positive and gram negative. E. coli was the most sensitive bacteria among all and E. faecalis was recorded as most resistant bacteria. Present study reveals significantly higher broad-spectrum antibacterial activity of M. Longifolia and such findings could be considered a valuable support in the treatment of UTI and respiratory tract infections.
In-Vitro Activities of Linezolid and Co-Trimoxazole against Isolates of Diverticulitis: Breakpoint Determinations
Samiullah Burki, Zeba Gul Burki, Javeid Iqbal, Ahmad Khan, Muhammad Nadeem
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Diverticulitis is a common colon disease with pouch like projection which leads to morbidity and mortality commonly cause by E.coli and P. aeruginosa.15 isolates of MDR E.coli and P. aeruginosa derived from patient of diverticulitis were identified using biochemical tests and EMB media. Their susceptibility, resistance, and MIC values were calculated using standard agar dilution method against Linezolid (linz) and co-trimoxazole (co-tri). Results revealed that at different concentrations (conc.) 0.5, 1, 2, 4, 8, 16mgl–1, 1, 2, 4, 16, 32, and 64mgl–1 of linz and co-tri respectively. Linz and co-triMIC90 against E.coli was achieved ≥ 16mgl–1 and >64mgl–1(P<0.01)respectively while against P.aeruginosaMIC90wasachieved at 2.25mgl–1 and > 64mgl–1 respectively (P<0.01). At maximum conc. of 16mgl–1 and 64mgl–1 of linz and co-tri87.5 % and 75 % pathogens of E.coli were susceptible. P .aeruginosa at similar conc. gives 100 % and 71.42 % susceptibility (P<0.01).It is conclude that linz against current multidrug resistance (MDR) pathogens of diverticulitis was potent than co-tri.
Sadia Zafar, Syeda Rabab Hassan, Sarah Ahmed, Rutaba Masroor, Zainab Abdul Qadir
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The objective of this study was to compare the level of awareness and attitude of Pharmacy Undergraduates and General public towards fibromyalgia and to observe the impact of Fibromyalgia on people’s daily routine. A retrospective study conducted to generate awareness, resolve misconceptions and motivate physicians for necessary measures. A cross sectional survey was conducted by using self administered questionnaire in July, 2013. The data of 200 sample population was then thoroughly analyzed and evaluated. The gender wise high prevalence was found in females and majority belonged to age group 18-25 yrs. Although only 8.5% of total respondents ever attended any informational session about Fibromyalgia. However, 86% of Pharmacy undergraduates had knowledge about Fibromyalgia, It was observed 57% of respondents experienced muscular pain especially in shoulder region. Pain killers were commonly used self medication or prescribed by physicians whereas, antidepressants were the 2nd most opted class of drugs used to treat symptoms. Non seriousness of patients (76%) was observed in following physician’s advice.
Samiullah Burki, Zeba Gul Burki, Izhar Ahmed, Javeid Iqbal
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Intra-abdominal infections (IAI’s) a common cause of sever sepsis in the world and is caused by methicillinresistant Staphylococcus aureus (MRSA), which include pancreatitis, appendicitis, peritonitis and cholecystitis. The aim of current work was to study resistance of MRSA against various antibiotics. A total of 14 clinical isolates of IAI’s patients were collected from public hospitals conformed using catalase and coagulase positive tests. Those isolates were evaluated for their resistance level against different antibacterial using agar dilution method. At concentration of 8 mg/l MRSA exhibited 100 % and 92.86 %sensitivity to linezolid and tobramycin while meropenem achieve this level at 128 mg/l (p<0.05) Tetracycline and cefuroxime give similar sensitivity levels against MRSA 128 mg/l and 8 mg/l .The mean sensitivity of MRSA at different concentrations of Linezolid was effective than levofloxacin while tobramycin also represent ~90 % mean sensitivity. MIC90 of linezolid and levofloxacin was ≥ 4mgl-1 and7mgl-1 respectively. Tobramycin and cefuroxime shows appropriate MIC’s of ≥ 6mg- 1 and 5.5mgl-1 (P<0.01).The finding suggest that potency of antimicrobials against multidrug resistant MRSA of IAI’s was linezolid> tobramycin >cefuroxime >levofloxacin>>…>Meropenem >tetracycline. IAI’s can be effectively manage with above study drugs.
Syed Aun Muhammad, Humaira Nadeem, Ahmad Sadiq
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Typhoid fever, caused by Salmonella typhi, is characterized by gastrointestinal illness and fatal bloody diarrhea. The emerging epidemic cases and resistance of this bacterium to broad spectrum antibiotics demands the development of new anti-typhoid drugs. In this study, oxadiazole has been synthesized with significant anti-Salmonella activity. This compound was structurally characterized through FTIR and NMR. The computational docking studies of oxadiazole with essential target protein (UDP-N-acetylmuramoyl-L-alanine:D-glutamate ligase) of Salmonella typhi showed stable binding affinity with minimum binding energy of -9.9 Kcal/mol. This computational study will add to our understanding of the drug designing and development, and to target these pathogenic bacteria to treat typhoid infections.
Atiquddin Mallick, Sheikh Abdul Khaliq, Muhammad Nasir, Zahid Khan
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The rational of this study was to determine the level of knowledge, attitude, and practice in regard to standards isolation, precautions among dentistry students in different dental colleges of Karachi so that steps could be taken to enhance the standards of dental practice and reduces the probabilities of cross infection. The main objective of the study was to determine Knowledge, Attitude and Practices in regard to infection control related precautions among the dental students and house officers in the dental colleges of Karachi and to find out association between KMDC (Karachi Medical &amp; Dental College) and other dental colleges for dental hygiene practices. The study has been conducted in five dental collages of Karachi, 409 students of third year, final year and internees were recruited to solve the questionnaire for the duration of December 2011 to January 2012. Sample size is determined, based upon WHO criteria and the statistical analysis was performed for mean, standard deviation and age ranges. Chi Sq. was applied to determine the significance at P value &lt;0.05. Findings of study revealed that majority of students are female in dental colleges of Karachi, among them, 77.70% believe that rate of transmission of Hepatitis-B is high while 12.30% rated AIDS as the highly transmissible infection. During the practice or trainings 24% of students and interns use goggles while 72% use detergents/antiseptics to wash their hands and 8% do not bend the needles after use. Pre dental examinations washing of hands were lacks by 5% of students and internees while almost same proportion (5%) do not get vaccination against Hepatitis-B infection. The study reveals that, it is quite evident that most of the students and internees have good knowledge of infection control in the dental clinics and also using personal procreative equipments. They are practicing the standard infection control methods. The attitude towards infection control was a little poor in some of the respondent. A large number of the respondent did not use goggles for droplet splash in the dental clinic and no significant association was found between KMDC and other dental colleges regarding dental hygiene practices.
Safia Abidi, Fatima Ramzan Ali, Sheikh Abdul Khaliq, Manzar Raza, Iqbal Azhar
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The progression of oral disease is affected by chronic metabolic disorder known as diabetes. Dental health is an integral part of the general health and oral cavity is considered as a mirror of the rest of the body. The most common dental problem of diabetic patients is periodontal disease, and it along with dental caries can damage the whole tooth. The aim of the study is to determine the dental problems in diabetic patients of Karachi, Pakistan. A survey form comprising of issues regarding dental problems was filled by dentists of 94 diabetic patients. The data was entered and analyzed by SPSS 19 software. Out of 94 diabetic patients, the male female ratio is almost same i.e. 51.1% and 48.9%, respectively. Majority of patients had periodontal problems (97.8%). Other common dental problems were endodontitis (45.25), surgery (64.5%), debris in mouth (77.45), loose or carious tooth (50.55%), and inflamed, swollen or bleeding gum (74.2%). 47.3% patients lost their natural teeth. Diabetic patients usually suffer from dental problems and special care must be taken to avoid or manage these problems.
Atiquddin Mallick, Sheikh Abdul Khaliq , Muhammad Nasir , Rehan Qureshi
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The main objective of the study was to determine of practices of sterilization techniques at private dental clinics of Karachi, Pakistan. 150 dental clinics of the town were selected, owned and run by qualified dentists. The purpose of the study was explained to the owners /practitioners verbal consent was taken. Author designed the questionnaire by close ended questions in order to get information for sterilization method and infection control. The survey was completed in two weeks while five house officers of Karachi Medical &amp; Dental College participated to in filling of questionnaire. The sample size of the study was 150 with 95% confidence interval. Sample selection criteria: (Inclusion) Dentists, Dental hygienists and Dental assistants who are responsible or oversee the sterilization procedure from dental clinics of District Central Karachi. Exclusion: Reception staff, dental technicians. The result shows that 121 (81%) out of 150 clinics used autoclave as the method of sterilization and 15(10%) of the clinics used dry heat as the method of sterilization. While 14(9.3%) still employ the boiling and chemical as method of sterilization. The result shows that the 65.3% were the owner of the clinic and 34.7 % were dentist among the respondents. It is worth noting that 115(76.7) were female and 35(23.3%) male were among respondent. Among the dentist who answered the questioner 79.3% were BDS and 20.7% were postgraduates. From the results of the study it is quite evident that the Infection control measures taken in dental clinics were quite satisfactory. It is worth noting that almost 81% of the clinics used autoclaving method of sterilization. Internationally, the method used for sterilization is autoclaving for the sterilization of instruments in the private dental clinics. Some of the dental clinics used, chemical and dry heat sterilizer for the sterilizations of instruments. However, PMDC (Pakistan Medical &amp; Dental Council) or any other government organization did not set any legal bindings for the quality and standards of dental practice in Pakistan.
M. L. Maheshwari, U. R. Mughal, Muhammad Ali Ghoto, Abdullah Dayo, Naheed Memon Mudassar Iqbal Arain, Abbas Ali
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The optimum experimental parameters for the reactions have been studied. The validity of the procedure was assessed and did not show any change in absorbance up to 24 hrs at room temperature. Statistical analysis of the result has been carried out revealing high accuracy, good precision and suitability for quality control application. The developed procedure is used for the determination of cefpodoxime in pharmaceutical formulations including tablets and suspensions. A good agreement is observed with labeled values Relative standard deviation (RSD) within 1% and recovery of the drug from pharmaceutical preparations was calculated within 95- 99.5% .
Riffat Yasmin, Sadia Shakeel, Wajiha Iffat, Madiha Fatima Sana
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This study was conducted to evaluate the awareness of pharmacy students’ about prescribing fixed dose combination (FDC) in pharmacy institutions in Karachi. A cross sectional study was conducted during July-Sep, 2013. Participants’ overall response towards the importance of the FDCs was found positive. Out of 600 students, 511 pharmacy students (85.16%) responded the questionnaire, belonging to public and private institutes of Karachi. 47.7% of the respondents were aware of the practice for prescribing FDCs. Only 29.15% students were informed about the standard protocol for prescribing FDCs. 65.75% of the students agreed that patient compliance can be improved by using simpler dosage schedule of FDCs. On the other hand 49.9% of the students claimed that FDCs may lead to alteration of therapeutic effect due to possible drug-drug interaction. It is concluded that pharmacy students’ awareness of prescribing FDC is the demand of modern medicine to improve the patient compliance, ease in drug administration, safe and successful use of drugs.
Sheikh Abdul Khaliq,, Zahid Khan, Atiquddin Mallick, Anab Fatima
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Retrospective study in different ethnic groups determines the burden and patterns of prostate cancer during the last eight years reported in Oncology wards of hospitals of Karachi, Pakistan. Compares the management pharmacotherapy/chemotherapy/surgery with international guidelines, develops strategies for screening and evidence based pharmacotherapy/chemotherapy/surgery of cases. Every single one male case with histologically and cytologically established prostate cancer was enrolled from January 2003 to December 2010. Data for all patients were collected retrospectively by patient’s file & charts, which represents the population of Karachi, Interior Sindh & Balochistan. 72 male patients investigated for their diagnosis of cancer type, ethnicity, age & gender. The statistical analysis was performed for mean, standard error & proportions. Screening, Pharmacotherapy/Chemotherapy/Surgery employed by the hospitals was compared with international guidelines and evidences. Proportionately major ethnic groups male diagnosed with prostate cancer in total male cases of prostate cancer was Sindhi (43%), Urdu Speaking/Immigrants (24%), Baloch (10%), Pukhtoon (8%), Punjabi (7%), Minorities & others (8%). Mean age at the time of diagnosis was 65.44±10.89 years, SE± 0.227 and RSD 34%. Screening strategies are implemented in <10% targeted population, however pharmacotherapy/chemotherapy/surgery was comparable with international guidelines. The study reveals that prostate cancer incidences are highest among Sindhi Speaking and then Urdu Speakings. Rests of the ethnic groups are in the range of 7-10%. There is a need to implement the screening strategies more extensively to the small/basic/rural health care centers for early diagnosis of the disease and new treatments strategies especially in surgical management like application of cryosurgery, high intensity ultrasound and proton beam radiation therapy are making revolution in the management of prostate cancer.
Huda Kafeel, Ramsha Rukh, Asma Zubair, Ayesha Ghazala, Hira Muzaffar, Hira Raees, Kanwal Riaz, Tania Qudsia, Zunaira Ali
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The main objective of this study is to investigate the prevalence of functional secondary amenorrhea and also to study the different variable factors associated with it with its possible pathological outcome in our community. A retrospective study is conducted in the city of Karachi. Data regarding the occurrence of amenorrhea, specifically functional secondary amenorrhea, their related complications and symptoms were collected together with demographic variables by means of structured questionnaire. Study sample was of 1052 women (age between 13 to 48 years) out of 1258 women approached. (n= 1052 with response rate 83.62%) 12 women out of 1052 (1.14%) gave a history of primary amenorrhea with no onset of menstrual cycle even at the age of 15. Contrary there were 44.77% women having history of no onset of menstrual cycle for more than 3 months duration during the past year. (Secondary amenorrhea).  5.04% was due to established ovarian cause like PCOs and 39.73% was due to functional causes like stress, excessive dieting, exercise or use of medications (like oral contraceptives or sedative hypnotics or SSRI’s) classified as Functional secondary amenorrhea. 11.12% amenorrhea was due to pregnancy. Among different variables studied weight, age, marital status, pregnancy history was found to be significant. A significant correlation between the use of oral contraceptives and secondary amenorrhea was found in about 7.03% of women. Obesity was found to be the most common effect in women having secondary amenorrhea.
*Sheikh Abdul Khaliq, Syed Baqir S. Naqvi, Anab Fatima
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Retrospective study in different ethnic groups determines the burden and patterns of breast cancers during the last eight years reported in Oncology wards of hospitals of Karachi, Pakistan and compares the pharmacotherapy/chemotherapy used with international guidelines, develops strategies for screening and evidence based pharmacotherapy/chemotherapy of cases. Every single one male &amp; female case with histologically and cytologically established breast cancer was enrolled from January 2003 to December 2010. Data for all patients were collected retrospectively by patient&rsquo;s file &amp; charts, which represents the population of Karachi, Interior Sindh &amp; Balochistan. 847 female patients investigated for their diagnosis of cancer type, ethnicity, age &amp; gender. The statistical analysis was performed for mean, standard error &amp; proportions. Pharmacotherapy/Chemotherapy &amp; screening employed by the hospitals was compared with international guidelines and evidences. Proportionately major ethnic groups female diagnosed with breast cancer in total female cases was Sindhi (25%), Urdu Speaking (48%), Baloch (6%), Pukhtoon (5%), Punjabi (11%), Siraiki (1%), Minorities &amp; others (4%). Mean age at the time of diagnosis was 44.07&plusmn;12.37 years, SE&plusmn; 0.069. Screening strategies are implemented in &lt;10% targeted population, however pharmacotherapy/chemotherapy was comparable with international guidelines. The study reveals that breast cancer incidences are highest among Urdu Speaking (17%) and then Sindhis (9%). Rests of the ethnic groups are in the range of 2-4%. There is a need to implement the screening strategies more extensively to the small/basic/rural health care centers for early diagnosis of the disease and new treatments like monoclonal antibodies are making revolution in the management of breast cancer.<br /><br />
Centratherum anthelminticum ameliorates antiatherogenic index in hyperlipidemic rabbits
*Tooba Lateef and Shamim A Qureshi
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The present study first time scrutinized the lipid lowering effect of ethanolic seed extract (ESEt) of Centratherum anthelminticum in high-fat diet (HFD) induced hyperlipidemic rabbits. ESEt was used to determine acute toxicity in overnight fasted normal rabbits while its effect on biochemical parameters including serum total cholesterol (TC), triglycerides (TG), high (HDL-c), low (LDL-c), very low-density (VLDL-c) lipoproteins, antiatherogenic index (AAI), alanine aminotransferase (ALT), catalase (CAT), creatine kinase (CK), lipase, lipid peroxidation (LPO), reduced glutathione (GSH), superoxide dismutase (SOD) and HMG-CoA/mevalonate ratio were estimated in HFD induced hyperlipidemic animal model. ESEt (10-2000 mg/kg) showed no sign of acute toxicity in rabbits. Similarly, three doses (200, 400, &amp; 600 mg/kg) of same extract induced significant reduction in serum levels of TC, TG, LDL-c, VLDL-c and an increase in HDL-c level with improvement in AAI found in test groups. Normal ALT and CK levels were also observed with positive progress found in antioxidant enzymes status, HMG-CoA / mevalonate ratio and lipase activity. Results conclude that ESEt exhibits antihyperlipidemic and antioxidant effects in HFD induced hyperlipidemic animal model.
Knowledge and Perception of Undergraduate Students about Generic Drugs and Their Attitude towards Generic Substitution in Karachi, Pakistan
*Fatima Ramzan Ali, Sheikh Abdul Khaliq, Samana Zehra, Hina A. Khan, Iqbal Azhar
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Generic substitution has become a common practice. In Pakistan living standards are below average. Improving knowledge and perception about generic drugs will increase the generic substitution, and it will reduce cost of treatment. The aim of study was to determine the knowledge, perception and attitude of undergraduate students of Pakistan about generic drugs. A questionnaire comprising of questions regarding knowledge and perception about generic drugs and attitude towards generic substitution was distributed to 100 students. Mostly students knew about generic drugs and difference between generic and brand names. Their idea about cost of generic drugs wasn&rsquo;t correct. Mostly students prefer doctor&rsquo;s advice while buying or changing their brand. Students substituting their brand didn&rsquo;t find any difference in efficacy of both drugs. Overall good knowledge and perception about generic drugs was found, and mostly students showed positive attitude towards drug substitution. However, few required additional information. <br />
Diagnostic criteria of different species of leishmaniasis in Balochistan, Pakistan
*Darshna Kumari, Muhammad Nadeem, Ayaz Ali Khan and Javeid Iqbal
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Leishmaniasis is a parasitic disease that results into severe lesion/lesions after bitten by the sandfly. The proper and immediate diagnosis is necessary for this lethal disease until it become worse in condition. The purpose of this research study is to present diagnostic criteria of leishmaniasis of different species which is helpful in early diagnosis. Diagnosis criteria include location and number of lesions, type and size of lesions located on the body of the patients. This study was conducted at public and private hospitals and clinics of Karachi Pakistan. Total 200 patients were included in this study. All patients were included in the study after fulfilling the inclusion criteria. Data was collected from the February, 2011 &ndash; December, 2012 in the form of well organized questionnaire which had following information as; age, sex, location of patients, site, number, and type of lesion. The mean age of patient was 35&plusmn;5 years.&nbsp; Out of all selected patients, 40 % were male and rest of 60 % was female. The highest ratio of patients was natives of Baluchistan Pakistan due to its climate which is favorable for sandfly. Majority of patients have single lesion&gt;multiple lesion&gt;double lesion&gt;binary lesion. The common type of lesion seen was the wet ulcerative type open and reddish lesion and the dry nodules. The size of the lesion was observed ranging from 1cm - 3cm respectively. It is observable from the lesion types that the cutaneous leishmaniasis is more common in Pakistan especially in Balochistan than other species of leishmaniasis. In the light of this study, it is concluded that the leishmaniasis is still highly dominated in the Pakistan especially in Balochistan province which is due to its favorable climate for the causative agent. Beside this, there is no proper treatment available and due to poor socioeconomic condition of Pakistan, delayed in diagnosis and treatment of such disease is common. For the purpose of treatment, derivative of pentavalent antimony have been applied that is also more poisonous. There is need of extensive study about parasite of leishmaniasis and their proper treatment and awareness should be provided in the dominated area of Pakistan.
*Ghousia. Saba, Javeid. Iqbal, Tasneem. Ahmad, Ayaz Ali Khan
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20 kDa pegylated interferon alpha-2a (UNIPEG&reg;) manufactured through the pegylation of E.coli-derived interferon alpha-2a. The hematological effects of Unipeg&reg; were studied after a single subcutaneous dose of 180 &micro;g (protein content) in ten healthy human subjects.&nbsp; Vital signs, adverse events and lab tests (hematological and biochemical) were monitored for safety analysis. Clinical laboratory tests results before and after drug administration were processed for any statistically significant change by computing the ANOVA (F-value) and performing t-tests. Statistically significant decrease in neutrophils, absolute neutrophil count, total white blood cells count and platelets count were observed but most of these were not clinically significant. Transient leucopenia and leucopenia was reported for 10% and 20% subjects, respectively, transient thrombocytopenia in 10% subjects and an increase in ALT levels above normal ranges in 30% of subjects were observed while no serious adverse effect was reported. The hematological effects were found similar to those of reported in literature for unmodified IFN-alpha-2a and other pegylated IFN-alpha-2a products generally used in therapy. <br />
*Mansoor Ahmad, Mahayrookh, Mehjabeen, Asif Bin Rehman, Noor Jahan and S.I. Ahmad
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The main objective of present study is to explore the hypotensive and GIT effect of traditionally important plant Cyperus&nbsp; rotudus. Aqueous extract of C. rotundus caused a decrease in mean arterial blood pressure in anaesthetized Sprague-Dawley rats in a dose dependant manner. At the dose of 3 mg/kg the MAB was found to reduce by 42.6% from its control. This fall in the MABP was statistically significant (p&lt;0.0005). The increased dose of C. rotundus (10 and 30 mg/kg) showed a less reduction in the MABP (22.3% and 10.4% respectively). The crude extract and its fractions (ethylacetate, chloroform, n-butanol and aqueous) were analyzed for its spasmogenic and spasmolytic activity in vitro, on rabbit intestine and the effects were compared with standard drugs acetylcholine, adrenaline and atropine. The crude extract of C. rotundus exhibited highly significant (70.16%) relaxing action on smooth muscles in comparison to control and standard drugs. When it was fractionated except ethylacetate fraction which showed spasmolytic action all other fraction showed very strong spasmogenic activity (chloroform 83.87%, n-butanol 77.11% and aqueous 96.5%). It was also observed that spasmolytic activity was dominant in crude extract.
*Bina S. Siddiqui, Syed Tahir Ali, Saima Tauseef, Saira Kamal, Ghazala H. Rizwani, Sabira Begum, and Aqeel
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The present study was carried out to investigate the antioxidant effect of the methanolic extract, its alkaloidal and non-alkaloidal fractions along with petroleum ether soluble, ether soluble and ethyl acetate soluble sub-fractions of non-alkaloidal part of the bark of Holarrhena pubescens. The pure compound conessine was also tested. The activity was determined by using DPPH free radical scavenging assay at 500 &mu;g/mL for the extract and the fractions, and at 200 &mu;g/mL for conessine and the standard (ascorbic acid). The non-alkaloidal fraction was found to be more active (63% inhibition; EC50 = 250 &mu;g / mL) than the alkaloidal fraction (16% inhibition) and its polar ethyl acetate soluble fraction was found to be most active (70% inhibition; EC50 = 250 &mu;g / mL). Conessine was non-active at the concentration used.
*Humera Ishaq, Raana Mahmood, Itrat Javed, TalatTariq, Iffat Mahmood
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Khamira Gaozaban ambri jadwar ood salib wala (KGA) is a traditional medicine in Southeast Asia, used as anxiolytic, antiepileptic and nervine tonic. We have evaluated its role as an anti-depressant agent in animal models of stress. We evaluated an anti-depressant activity by forced swim and marble burying method. 96 NMRI mice were randomly divided into Control group which received saline, a standard group which received Imipramine and two test groups which were given two doses 86 mg/kg and 170 mg/kg doses of KGA with different models of treatments. Each group consisted of 6 animals irrespective of sex. Results show pronounce anti-depressant effect both in acute (One day) and sub-acute (10 days) treatment with CMS (chronic mild stress) model and one day and 15 day treatments in marble burying test. Concluding results suggest strong anti-depressant activity of KGA in different treatment patterns.
*Amna Mumtaz, Muhammad Nadeem, Javeid Iqbal, Samiullah Burki
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Deafness is the disability to hear sounds usually due to malfunctioning of cochlear cells. These cells are responsible for deafness. If inner ear or auditory nerve is involved in causing deafness it is called sensory neural hearing loss. Causes of hearing loss vary in different regions of the world. Many diseases like meningitis, measles and high grade fever are responsible for deafness as well as trend of consanguineous marriages and positive family history is also thought to be responsible for deafness. As Pakistan is a developing country lack of immunization, trend of consanguineous marriages, factors associated with prenatal and postnatal care of mother play a major role in causing deafness in children, management of deafness is difficult and expensive. It includes hearing aid, cochlear implant and rehabilitation services the purpose of this study was to find the major causes of deafness in Pakistani children. For this purpose 122 children were included from deaf school located in Karachi, Pakistan. The data was gathered in the form of questioners and interviews of parents and children, and there previous audiological test reports. The provided information was analyzed and it was noted that the consanguineous marriages are responsible for deafness as well as positive family history and diseases also play role in causing deafness. In this study, it was found that&nbsp; 69.67% of&nbsp; deaf children&nbsp; have parental relationship(cousins) ,44.26% have family history of deafness .The cause of deafness was unknown in 65.57 children Ear infection was present in 7(5.73%) children .High grade fever was 3.27 %. Meningitis was 2.45 %, Measles was 1.63%, 4.9% were born premature&nbsp; ,jaundice was present in 2.45% of children but due to lack of education and awareness parents were not able to provide satisfactory answers of questioners/interviews. It was concluded that trend of family marriages is common in Pakistani population, poor immunization of children, no screening at the time of birth, lack of awareness and poor socioeconomic conditions are factors which are responsible for deafness in children of Pakistan.
*Muhammad Nadeem, Muhammad Hanif and Javeid Iqbal
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The commonly used renal replacement therapy for the end stage renal disease (ESRD) is the maintenance dialysis and kidney transplantation. The objective of the study was to evaluate and determine the frequency of different complications during and after haemodylisis in patients having ESRD. A patient having approaches for the renal transplantation is the gold standard of treatment. The maintenance haemodialysis is the substitute for the proper kidney functions. On one hand, it is blessing for renal failure patients, while on other hand, complications may occurs during and after the process of hemodialysis. Some are inherent side effects of the normal extra corporeal circuit, some results from technical errors, &amp; yet others are due to abnormal reactions during the dialysis procedure. This prospective and observational study was conducted at two different public and private hospitals of Karachi, Pakistan. Patients were selected from the lists of regular hemodialysis patients during the period of August, 2011 to April, 2012. The most frequently observed complications were cardiovascular system (CVS). These complications like hypotension &amp; arrhythmia were at the top with frequency of 79.3%. The gastrointestinal (GIT) complications like nausea, vomiting abdominal pain followed the CVS complication in order of frequency. There is a need for development of effective strategies to prevent gastrointestinal bleeding in patients on hemodialysis who use Nonsteroidal anti-inflammatory drugs (NSAIDs). These complications may be decreased by taking some measures such as premedication of hemodialysis, well trained dialysis machine operators, latest technology dialysis machines,&nbsp; full monitoring during the process of dialysis and to improve the socioeconomic conditions of the patients so as to reduce the post dialysis problems such as infections at the site of catheter.
*Fakhsheena Anjum, Noor Jahan, Sana Ghayas, Shumaila Shoaib, Nighat Tanveer, Warda Naseem and Anam Muzaffar
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This study was conducted to reveal primary dysmenorrhea and its effects in young females belonging to various universities in Karachi, Pakistan. Remedies used to alleviate the undesired effects were also determined using a structured questionnaire. A structured questionnaire was filled by 621 subjects in the presence of the study researchers after taking their consent. The survey was conducted from March to May 2012. The results of the study showed that dysmenorrhea was mild in 28.8% (n=179), moderate in 36.9% (n=229) and severe in 15.8% (n=98) subjects. The age of menarche of majority of the females was 12-15 years with 85% (n=528) having regular and 15 % (n=93) having irregular menstruation. The most frequently reported associated symptoms were abdominal pain in 75.04% (n=466) females, headache in 15.62% (n=97), nausea in 20.45% (n=27) and vomiting in 7.41% (n=46) females. Only 9.33% (n=58) of the females consulted physicians, 33.5% (n=208) self medicated and 66.3% (n=412) took no action for their pain. Conventional medicine was used by 26.41% (n=164) females, household remedies by 9.02% (n=56), herbal by 2.89% (n=18) and homeopathic by 2.41 % (n=15) females. Paracetamol, ibuprofen and mefenemic acid were reported as commonly used allopathic medicines for dysmenorrhea; green tea, black caraway, coriander/ginger tea were used as herbal remedies whereas hot milk, boiled eggs and hot water bottles were used as household remedies by the participating females. Dysmenorrhea also affected different activities and performances of 52.3% (n=325) subjects; stress and depression affected 33.17% (n=207) subjects. Various symptoms contribute to severity of primary dysmenorrhea in which abdominal pain, headache and nausea are prevalent among the females. Due to this, activities and performances of young females are disturbed to quite much extent. The need for awareness regarding primary dysmenorrhea among young females is necessary and should be addressed by health care professionals and health related educational programs.<br />
*Fakhsheena Anjum, Nighat Razvi, Hina Yasin, Arije Ahmad, Marvi Khan Sherwani, Nimra Rahim Khan and Sidra Arshad
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This study was conducted to find the causes of migraine in Karachi, Pakistan and also to assess the efficacy of mushrooms (GANODERMA LUCIDUM therapy) in treatment of migraine. Migraine is an episodic headache that affects the general population. There are lots of factors that cause migraine and may include stress, exposure to light and sounds, anxiety, caffeine reduction etc. Many medicines are used for treating migraine and Ganoderma lucidum, a medicinal fungus belonging to the Polyporaceae family, (known in Japan as REISHI), is now being used in Pakistan for this purpose. It has proved to completely eradicate migraine without side effects. The study was conducted by researchers using a specially designed questionnaire developed from different sources to find the major factors contributing to the occurrence of migraine. About 220 questionnaires were filled by the subjects from March to May 2012. Regarding the treatment using mushrooms (ganotherapy), about 66 cases of migrainuers were studied by the researchers who were treated at DXN International Clinic, Karachi, Pakistan. Results recorded were calculated statistically. People having migraine may experience different types of symptoms and they may belong to different age groups. The most fre&not;quent aggravating factors reported by migrainuers were stress 50.90% (n=112), sunlight 48.18% (n=106) and loud noise 45.5% (n=100). The relieving factors for migraine reported by most of the migrainuers were rest/sleep 61.8% (n=136), dark/quiet environment 39.54% (n=87) and various medications used 24.09% (n=53). Ganotherapy (treatment with Ganoderma lucidum) can prove to be very helpful in treating migraines with almost no side effects. According to the cases studied after ganotherapy, 93.99 % persons (n=62) had relief after taking the product among which 83.18% (n=54) of the people experienced no side effects and 25.8% persons (n=17) used G. lucidum powder for the treatment of conditions other than migraine as well. Migraine is a common cause of severe, recurring headache; however, it can be effectively treated and sometimes even prevented. A good trigger-management strategy can be a very powerful tool to help manage migraine better. After the survey, it was found that the most common causes of migraine in Karachi were stress, exposure to light, sound, and empty stomach. It was also found that the treatment for migraine through Ganoderma lucidum is very effective and may completely eradicate this condition with almost no side effects in majority of patients who used it.
*Dilnawaz Shaikh, Jahanzeb Shaikh, Asif Bin Rehman and Sumaira Shafi
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Methanolic extract of Hairs and Glands covering fruits of Mallotus philippinensis (kamala powder) were subjected to Antimicrobial and toxicological screening. Antimicrobial profile indicated that extract was effective against all Gram positive cocci and bacilli used in the study. Among Gram negative bacilli, three important pathogenic species i.e. Salmonella typhi, Salmonella para typhiA and Pseudomonas aeroginosa showed sensitivity to the plant extract. Among Fungi tested, Candida albicans was sensitive whereas penicillium and Aspergillus species were non-sensitive to the extract. Acute toxicity studies in mice indicated that kamala powder is feebly toxic. No mortality is observed even at a high dose of 1000&micro;m/kg B.W. However male mice exhibited significant decrease in body weight. Results of autopsy also showed significant decrease in weight of Liver and spleen at P&lt;0.05 Histopathological studies indicated minor pathological changes in kidneys and liver of the test animals.<br /><br />
*Hina Rehman, Ammar Hussain and Javeid Iqbal
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Drug Interaction is increasing day by day leading to the major manifestations of Health care issues. According to &ldquo;WHO&rdquo; Drug Interaction was estimated to be from 6.2 % to 6.7 % per year. According to the &ldquo;Journal of the American Medical Association&rdquo; (JAMA 1996) reported that 108,000 American died in hospital and 2.2 million American had reaction to &ldquo;FDA&rdquo; permitted medication. To overcome for this scenario there are numerous sources of in sequence which accessible to Prescriber, Pharmacist and User about the Drug Interaction. In 2009, in the UK, drugs are gradually more obtainable over the counter and on-line devoid of prescription. Additionally, close at hand is widespread use of numerous herbal medicines from relatively under-regulated suppliers and the constituents of such products are often not known. This clinical reality of the widespread use of potent medicines &ndash; be they allopathic or traditional showed us the need for a practical hands-on guide that aims to be a compact, succinct and accessible source of Information for practitioners, prescribers and the public about adverse drug-Interactions. In this Cross Sectional Study total 300 Prescriptions were collected after analysis 250 informed consent have filled. Rest in 50 prescriptions the prescribing pattern errors have found including consent displeasure. In 250 prescriptions 70 is interacted and 180 is non-interacted or safe, without any significance level. The statically data have given below and graph demonstrates the interaction in all clinic, Government and private sectors hospitals. In this study poly prescription evaluation in primary, secondary and tertiary care hospitals. The percentage of interacted and non-interacted prescription is 28% in the city of Karachi, Pakistan. Female genders were more susceptible for interaction due to various causes about 17.6% and Male about 10.4% out of 28%.The major significance level is about 4% in Major Interaction, Moderate is about 13.6% and Minor is about 14.8%. Most Interaction Found in Cardiovascular is about 11.6% along with it 2.0 % interaction in Angina and 1.2% in Arrthymias.