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Aims: The objective of the study is to explore the knowledge and attitude towards hand hygiene practices among 4th year and 5th year clerkship pharmacy students in a private medical university in Karachi, Pakistan. Methodology: A cross- sectional study was conducted for the period of 2 months (November 2020- December, 2020). A well-structured questionnaire was developed to determine the current habit of students’ hand hygiene. The statistical data assimilation recorded through SPSS version 20 to integrate numerical significance. Results: Questionnaire was distributed to 193 students out of which, one hundred Eighty (n=180/193) students participated in this study (response rate 93.26%. Although the majority of students had a fair knowledge of hand hygiene practices, a number of them had few misconceptions. The hand sanitizing practices while encountering patient or prior to patient’s contact showed the 88.3% correct answers. In our study the 75% of participants correctly answered that “traditional hand washing (apply enough soap to cover and rub hands and clean in between the fingers using water) can help stop picking up infections and spreading them to others.” The current study showed that 82.2 percent Healthcare providers are educating patients and their families about hand hygiene and its importance, the 23.3% negative response was collected in context to inspected the particular World Health Organization (WHO) and center of disease control (CDC)rules for hand cleanliness. Conclusion: The current study showed that students had adequate knowledge regarding the importance of hand hygiene. However, there were few students who had inadequate knowledge related to WHO and CDC rules for hand cleanliness which can improve by providing appropriate education and guidance.

The pharmaceutical products and their therapeutic efficacy were comprised' due to the involvement of both physicochemical and microbial characteristics of the pharmaceuticals. However, liquid preparations are highly at risk due to the high percentage of sucrose contains that is beneficial for the growth of microbes. The inspection was to find to judge the microbial and physicochemical qualities of samples of paracetamol and cetirizine sold in Karachi, Pakistan. Three hundred fifty (350) pharmaceuticals brand were investigating; their organoleptic properties such as density, color, pH, test and total content of active ingredients, total viable count, and type of microbe of samples. These tests were conducted followed by the standard techniques and procedure. Assess the brands of paracetamol and cetirizine samples were meet the standard microbial specifications. The result of the organoleptic test was sweet, according to the color sample was found green, pink, red, yellow, and transparent liquids. The density of samples fluctuated between (1.150 - 1.390) g/ml. Similarly, the pH of the samples was recorded between (4.72 - 6.10). The active ingredient concentration of both samples was observed, ranging from 99% - 104%. The microbial limit many tests were conducted for the observation; the absence of 5 specified microbes in non-sterile pharmaceutical preparation. Pseudomonas sp. Escherichia coli (E-coli), salmonella spp, Staphylococcus spp, and Candida Albicans. All the samples of paracetamol and cetirizine were found contaminated under the acceptable limit. This observation explained that the ten brands of paracetamol and cetirizine sold in the pharmacy of Karachi Pakistan were complying with specifications of pharmacopeia, about both physicochemical and microbial characteristics analyzed dosage form fit for used and acceptable for pediatric and geriatric patients.

Background: For the suppression of covid-19 virus development of vaccines are one of the foremost step but this rapid development enlarge the probability of side effects. In this study a questionnaire based survey conducted to evaluate post covid vaccination short term side effects. Objectives: The aim of the study was to highlight the side effects of different available vaccines such as Pfizer, AstraZeneca, Sputnik, Sino-Pharm, Sinovac and Cansino-Bio in people of Karachi, Pakistan. Methodology: A questionnaire based cross sectional study was conducted between May - October 2021.Questionarre were prepared in Google form link of the form were distributed randomly through Whatsapp language of questionnaire was English. This survey had four sections which included socio demographic data of all Participants, health status, type of vaccine participants were vaccinated and post vaccination short term side effects among individuals were collected data were evaluated by using SPSS version 20.0. Results: A total of (n=120) participants were taken part which included n= 42 (35.8%) males, n= 75 (62.5%) females and n= 3 (2.5%) transgenders. Participants which were diabetics and hypertensive included n=1(2.38%), n= 2 (4.76%) males, n=3 (4%), n=3 (4%) females and n= 1 (33.3%) transgender however n=2 (2.66%) females were suffered from heart disease. Participants with liver disease and renal insufficiency included n=2 (47.6%), n=1 (2.38%) males, n=2 (2.66%), n=3 (4%) females and n=1(3.33%) transgender. Participants received Pfizer vaccine included n=3 (7.1%) males, n=11 (14.6%) female and n=1(33.3%) transgender whereas n=2 (2.66%) females and n=1 (33.3%) transgender were vaccinated by AstraZeneca. n=2 (2.66%) female participants immunize by Sputnik. n=13 (30.9%) males, n=29 (38.6%) females and n=1 (33.3%) transgender were vaccinated by Sino-Pharm. n=17 (40.4%), n=28 (37.3%) and n=1 (33.3%) were immunized by Sinovac vaccine and n=9(21.4%)males, n=3 (4%) females and n=1 (33.3%) transgender were vaccinated by Cansino-Bio whereas post vaccination Side effects such as pain at the site of injection were found n=27 (64.2%) in males, n=41(54.6%)in females and n= 2 (66.6%) in transgenders, participants faced fever after covid vaccination included n=14 (33.3%) males, n=23(30.6%) females another side effect like fatigue were reported by n=14 (33.3%) males, n= 21 (28%) females whereas side effect such as nausea and vomiting were reported by n=12 (28.5%) males , n= 13 (17.3%) females and n= 1 (33.3%) transgender, Abdominal Pain after covid vaccination were reported in n= 5 (11.9%) males, n= 6 (8%) females whereas diarrhea were reported in n=7 (35.7%) males n= 12 (16%) females which subsided after few days or hours and no hospitalization were reported n=15(35.7%) males, n=28(37.3%) females reported that they didn’t experienced these side effects. Conclusion: Side effects after Covid vaccination were predictable and mild such as pain at the site of injection, fever, fatigue, Nausea, vomiting, abdominal pain and diarrhea these were common short term side effects which were subsided in few days or hours This questionnaire based survey is a preliminary study to evaluate short time side effects which help in reducing vaccine hesitancy to some extent and clear conspiracies such as insertion of microchip and infertility associated with Covid vaccines. However further surveillance program needed to evaluate long term safety profile of covid vaccine with large sample size.

Background: The Ventilator associated pneumonia (VAP) is a common condition with inflammation of lungs. The patients on mechanical ventilation or artificial breathings for 48 to 72 hours tend to developed this condition., which is a type of Nosocomial Pneumonia. Objective: To assess the causative agent and treatment pattern among the patients suffering from ventilator associated pneumonia. Methodology: A cross sectional study was conducted for the period of 8 months at a tertiary health care setup of the Karachi Pakistan among the patient’s with VAP. Total of 72 patients with confirmed diagnosis of VAP were included in the study. Data was collected from the children intensive care units on a structed questionnaire. The required variables were obtained from the patients files/Records after the ethical approval was obtained before the collection of data Results were evaluated using the SPSS version 20.0. Results: The study found out that the VAP is most type of hospital acquired pneumonia form the health care system., showed 59.8% (n=61) males and 34.3% (n=35) females’ patients with VAP diagnosis. The age group revealed majority of the patients 46.1% (n=47) were 0–1-year-old, 11.8% (n=12) patients were above 2- 3 years old. 18.6% patients (n=19) were >3 years-4years old. The study also assesses ventilators support >48 hours have around 20-30% (Mean 6.9 days CI: 1.16-3.65) chance to develop the VAP. The subsequent effects of VAP shows the two-fold rates of mortality hence requiring the more length of stay at hospital and extra charges. Conclusion: The VAP occurs among the considerable numbers of patients on the ventilator supports, the findings suggests that an appropriate management, prevention strategies and effective treatment is needed to reduces the mortality and complications of VAP.

Background: The COVID-19 pandemic has affected not only the physical health, but mental health of general population. Objective: The objective of the study was to assess the anxiety and levels of stress during COVID-among the population of Karachi. Methodology: A cross-sectional study was conducted for the period of 8 months May 2020-December 2020, the required variables were collected on a questionnaire. Data was analyzed and descriptive statistics was applied using SPSS version 21 with 95% CI. Results: Out of 450 participants, 45.8% males, 54.2% females. The majority (39.1%) of patients were in group of 51-70 years of age. The levels of anxiety were categories in mild (21.5%), moderate (38.2%) severe (15.2%) and no anxiety (25.1%). The contributing factors in stress and anxiety were the fear (68.3%), panic situation by media (58.5%) and stress due to pandemic (64.2%). Conclusion: The pandemic of COVID-19 is a stressful situation which needs a proper management and counselling of community regarding the precautionary measures and guidance to control the psychological parameters.

Objective: The present study was designed to assess the perception, need and the barriers of PV and ADRs reporting in the hospital settings of Karachi, Pakistan. Methods: A cross-sectional survey was conducted from October 2019 to February 2020 by the random sampling in the healthcare professionals including physicians, pharmacists and nurses. Questionnaire was distributed to 525 participants (n=175 from each group) being serving for one or more year in hospitals and clinics. Overall, 425 participants were responded having 138 physicians, 143 pharmacists and 145 nurses. Results: Perception of pharmacovigilance was found to be 81.02%, 73.40% and 35.17% respectively in physicians, pharmacists and nurses. Overall, 80.70% of respondents were felt the need of drug monitoring system in each hospital to improve patients’ responses against treatment. The main hindrance for PV in our society was the lacking/ absence of the ADRs monitoring and reporting system marked by the physicians and pharmacists. Conclusion: ADRs reporting and pharmacovigilance are not practiced properly in our region. It’s a time to pay attention to this neglected area not only to strengthen the infra structure of healthcare units but also to increase the patient compliance and to avoid any drug associated disaster in future.

Objective: To assess the prevalence of hepatitis B and C among elderly patients at different clinical settings of three major cities of Sindh, Pakistan. Study Design: Cross sectional observational study Place and Duration of Study: Department of Department of Medicine, Muhammad Medical College, Mirpurkhas from 1st November 2020 to 30th June 2021. Methodology: One thousand and two hundred patients from three different cities of Sindh Province either gender, ages and type of hepatitis were recorded. Results: There were 60.83% males and 39.17% females. 35.83% patients belonged to age >50 years while the prevalence rate of hepatitis was 9.16, hepatitis C 10.33 and both was 4.83%. The patients of hepatitis C was found in females than males. Hepatitis B and C was also more prevalent in more than 50 years of age. Conclusion: The prevalence rate of Hepatitis B, C and both, however the male gender is at more risk of hepatitis possibility due to expended social life circle and other contributing risk factors such as blood transfusion, frequent physical contacts and exposure to contaminated instruments at salons. Key words: Prevalence, Hepatitis B & C, Gender

Objective: This study was to assess the common withdrawal effects of drugs among addicted population in rehabilitation. Study Design: Cross Sectional Survey. Setting: Different Rehabilitation Centers Located Across the City, Karachi. Period: December 2018 to June 2019. Material & Methods: 400 filled questionnaires were obtained from randomly selected subjects (addicted persons). Results: The results of the study showed, most drugs abused age group is 20-40 year i.e. 71.6%, 13-19 year 18.7%, and 9.7% for population above 40 years of age. Most abused drugs found 34.8%, 26.8%, 9.6% 6.7% for cannabis, tobacco, heroin, and morphine accordingly. n=188 (47%) of patients had adaptive response towards treatment in rehabilitation while n=60 (15%) shows negative and aggressive behaviors. n=60 (15%) patients found guilty of drugs abused while n= 180 45% found it pleasurable. Conclusions: A persistent, safe and evidence-based practices is required in management of drugs abuse among the addicted patients to avoid the risk factors.

Introduction: Asthma is a common chronic inflammatory disorder of respiratory airways with high growing prevalence around the globe. Objectives: To evaluate the current prescribing practice and analyze the prescription for rational use of drugs of asthma by comparing with international guidelines of GINA (Global Initiative for Asthma. Methodology: A cross-sectional study was conducted among the patients with confirmed diagnosis of asthma for the period of eight months at different setups of Karachi. The prescription and patients record files were evaluated for prescribing pattern and disease profile of asthma. Results: study concluded 73.5% (n= 735) patients were male, while 26.5% (n= 265) patients were females, 42% (n= 105) patients were from inpatients setting of public sector hospitals, 26.8% (n= 67) from private sector hospital and 50% (n= 250) patients were from private clinics, while 58% (n= 145) were from out-patients departments of public sector hospitals. The inhaled corticosteroids were prescribed to almost more than half of the enrolled patients either monotherapy or combined drugs therapies 44.1% (n= 64), medication of class long acting beta agonists to 22.7% (n= 33) patinets, 17.2% (n= 25) patients were prescribed with leukotriene inhibiters. Conclusion: The asthma treatment guidelines suggests the prescribing of corticosteroids and long acting beta agonists in combinations (LABA’s+ICS), that was observed in current study as successful therapy in two drug combinations therapies. Fluticasone+Salmeterol combination was observed as successful therapy.

Dental caries is known as an infectious disease of microbiologic origin. Streptococcus mutans is established to be the main causative agent, which leads to localized dissolution and destruction of the calcified tissues. It is the most prevalent oral disease which shows an inevitable geographic dissimilarity, socioeconomic patterns and severity around the globe. The role of Fluoride in Caries prevention is extremely imperative as it is substance which relates strongly in the caries process and favours remineralisation of the affected tooth after the bacterial attack has ceased. Objectives: The objective of this study was to record dental caries experience in rural population of district Matiari Sindh. Study Design: Descriptive Cross Sectional. Setting: Camp of Taluka Hospital Matiari. Period: From the period of one year from Jan-Dec 2018. Material & Methods: A total of 102 visitants of camp were included in the study with caries evaluation of around 2569 teeth. Dental Caries status was checked by using DMFT index as recommended by WHO for oral health surveys. Results: Mean DMFT was found to be 0.07±. 146 (5.75%) teeth were found decayed, 43 (1.7%) were found missing due to caries, No tooth was found restored while 2378 (92.6%) were found to be in sound condition. Conclusion: Access to Oral and Dental healthcare services found to be minimal may be due to inadequate Dental facilities and lack of Dental professionals in rural areas of Sindh province.

Objectives: Oral health performs a central part in general health which is associated with good oral hygiene. Teeth and their supporting (periodontal) structures are considered most important to oral health. Therefore, Most prevalent oral diseases such as odontogenic infections (dental caries, gingivitis, periodontal disease) gum disease, oral mucosal and congenital dental problems are foremost oral health dilemma in general population. Objective: The main objective of current study was to find out the Prevalence of odontogenic infections and their risk factors among the general population. Study Design: This is a descriptive cross sectional study. Setting: Dental patients who came to different dental clinical settings of Hyderabad, Pakistan. Period: August to December 2018. Material and Methods: A total of 300 patient’s data were collected. In current study, the variables of interest are microbial odontogenic infections such as dental caries, gingivitis and periodontal disease were included in study. Following risk factors were explored: gender, age, residence, education level, disease duration, smoking, family history, and tooth paste habit. All information/data were personally collected by interview technique and oral cavity examination. The observational data were reported in the specific form and used descriptive statistics to find out the results. Results: A total of 300 dental patients having various infections such as gingivitis (47%), dental caries (20.7%) and periodontal infection (32.3%) were reported in this study. Of these, 162(54%) were females and 138(46%) of males. The most common age of patients i.e. 41.7% were from 41 to 60 years. Education status showed that 86% of the dental patients had education and 35.3% had family history of dental diseases. Factors such as mostly duration of diseases were > 6 months(33.7%) and almost 66% patients has habit of cleaning the teeths, However, Calculus and tarta deposited in 62.7% patients teeth. Smoking (21.3%) and 46.6% patients used sweet foods on daily purpose. Moreover, amoxicillin most frequently prescribed antimicrobial agent 39% followed by metronidazole 32.7%. Conclusion: Dental diseases are common public health problem among our society, poor oral hygiene & dietary habits and deposition of calculus are associated factors for odontogenic infections. Moreover, prescribing pattern shows that Amoxicillin and Metronidazole has been considered as first-line treatment for oral infections. Therefore, oral hygiene education, dietary and proper cleaning of teeth habits and dental visit at early stage of disease should be recommended for patients to avoid and cure dental odontogenic infections.

Background: To assess the contributing factors to adherence of pharmacotherapy and perception of elderly patients. Methods: This prospective cross-sectional study was conducted in the outpatient clinic of Civil Hospital Badin, Pakistan from January to June 2019. A total of 300 samples were selected to analyze the results. A self-designed proforma (prescribing indicator form) was used for collecting data including patient demographics, diagnosis, and the current medications prescribed for each patient. Results: Of the 300 selected participants, 221(73.7%) were male, while 79 (26.3%) were female. Majority of the subjects in the age group of 60–69 (52%) and 70–79 years (27%) followed by those aged >79 (21%). Antibiotics were prescribed to 17.2% and vitamins to 14.7%. Patients’ responses related to nonadherence factor were 92.7% for the cost, 32.7% for the long treatment duration, and 24% for the lack of knowledge. Out of the total patients, 28% were forgetful, 26.7% complained about complex therapy, 26.3% blamed financial problems, 19.7% patients had side effects, and 14.3% were negligent in taking the medication. Conclusion: Patient conformity can be enhanced by dropping polypharmacy and simplifying complex management, use of extended formulations, rate of medications, and by creating awareness among elderly patients. Keywords: elderly, polypharmacy, pharmacotherapy, adherence

Risperidone is an atypical antipsychotic agent clinically used to treat schizophrenia, bipolar diseases, and autism. Usually, the frequency of doses is twice daily. In the present study, risperidone controlled release matrices formulated using hydrophilic and hydrophobic polymers. The tablets were prepared by direct compression. The pre-compression and post-compression properties were assessed, along with swelling studies. The morphology of particles observed using scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FT-IR). The stability study on the drug was performed using thermal gravimetric analysis (TGA) and differential thermal analysis (DTA). The optimized formulation was prepared with the help of hydrophilic polymer K100M (40% ratio). Furthermore, release kinetics had investigated. The release pattern of optimized formulation FT5 fitted best to zero-order kinetics and showed excellent release characteristics. The model-independent approach had been used, formulations FT6 and FT8 showed resemblance with FT5 in all three media, respectively. The once daily formulation of risperidone could be beneficial for schizophrenia patients and their caregivers and will improve patient compliance.

Objectives: Antibiotics widely used now a day in dental practice for treatment of acute odontogenic, non-odontogenic infections and as a prophylactic purpose for focal infections in patients at possibility for infective endocarditis development as well as prevention of surgical infection of wound and controlling of orofacial infections. Studies of prescribing trends provide information about the quality & pattern of use causes of drug use, and their outcomes. The main objective of this study was to assist trends and the rational utilization of antibiotics in dental practice. Study Design: Descriptive study. Settings: The current study was conducted among the different private dental clinical settings of Sialkot. Period: Eight months study (Jan-Aug 2018). Material and Methods: Sample size was 700 prescriptions which were gathered during. A purposive sampling was used for collection of prescription. A proforma was used for recording all required demographic & prescribing data was designed to collect all information associated to antibiotic prescribing trend. The data was collected, compiled, & analysed on MS Excel and descriptive statistics was used for analysing the result of the study. Results: A total of 700 prescriptions were collected from various Dental clinics. Among the study, 58.7% patients were male and 41.3 % females and more frequent age group was 51-68 (37%). Mostly patients have pervious medication history (38.8%) and most common diagnosis was periodontal abscess (16.6%) observed during our study followed by pulpitis (15.9%). The trend observed was that majority 35.3% would prescribe antibiotics for patients who presented with elevated body temperature. Commonly 5 drugs per prescription prescribed (26.7%) least numbers of drugs prescribed per prescription is 2(5.9%). Total 3445 drugs were prescribed in 700 prescriptions. Analgesics are frequently prescribed drug category (22.3%) followed by antibiotics (21.8%) Amoxicillin and clavulanic acid was mostly used (31.9%) in these dental centres. Conclusion: This study show that most prevalent dental disease for which doctors prescribed antibacterial was periapical or periodontal abscess and Amoxicillin and clavulanic acid used as a 1st choice for oral infections.

Objective: To assess the general perspective of population their believes and myths regarding the pandemic outbreak and use of mask as precautionary measures Methods: A Cross-sectional observational study conducted from January-June 2020, among the general population of Karachi Total 470 participant age range of 18-60 years were included in the study Data was analyzed by SPSS version 21 0, for descriptive statistics Correlation between variables was assess by Kruskal Wallis Test, spearman rank correlation was established to assess the significant correlation between Knowledge, myths and practices Result: Out of 470 respondents, 74 31% were male and 25 69% of female More than half of respondents aged between 51 to 70 years i e 53 92% While 21 76% respondents were categorized in illiterate category The mean rank score for knowledge, myths and practices were 217 95±2 1, myths score was 236 07±2 1, 241 12±2 1 respectively The spearman rank correlation was established between knowledge myths and practices, a significant correlation between was established by Knowledge-myths (r= 0 0176, p= 0 015), knowledge-practices (r= 0 0174, p= 0 001) however myths-practices (r= 0 0170, p< 0 001) Believes and myths related to the mask was concerned i e 56 1 were using N-95 masks, 89% respondents reused the masks, 59 1% used the mask between 2 to 5 times Wearing mask is not a precautionary measure was mainly found as a myth in respondents i e 78 7% 67 2% respondents had myths about unnecessary use of mask The study highlighted the non-optimal behavior and practice with regards to the use of preventive measure including the use of mask in the pandemic outbreak © 2020 Assiut University All rights reserved

Introduction: Drug plays a fundamental role in disease prevention and ultimately promotes healthy society. Inappropriate prescribing traditions are not only goes toward useless & unsafe treatment but also prolongation of illness and distress the patient and increased economic burden. Therefore evaluation of drug-drug interactions are considered a necessary starting in forming an effective drug utilization stewardship program with the leading objectives of upgrade the efficacy of treatment and reducing the microbial resistance; this study can also be helped as a pharmaco-epidemiological extent for carrying out of a national preventive drug policy. Objectives: To assess Drug-Drug interactions among dental prescriptions at different clinical settings of Sialkot, Punjab, Pakistan. Study Design: A descriptive observational study. Settings: A hospital based study was conducted in different clinical settings of Sialkot, Punjab, Pakistan. Period: Six months from January to June 2018 according to study criteria. Materials and Methods: The Sample size is 500 prescriptions were collected randomly in six months from January to June 2018 according to study criteria. A structured data form was used for collecting demographics, diagnosis, complications, present medications prescribed for each patient and find out number of prescriptions which shows drug-drug interactions and level of severity as well. MS Excel and descriptive statistics was used for find out the result of the study. Results: The current study finding shows that males have more prevalence i.e. 55.8% of dental problems compared to females (44.2%). Mostly patients were included in 51-60 age group (30.2%). 50.2% patients have pervious medication history and most common diagnosis was acute periapical infection (26.8%). Further mostly analgesics (26%) were prescribed followed by antibiotics (21.5%) with elevated body temperature (29.4%). Commonly six drugs per prescription prescribed (34.2%) least numbers of drugs prescribed per prescription is 2(8.2%). 30.6% prescriptions reported with drug-drug interaction in which 26.8% were prescribed in acute periapical infections. More frequently was observed between Glimepiride – Levofloxacin (25.5%) followed by levofloxacin-prednisolone (24.8%). Conclusion: It was concluded that the frequency of drug-drug interactions in prescriptions by dentist in private dental clinics of Sialkot is high but majority of drug interactions with other drugs were found to be of significant minor occurring at pharmacodynamics level.