International Journal of Pharmacy & Integrated Health Sciences
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SHORTAGE OF ESSENTIAL MEDICINES DURING THE COVID-19 PANDEMIC: CROSS SECTIONAL STUDY FROM COMMUNITY PHARMACIES
No full textBackground: The drug shortage is a very serious issue regarding the quality of Health System of any country. The problem is increased in the pandemic causing serious issues to the health system. Objectives: The objective of current study was to evaluate the factors responsible for the drug shortages in Pakistan and way forward to avoid these problems in the future. Methodology: A cross-sectional observational study was carried out in different cities of Pakistan. An online form was designed after thorough literature review. The study population included Staff pharmacists, Pharmacy managers and pharmacists self-owning pharmacies. Data was then collected, analyzed using SPSS-26. Results: The majority of pharmacists agreed that Global restrictions on trade activities added to drug shortage during COVID-19. The knowledge was relatively higher in pharmacists of Punjab as compared to pharmacists of other provinces. Majority of pharmacist (52%) from Punjab province of Pakistan strongly believed that Provincial drug regulatory department should play its role effectively during the emergency crisis to prevent drug shortages during the pandemic. Conclusion: In order to prevent the problem of drug shortages, efforts should be made to control the factors responsible for the drug shortages and local production should be enhanced along with proper control by regulatory authorities
EDITORIAL: PIONEERING THE FUTURE OF HEALTHCARE THROUGH ADVANCES IN NOVEL DRUG DELIVERY SYSTEMS
No full textWith great delight and anticipation, I extend my heartfelt greetings to you as we commence a new venture with the latest release of the International Journal of Pharmacy and Integrated Health Sciences (IJPIHS). This issue is particularly noteworthy as it highlights the pivotal domains of Pharmaceutical Sciences, Clinical Pharmacy, and Drug Delivery Systems, demonstrating their significant influence on applications in healthcare.
In the ever-evolving landscape of pharmaceuticals and healthcare, the quest for innovative drug delivery systems has emerged as a pivotal force, reshaping the dynamics of patient care and treatment outcomes. This editorial aims to shed light on the ground-breaking advancements in novel drug delivery systems, as we navigate the frontiers of the pharmaceutical industry in our pursuit of improved therapeutic efficacy and patient well-being. In recent years, the field of drug delivery has witnessed a paradigm shift, driven by a convergence of interdisciplinary research, technological breakthroughs, and a deep understanding of physiological processes. The International Journal of Pharmacy and Integrated Health Sciences is proud to contribute to this ongoing dialogue by showcasing the latest research and developments in novel drug delivery systems.
One of the key challenges in traditional drug administration lies in achieving optimal drug concentrations at the target site while minimizing side effects. Novel drug delivery systems address this challenge by providing precise control over drug release kinetics, enhancing bioavailability, and enabling targeted delivery to specific tissues or cells. This not only maximizes therapeutic effects but also minimizes adverse reactions, thereby improving patient compliance and overall treatment outcomes.
Nanotechnology has emerged as a frontrunner in this domain, offering unprecedented opportunities for designing advanced drug delivery platforms. Nanoparticles, liposomes, and micelles provide versatile carriers for drugs, allowing for controlled release and targeted delivery. These nanocarriers not only protect the drug from degradation but also facilitate its transport across biological barriers, opening new avenues for personalized medicine and tailored treatment strategies.
As we delve into the articles featured in this issue of the International Journal of Pharmacy and Integrated Health Sciences, we invite our readers to explore the multifaceted world of novel drug delivery systems. From cutting-edge research on nanomedicine to the implementation of smart drug delivery devices, the diverse contributions in this journal underscore the transformative potential of these innovations in reshaping the future of healthcare. I want to convey my appreciation to the readers of IJPIHS for their ongoing support and active involvement with our journal. Your commitment to staying informed and exchanging knowledge fuels our relentless pursuit of excellence. Thank you for being part of this remarkable journey
COPD RISK IN PAKISTANI PUNJABI POPULATION: ROLE OF GATM, PSMA4, AND CHRNA5-A3-B4 GENE VARIANTS
No full textBackground: Chronic obstructive pulmonary disease (COPD) is a complex, multifactorial and polygenic disease concerning genetic and environmental factors. Objectives: The selected single nucleotide polymorphisms (SNPs) within or between potential candidate genes were studied to find the association with the onset of COPD disease in the Punjabi population of Pakistan. Methods: 254 COPD patients and 219 control subjects were enrolled for this case-control study. After a literature review and with the help of bioinformatics tools, risk-associated deleterious SNPs residing within or among genes GATM, PSMA4, CHRNA3, CHRNA5, and CHRNB4 were selected to evaluate their association with COPD. Following the mini-sequencing technique, the disease’s association analysis was done using PLINK v1.9 and SHEsis Plus. Results: The mean age of cases was 48.9 ± 9.04 years (N=254), comprising 55.1% males and 44.9% females with 36.6% positive family history of COPD. ‘C’ alleles for rs200551904, rs199547652 and rs1288775 are associated with COPD (p-value 9.70x10-9, 1.14x10-5 and 7.45x10-4 respectively), whereas the ‘CC’ genotype of rs8053 seems to be a protective factor for the disease. The variants rs1288775 and rs199547652 remained associated even with adjusting results for smoking exposure (p-value 0.002 and 1.22 x10-6, respectively). Haplotype analysis for rs1145086, rs1288775, rs8053, rs77994111, rs16969968, rs200551904, rs199547652, rs19968256, and rs181037724 shows that four of the haplotypes H4, H9, H10 and H14, (GATAGGACC; CACAAGACC; CATAGGACC; GACAAGACC respectively), are associated with the disease, while two haplotypes, H1 and H11 (CACAGGCCC and CGCAGGACC respectively), are protective factors against the disease. Conclusion: The association of COPD with chromosome 15 variants in the Punjabi population is reported in this study
ASSESSMENT OF WHO/INRUD CORE DRUG USE INDICATORS AT PUBLIC AND PRIVATE HEALTHCARE CENTRES IN LAHORE, PAKISTAN: A MULTICENTRE CROSS-SECTIONAL STUDY
No full textBackground: A key element of the pharmaceutical care plan is the appropriate use of medications. Objectives: Using the WHO/INRUD core drug use indicators, this study sought to evaluate medication usage trends at both public and private healthcare centres in the Lahore district of the Punjab province of Pakistan. Methodology: A cross-sectional and descriptive study design was adopted. For data collection, 399 prescriptions (199 prescriptions from public and 200 prescriptions from private healthcare facilities) were systematically sampled written from February to July 2022. To evaluate the prescription indicator, patient-care and facility-specific indicators, patients randomly selected from both public and private hospitals were examined and interviewed. For each of the WHO/INRUD indicators, we considered ideal criteria that have been published. Results: The average number of medicines prescribed each encounter was reported to be 6.26% in public hospitals and 4.14% in private hospitals among the prescribing indicators, generic medication, antibiotics, and the number of times patients received injections were prescribed, respectively, in 54%, 84%, and 89% of public hospitals and 19%, 61.7%, and 78% of private hospitals. In the public and private sectors, respectively, 71% and 97% of prescription drugs were from the list of essential drugs. The average consultation time was found to be 2.1 minutes in public hospitals and 3.2 minutes in private hospitals, while the average dispensing time was reported to be 37 seconds in public hospitals and 39 seconds in private hospitals. Of the total prescribed medicines, 84% and 97 % were dispensed in public and private hospitals respectively and the percent medicine adequately labelled was 100% in both healthcare facilities. Regarding patient awareness, 69% of patients in private hospitals and 42.5% of patients in public hospitals were aware of the proper dosage, frequency, and duration of the medications that were prescribed. In terms of facility-specific data, both public and private hospitals had 100% availability of the EDL copy and 82% stock of the important medications, respectively. Conclusion: Irrational use of drugs was observed in both public and private healthcare facilities. WHO/INRUD proposed 12 key initiatives to encourage rational use of medications must be put into practice as a result of present study
DRUGS SAFETY IN CHILDREN
No full textBackground: There is a need to promote drug-related safety in children and prevent them from drug-related toxicities. Understanding pediatric pharmacology, drug dosing, and physiological differences between children and adults is crucial for ensuring safe and effective pediatric care. Objectives: The focus of the current review is the safety and efficacy of drugs in children that involve medication errors and adverse drug reactions. The present study includes awareness of past medication-related incidents, off-label drug usage, inappropriate antibiotic prescriptions, adverse reactions to over-the-counter drugs, and cases of pharmaceutical poisoning in children. Methodology: Pertinent literature databases from search engines like Google Scholar and PubMed were retrieved and analyzed, and WHO and FDA guidelines were followed. Results: The literature survey showed that these problems can be overcome by taking safety measures and following evidence-based practice recommended by the FDA, reducing dosing errors, and preventing ADRs. The Best Pharmaceuticals for Children Act (BPCA) and Pediatric Research Equity Act (PREA) has made efforts in conducting drug research and improving pediatric labelling. Conclusion: A warning showing more recent information about contraindications must be mentioned in pharmaceutical labelling so the patient and doctors would be better aware of drug contraindications and their adverse effects
PREVALENCE OF DEPRESSION, ANXIETY AND STRESS AMONG UNIVERSITY TEACHERS OF ISLAMABAD, PAKISTAN
No full textBackground: Teaching profession used to be less stressed, but it has been among most stressed profession for last twenty years. Objectives: This study was carried out to find the prevalence of depression, stress and anxiety among teachers of Pakistan and how it is related to their daily life. In past, this research was conducted only in primary and secondary school teachers and not in university teachers, hence we conducted this study in university teachers of Islamabad. Methodology: Between December 2022 to April 2023, we conducted a cross-sectional survey in Islamabad using a sample size of 104 university teachers. The survey was performed using a self-developed and revalidated questionnaire to assess the depression, anxiety and stress. There were four sections in the questionnaire, section 1 aimed at assessing the sociodemographic characteristics of participants, section 2 contained 5 questions about risk factors, section 3 contained DASS scale to measure the depression, stress and anxiety, it consisted of 21 questions and section 4 contained 5 questions from Mental health Inventory. SPSS version 25 was used for data analysis. Gender differences of study variable were determined by using a t-test. The study was approved by an ethical review board of University of Lahore Islamabad Campus. Results: Results showed 66.3% of university teachers exhibited moderate to extremely severe level of anxiety followed by 32.7% of stress and 44.3% of depression in moderate to extremely severe range which is higher than expected. The Pearson correlation showed a significant relation between mental health variables and depression, stress and anxiety levels. The independent t test showed no significant difference for depression, stress and anxiety with respect to gender. Conclusion: Our findings revealed that most of the teachers have higher than expected level of anxiety and depression as compared to estimation given by WHO, indicating a critical concern within the academic community in Islamabad. To navigate this challenge, it is imperative to develop and implement proactive strategies aimed at mitigating the risk factors associated with these mental health issues
THE TRANSFORMATIVE FUTURE OF METABOLOMICS FROM DIAGNOSTICS TO THERAPEUTICS
No full textMetabolomics, or the study of metabolites produced during chemical reactions in living organisms, is a fast-growing topic within the "omics" sciences. It has proven valuable in various disciplines, including plant biology and medicine. However, there are still issues to be addressed. Metabolomics has already found biomarkers for multiple disorders, and the emphasis is now turning from diagnosis to treatment, resulting in "therapeutic metabolomics." This innovative approach seeks to comprehend and address the underlying pathophysiology of diseases. The next significant metabolomics hurdle will be identifying safe medicines that selectively target illness causes and demonstrate clinical utility. For example, current prostate cancer research has identified sarcosine pathway components as both disease progression biomarkers and possible therapeutic targets (1). Alongside concurrent brain imaging modalities, new data compilation approaches are needed for the metabolomics-based diagnosis of brain cancers. Furthermore, to expedite the measurement process, hyperpolarization techniques for the C12 isotope of metabolic substrates are required (2). Nowadays, the trend is shifting towards clinical studies. Within the next few years, it will become evident and apparent whether metabolomics can replace other studies that include genomics and proteomics in oncology. Even though metabolomics is increasingly used to determine the etiology of diseases in which metabolic changes play a role, several biomarkers have been identified for several diseases. However, metabolite profiling for many diseasesin adults has still not been focused on and studied (3). In the future, environmental metabolomics will be more concerned with understanding how organisms react to abiotic influences and interact with other organisms. This approach will expand our understanding of ecological interactions, allowing studies to go beyond individual individuals to entire populations. While closely related to ecophysiology and ecology, this research will eventually facilitate genetic adaptation studies, providing insights into how animals evolve and thrive in changing environments (2,3)
A COMPREHENSIVE REVIEW OF THE SELF-EMULSIFYING DRUG DELIVERY SYSTEM (SEDDS) AND ITS RECENTLY DEVELOPED FORMULATIONS
No full textBackground: Poor water solubility of the therapeutic compounds has become a very challenging issue for the delivery of drugs through conventional approaches. Over 40% of newly discovered active compounds also have a lack of water solubility and are lipophilic in nature. One approach for increasing the oral bioavailability of therapeutic agents is to deliver the drug via a self-emulsifying drug delivery system (SEDDS). Although many studies have been carried out, there are few drug products on the pharmaceutical market formulated as SEDDS, confirming the difficulty of formulating hydrophobic drug compounds into such formulations. Objectives: This review aims to describe the SEDDS formulation, its composition, as well as the manufacturing techniques and recently developed formulations, and also highlights an important characterization test for the evaluation of SEDDS. Methodology: Relevant literature was searched in English using different databases, i.e. Google Scholar, PubMed, and Scopus. Results: Within recent years, SEDDS was also discovered for oral administration of hydrophilic macromolecular drugs such as peptides, proteins, polysaccharides and pDNA. SEDDS are stable blends of surfactants, oils, solvents, and co-solvents. This system of drug delivery is useful for improving the aqueous solubility of drugs. They could be manufactured by the spray cooling method, the melt granulation process, the lyophilization technique, and by extrusion or spheronization. Various characterization tests, such as zeta potential, viscosity, dispersibility, cloud test, percentage transmittance, etc., could also be performed to confirm the stability of the SEEDS. Conclusion: Recently, many formulations have been developed for the delivery of drugs through the use of SEEDS and have shown increased bioavailability of the drug, as well as many promising outcomes
THE PRESCRIBING TRENDS OF ACE-INHIBITORS AFTER MYOCARDIAL INFARCTION IN TERTIARY CARE HOSPITALS OF HAZARA REGION
No full textBackground: There is good evidence that angiotensin-converting enzyme (ACE) inhibitors are beneficial after myocardial infarction (MI). However, it is not known how widely this evidence is used in practice or whether all eligible patients receive this therapy. Objective: In three sizable tertiary care hospitals in the Hazara region, the study\u27s objective was to evaluate the usage of ACE-inhibitors in patients who had experienced MI. Methods: Data collection from patients was used to collect the cases and examine the prescription pattern of use of ACE inhibitors, combination-based therapy, reasons for prescribing ACE inhibitors in STEMI, or reasons for prescribing ACE inhibitors in NSTEMI. To determine if proof-based prescribing of ACE-inhibitors following MI is taking place, data about ACE-inhibitor prescriptions is compared with recommended criteria. Descriptive statistics were used to estimate percentage frequencies. Results: There were 460 patients. 63.3% are male and 36.7% are female. 30% of patients who suffered an ST elevation MI received ACE inhibitors; in contrast, a greater part of patients (70%) who suffered a non-ST elevation MI received ACE inhibitors. 43.3% of the patients were prescribed ramipril, and 42% of the patients received lisinopril. Captopril, enalapril, quinapril, and fosinopril were prescribed to 7.4%, 5.4%, 1.5%, and 0.4% of patients, respectively. Ramipril was most commonly prescribed. It was also assessed that 44% of the patients received Β-blockers as combination therapy. The most prescribed Β-blocker was bisoprolol and then metoprolol. Conclusion: Most patients admitted to three tertiary care hospitals with myocardial infarction (MI) were prescribed an ACE inhibitor in an appropriate manner
COMPARISON OF PRACTICES RELATED TO MID-MORNING SNACKS AMONG SCHOOL GIRLS OF DIFFERENT SOCIOECONOMIC STATUS
No full textBackground: Adolescence is the second most critical period of physical growth and development; therefore, it is very important to fulfill their dietary needs in this period. Objective: To compare practices related to mid-morning snacks and observation of students for taking healthy foods as mid-morning snacks. Methodology: This is the survey based or conclusive research that was conducted on teenage girls of Beacon house School System Lahore and Govt. Model Girls High School Lahore. The sample size was calculated from the online calculator Raosoft (Raosoft 2020). The study sample size was 60. They were divided into two groups with 30 in each group; one of high and the second of low socio-economic status. This research was conducted with the ethical permission of Department of Food and Nutrition; College of Home Economics and this data were collected with the consent of School’s authorities and students. Data collection tools were Anthropometrics, Interview schedule and Dietary record. Results: Mean age was 13.6±15.9. Results of taking mid-morning snacks in students was recorded 9.084±0.05. Awareness about nutritive mid-morning snacks was 2.639±0.05. Fruits preferences were 6.358±0.05. Food frequency of high carbohydrate food was 10.24±0.221. High fat food frequency was recorded as 13.9±0.229. Result of food frequency of beverages was 7.59±0.219. Frequency of mid-morning meals was 6.7±0.309. Conclusion: Results revealed that the snacking practices of both schools were unhealthy and intake of unhealthy snacks was more prevalent as compared to healthy snacks