Evaluation of drug-drug interactions in the prescription dispensed at retail pharmacies

ABSTRACT Drug Interactions is main issue of Health care system. This study was conducted to identify the nature and rate of occurrence of drug-drug interaction in prescriptions dispensed at retail pharmacies in Hyderabad, Pakistan. In this study the total 723 handwritten prescriptions were collected and from that only 630 clearly written prescription containing two or more than two medications were selected for analysis. Drug-drug interactions (DDIs) were detected by using the specially designed drug interaction checkers and detected interactions further confirmed by the Thomson Micromedex Health Care Series 2, British national formulary 63, Stockleys Drug Interaction checker. Out of total 630 prescriptions, 164 prescriptions (i-e 26%) of all the prescriptions contained 233 drug-drug interactions. Interactions then categorized on the basis of severity. On the basis of severity from the total 233 interaction, 26 (11%) of total interactions were of major type, 134 (58%) of total interactions were of moderate type and remaining 73 (31%) interactions were of minor type. Our study resulted that the prescriptions dispensed at retail pharmacies contained a high rate of drug-drug interactions. So an appropriate surveillance system must be implemented, physician and pharmacist must remain vigilant in investigation of drug-drug interactions to prevent adverse drug reaction

TRANSLATION, VALIDATION AND PSYCHOMETRIC EVALUATION OF PROBLEM AREAS IN DIABETES QUESTIONNAIRE: THE URDU VERSION

Objective: The study aims to translate and examine the psychometric properties of the Urdu version of Problem Areas in Diabetes (PAID) questionnaire among Type 2 diabetic patients (T2DM) in Quetta, Pakistan. Method: A standard ‘‘forward–backward’’ procedure of translation was used to translate the English version of PAID into Urdu (official language of Pakistan). The translated version was then validated on a convenience sample of 120 T2DM patients attending a public hospital in Quetta, Pakistan. Test-retest was carried out in order to evaluate the stability of test over time using Intraclass Correlation Coefficient. Reliability of questionnaire was tested using Cronbach alpha coefficient. Collected data were analysed for their consistency and validity using KMO confirmatory factor analysis. Results: Adopting the recommended scoring method, PAID score was 36.25 indicating moderate diabetesrelated issues in our study respondents. The instrument demonstrated good internal consistency (Cronbach’s alpha = 0.838). The test–retest reliability value was 0.820. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy for the factor analysis was 0.834, an index of which Kaiser described as “meritorious” for factorial analyses. Factor analysis extracted 2 factors with cumulative explained variance of 40%. The oblique rotation of items showed strong loading (> 0.60) for all of the study items. The Structure and Pattern Matrix showed that item all questions were clearly factorized into construct confirming our finding not to exclude any item in the original questionnaire. Conclusion: Results from this translation and validation study conclude that the Urdu version of the PAID is a reliable and valid measure of problem faced by T2DM patients and therefore a valid tool for the advancement of person-centered healthcare

Antibiotic susceptibility patterns of bacterial isolates of patients with upper respiratory tract infections

To evaluate the antibiotic susceptibility patterns in URTIs reporting to tertiary hospitals of Lahore. A cross-sectional study employing 259 culture sensitivity reports obtained from tertiary care hospitals of Lahore. Using SPSS, descriptive statistics were used to estimate frequencies and percentages. In URTIs, S. aureus (5%) was the frequent gram-positive isolate followed by MRSA (1.5%) and MSSA (1.5%), while P. aeruginosa (15.8%) was the prevalent gram-negative isolate followed by Klebsiella (13.1%) and E. coli (6.9%). Against P. aeruginosa, ceftazidime (7.7%), cefuroxime/ceftriaxone (4.6%), amoxicillin (4.3%) and ciprofloxacin (4.2%), were tested resistant, while imipenem (11.2%), ciprofloxacin (9.2%), amikacin (9.2%), meropenem/ levofloxacin/gentamicin (8.1%) and piptaz (6.9%) were found sensitive. Against Klebsiella, carbepenems (7.3%), amikacin (6.5%), ciprofloxacin (5.4%) and gentamicin (5%) were tested sensitive, whereas, ceftazidime (8.5%), ceftriaxone (5.8%), cefaclor (5.5%), ampicillin (4.6%), co-amoxiclave (4.2%) and ciftazidime/ciprofloxacin (3.8%) were found resistant. Overall, imipenem (35%), meropenem (30.8%) and amikacin (31.9%) were the three most sensitive antibiotics, while ceftazidime (25.4%), ceftriaxone (19.2%) and ampicillin (18.5%) were the three most resistant antibiotics. Data suggested that P.aeruginosa and Klebsiella, were the most frequent bacterial isolates in URTIs of Lahore. These isolates were resistant to ampicillin, cefuroxime and ceftazidime, but were sensitive to carbapenem and aminoglycosides