Inter-District Inequalities in Social Service Delivery: A Rationalised Approach towards Funds Disbursement

For a less developed country, Pakistan has experienced a relatively high average per capita growth rate of 2.2 percent, for the period 1950-99 [Easterly (2003)]. Unfortunately, high growth rates have not trickled down sufficiently and the living condition of the general populace leaves a lot to be desired. The UNDP’s Human Development Index (HDI) report released in 2010, ranked Pakistan at 144th on the HDI, out of 178 countries [Wasif (2010)]. The HDI conceptualises poverty to be a multi-dimensional construct and considers adult literacy and life expectancy to be key indicators of the quality of life. Given, that Pakistan has experienced high growth rates but ranks so poorly on the HDI, clearly indicates that despite economic growth, the country faces serious challenges in social service delivery. The coverage of social services is limited and varies across different regions of the country. Easterly (2003) points out that in terms of adult literacy there is a huge variation across provinces and female literacy is only 3 percent in rural Balochistan and Khyber Pakhtunkhwa whereas it is 41 percent in urban Sindh. Zaidi (2005) shows that the situation is not much different in case of health outcomes. The study shows that across the country, nearly half of pregnant women suffer from anaemia and 35 percent of children under age five are malnourished. Moreover, the numbers for infant mortality vary across provinces considerably with urban Punjab having an infant mortality of 70.6 per 1,000 live births compared to the 120.6 of urban Balochistan.

Loading of anticancer drug anastrozole using Fe3O4@SiO2

Anastrozole is a prescription drug that is used to treat hormone-dependent breast cancer, mostly in women who have gone through menopause. Once a day, it is taken by mouth. Anastrozole stops the activity of an enzyme called aromatase, which changes androgens into oestrogens. But taking the drug often comes with side effects that depend on how much you take, such as tiredness, diarrhea, hot flashes, nausea, headaches, muscle and joint pain, and so on. Anastrozole has also been linked to other side effects and more bone loss. To overcome the side effects of anastrozole and for their efficient delivery anastrozole must be loaded on the surfaces which is biocompatible and stable towards human body. So, the co-precipitation method was used to make iron oxide nanoparticles, which were then covered with silica using the Stober method. The made Fe3O4@SiO2 nanocomposite was taken out as a black powder and studied using FTIR, EDX, and SEM. The SEM picture showed that the Fe3O4 and Fe3O4@SiO2 nanoparticles size ranges were between 30 and 45 nm and 55 to 70 nm respectively. We also looked at how contact time, pH, and the amount of nanocomposite affected the loading of the drug. The best adsorption (85.6%) happened when the reaction lasted 12 h, the pH was 4, and the adsorbent dose was 10 mg

Bioequivalence evaluation of new microparticulate capsule and marketed tablet dosage forms of lornoxicam in healthy volunteers

Purpose: To compare oral bioavailability and pharmacokinetic parameters of different lornoxicam formulations and to assess similarity in plasma level profiles by statistical techniques.Methods: An open-label, two-period crossover trial was followed in 24 healthy Pakistani volunteers (22 males, 2 females). Each participant received a single dose of lornoxicam controlled release (CR) microparticles and two doses (morning and evening) of conventional lornoxicam immediate release (IR) tablet formulation. The microparticles were prepared by spray drying method. The formulations were administered again in an alternate manner after a washout period of one week. Pharmacokinetic parameters were determined by Kinetica 4.0 software using plasma concentration-time data. Moreover, data were statistically analyzed at 90 % confidence interval (CI) and Schuirmann’s two one-sided t-test procedure.Results: Peak plasma concentration (Cmax) was 20.2 % lower for CR formulation compared to IR formulation (270.90 ng/ml vs 339.44 ng/ml, respectively) while time taken to attain Cmax (tmax) was 5.25 and 2.08 h, respectively. Area under the plasma drug level versus time (AUC) curve was comparable for both CR and IR formulations. The 90 % confidence interval (CI) values computed for Cmax, AUC0-24, and AUC0- , after log transformation, were 87.21, 108.51 and 102.74 %, respectively, and were within predefined bioequivalence range (80 - 125 %).Conclusion: The findings suggest that CR formulation of lornoxicam did not change the overall pharmacokinetic properties of lornoxicam in terms of extent and rate of lornoxicam absorption.Keywords: Analgesic, Microparticles, Controlled release, Lornoxicam, NSAIDs, Pharmacokinetic

Formulation Optimization and In-vitro Evaluation of Oral Floating Captopril Matrix Tablets using Factorial Design

Purpose: To develop a zero-order sustained release floating formulation of captopril, and optimize its drug release for enhanced oral bioavailability.Methods: A relatively new approach, 32 full factorial design, was used to formulate floating captopril matrix tablets and to systematically optimize its drug release using varying levels of xanthan gum and hydroxypropyl methylcellulose (HPMC) K100M polymers. Calcium carbonate was used as gasgenerating agent. After setting the levels by preliminary trials, nine tablet formulations (F1 - F9) were prepared by wet granulation method using Design Expert Software® - suggested combinations of polymers. The concentrations of HPMC K100M (X1) and xanthan gum (X2) were chosen as control variables. Conversely, the response variables selected were timed to release 50 % of the drug (t50%) at 6 h (Q6) and 12 h (Q12). Fourier transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC) were used to assess compatibility between the drug and the excipients. The validity of the developed mathematical equations was assessed by designing three extra check-points.Results: The response surface plots drawn demonstrated the suitability of the hydrophilic matrixforming agents for formulating controlled release floating tablets of captopril. FTIR and DSC spectra showed no noticeable incompatibility between drug and polymers in both physical mixtures and in formulations. Floating time lag remained < 5.5 min with floating duration > 12 h. Considerable agreement was observed between predicted and actual release parameters. Fitting the data into different kinetic models showed that non-Fickian behavior for diffusion exponent (n) differed from 0.588 and 0.811.Conclusion: Optimum formulation (F4) showed satisfactory release profile. Moreover, the study successfully demonstrated influence of polymer blends in controlling release variables.Keywords: Captopril, Xanthan gum, Hydroxy propyl methyl cellulose , Factorial design, Bioavailabilit

Software Quality Assurance Trend and Practices: A case study of Software Industry in Pakistan

Rise of the digital era, technology, and easy business setup, these factors provide all required elements to give a boost to the Pakistan software industry. As 65% population consists of youngsters in Pakistan and millions of students rush to set up a business right after their academic completion every year, software firms have become the easiest way to gain the tag of entrepreneur and CEO. However, the software houses have now given the sense of mushrooms in a jungle, very few of them are able to fulfill the quality standard and the major chunk of them just grow in the season. That became the major reason for most of the software houses getting out from the software industry as rapidly as they enter the market. This large evacuation from the software industry gives a wake-up call to existing software houses working right now to give a solid look towards the quality standard of their software products. To get an understanding of the major key of success that helps the software houses to gain the sustainability in Pakistan software industry we conduct a survey from existing software houses of different kinds from successful firm to struggling firm, in order to have a thoughtful culmination of our research

Role of MicroRNA in Endometrial Carcinoma

Endometrial carcinoma (EC) is a hall mark of gynecological malignancies that usually affects women above the age 50. It is one of the major causes of mortality in females with ever increasing prevalence and the mortality rate is 1.7 to 2.4 per 100000 and each year 10000 death occur due to ECs. MiRNAs regulate the expression of different proto-oncogenes and signaling pathways that are directly or indirectly involved in the development of cancer. Different miRNAs i.e. (miRNA-449, miRNA 370, miRNA-424, and miRNA-152) which gets up or down regulated during endometrial cancer are the potential biomarkers for early diagnosis of EC. Targeting this relationship between the miRNA and signaling pathways may help in the development of new treatment in endometrial cancer. In current study, we reviewed literature from PubMed using miRNA and endometrial cancer as keywords and outlined the synthesis of potent miRNA and role of different miRNAs involved in ECs. The study revealed different sub types of miRNA played crucial role in the development of cancer by up and down regulation of different metabolic pathways. Many evidences have supported that miRNAs play role in control and regulation of different pathways leading to cancer and targeting these pathways may bring changes in the diagnosis as well as in treatment of EC

Nanosponge-based hydrogel preparation of fluconazole for improved topical delivery

Purpose: To develop polymeric nanosponge based hydrogel system of fluconazole (FZ) for improved delivery for topical application.Method: Six different nanosponge preparations of fluconazole were formulated by oil-in-water (o/w) emulsion solvent diffusion method using various drug to polymer (ethylcellulose, EC) ratios. Polyvinyl alcohol (PVA) and dichloromethane were used to prepare the aqueous and dispersed phases, respectively. The nanosponges (NS) were studied for entrapment efficiency, particle size, structural properties, size and appearance, and in vitro drug release. Furthermore, the hydrogel formulation was evaluated for ex vivo permeation characteristics.Results: Morphological studies revealed porous nanosized particles with the outer surface resembling orange peel. The nanosponges had particle size in the range of 220.2 ± 4.5 to 624.1 ± 10.4 nm. Release studies showed 43.9 ± 3.2 % drug release at 6 h, confirming the sustained release pattern of the drug-loaded nanosponges. Powder x-ray diffraction (PXRD) and Fourier transform infra-red (FTIR) analyses indicate complex formation in the nanosponge structure. Out of six nanosponge formulations prepared, F3 containing FZ and EC in the ratio of 1:0.7 showed optimum physicochemical and release characteristics and, therefore, was selected for hydrogel formulation. Kinetic analysis of the permeation data revealed a Higuchi diffusion pattern. Ex vivo permeation studies indicate that the hydrogel preparation displayed adequate drug permeation through rat abdominal skin.Conclusion: A nanosponge-loaded hydrogel of fluconazole for improved permeation of the drug through skin has been successfully developed. Safety and toxicity tests are required to ascertain its potential suitability for use in humans.Keywords: Fluconazole, Nanosponges, Ethylcellulose, Drug release, Franz diffusion cell, Higuchi diffusio

Relationship of BMI and age with gallstone disease

Objective: To find out the relationship of BMI and age in patients with gallstone disease.  Methodology: This is a cross-sectional study done from March 2019 to February 2020 at the Department of General Surgery PIMS, Islamabad. All patients admitted with a diagnosis of Cholelithiasis were included and patients with previous abdominal surgery were excluded from the study. Patients’ data was collected about their age, sex, dietary habits, occupation and medical history. Their weight in kilograms and heights in centimeters were measured and BMI was calculated in kg/cm2. All data was collected, recorded and analyzed using SPSS 22. Results: A total of 158 patients were included in the study with mean age was 46.2±6.7 years (18 - 83 years). Majority (63%) of the patients were between 41 and 60 age group. There were 120 females and 38 males with ratio of 3:1. The mean BMI of the study population was 25.8 ± 7.61 (Range 19.37 - 33.12). Most of the patients were healthy (n=86, 54.4%) having their BMIs between 18 and 24.9 whereas 72 (46.6%) patients were overweight and obese. Conclusion: Increased frequency of cholelithiasis is found with increasing age even with normal BMI

STAPHYLOCOCCUS CASSETTE CHROMOSOME MEC TYPING OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS STRAINS PREVAILING IN HAYATABAD MEDICAL COMPLEX, PESHAWAR

Introduction: Methicillin resistance Staphylococcus aureus is a very potential human pathogen, and its significant antibiotic resistance further complicates the management of this pathogen. Methicillin resistance in S. aureus is conferred by the presence of SCCmec elements but there are different types of SCCmec in MRSA which results in the need of typing of SCCmec elements. Material & Methods: This cross-sectional study was conducted to determine the current antibiotic resistance pattern and prevalence of different types of SCCmec elements in the circulating MRSA at Hayatabad Medical Complex, Peshawar. A total of 60 non repetitive MRSA isolates collected from pus aspirate and wound swab were enrolled in the study. All the MRSA isolates were tested by disc diffusion method against the ten antibiotics and further subjected to the SCCmec typing through two multiplex PCR reactions. Results: Out of the total tested MRSA isolates 80% were resistant to Ciprofloxacin, 63.4% to Erythromycin, 58.4% to Gentamicin, 55.0% to Cotrimoxazole, 51.6% to Tetracycline, 48.4% Fusidic acid, 46.6% to Clindamycin, 35.0% to Doxycycline, while Quinupristin/Dalfopristin and Linezolid kill 100% strains of the MRSA included in the study. SCCmec typing of MRSA isolates showed that prevalence of SCCmec type-III was 3.3% (3/60), types-IV was 58.3% (35/60), and type-V was 38.3% (23/60). Conclusion: The studied MRSA showed worrisome resistance, but Quinupristin/Dalfopristin and Linezolid kill all the strains of MRSA. The prevalence of SCCmec types IV and V is very high which indicates that the circulating MRSA clone are community associated, because they harbour SCCmec type IV and V