Potential drug-drug interactions in the neurology ward of a tertiary care hospital in Peshawar, Pakistan

Purpose: To identify and report the prevalence of potential drug-drug interactions (pDDIs) in a neurology ward, as well as their levels and association with risk factors.Methods: The study was conducted in the neurology ward of Northwest General Hospital Peshawar, Pakistan. Medical records of 205 randomly selected patients were retrospectively reviewed for potential drug-drug interactions using Micromedex Drug-Reax Software.Results: The total number of interactions identified were 633. About 96 % of the patients showed at least one type of potential interaction regardless of its severity. The identified pDDIs were categorized on the basis of severity, scientific evidence and onset. Based on severity, of the total of 633 pDDIs, 62.2 % were of major type while 31.8 % were of moderate type. On the basis of scientific evidence, 16.42 % were excellent type, 32.22 % in good category while fair category was the highest (55.60 %). The onset categories such as rapid (27.64 %), delayed (24.96 %) and non-specified onset (53.71 %) were also noted.Conclusion: Computerized DDIs programs are very helpful in minimizing harmful drug interactions. With this type of program, this better patient health outcomes can be achieved.Keywords: Drug-drug interaction, Patients, Drug reactio

Isolation and identification of phenolic antioxidants from Pistacia integerrima gall and their anticholine esterase activities

The galls of Pistacia integerrima are utilized in folk medicines for the treatment of cough, asthma, dysentery, liver disorders and for snake bite. A number of biological active compounds like alkaloids, flavonoids, tannins, saponins and sterols from leaf, stem, bark, galls and fruit of this plant have been isolated. A number of authors have attempted to evaluate the medicinal potentials of this plant. Owing to the numerous ethno medicinal uses Pistacia integerrima the present study was aimed to isolate bioactive phenolic compounds from this plant and evaluate its antioxidant and enzyme inhibitory potentials against acetylcholine esterase (AChE) and butyryl cholinesterase (BChE). The ethyl acetate fraction was highly potent in scavenging the DPPH and ABTS free radicals (86.07 ± 0.92% and 83.50 ± 1.03% respectively) and inhibiting the selected enzymes (80.80 ± 2.45 and 82.56 ± 0.65 against AChE and BChE respectively). Two compounds, quercetin and pyrogallol were isolated for the first time from this plant. The isolated compounds were characterized by HPLC, FTIR and 1H-NMR. From the results it was concluded that this plant can be useful in releaving the oxidative stress and in the treatment neurological disorders

In vivo amelioration of aflatoxin B1 in broiler chicks by magnetic carbon nanocomposite

ABSTRACT: In this study an Iron oxide/carbon nanocomposite from maize straw was prepared and was characterized by XRD, SEM, EDX, FTIR, TG/DTA and Surface area analyzer. The adsorbent was fed to different groups of poultry birds along with aflatoxin B1. Different physiological and blood parameters were monitored in order to study the efficacy of the prepared adsorbent for binding of aflatoxin B1 in the gastrointestinal tract of chickens. It was found that adsorbent at dose of 0.3%/ kg feed was highly effective in detoxifying aflatoxin B1 in gastrointestinal tract of poultry birdswith no harmful effects. The high doses given to groups E and F; 0.4% and 0.5% respectively showed slight variation in tested parameters from group A. No negative symptoms associated with the use of activated carbon as previously reported were observed for the adsorbent under study

Identification of drug-related problems and pharmacist′s interventions in asthmatic patients at a private tertiary care facility-Pakistan

Background: Drug-related problems (DRPs) potentially contribute to morbidity, mortality and financial indicators. There is increasing evidence that participation and interventions of clinical pharmacists in health care have a positive influence on clinical practice. Objectives: The main focus of this study was to identify DRPs, evaluate clinical pharmacy services and document pharmacist′s interventions. Materials and Methods: A 3 months prospective observational study from October, 2014 to January, 2015 was carried out on 80 asthmatic patients admitted to pulmonology unit at Northwest general hospital and research center, Peshawar, Pakistan. The drug therapy details of the patients were collected from inpatient treatment charts using a predesigned questionnaire. The DRPs were identified, and clinical interventions made by pharmacists were documented. Results: A total of 37 patients (61.25%) presenting 91 DRPs were identified, including potential drug-drug interactions 39 (48.75%), drug selection 27 (33.75%), drug use process 12 (15%), drug monitoring 5 (6.25%), adverse drug reactions 5 (6.25%) and dosing 3 (3.75%). Clinical interventions documented by pharmacist were drug information response 21 (26.25%), patient education and counseling 14 (17.5%), change/clarify medication order 11 (13.5%), proper storage and cost effectiveness 10 (12.5%), medication error/brand duplication 7 (8.75%), change of drug/dosage 3 (3.75%), dose calculation in special population 3 (3.75%) and discharge plan 2 (2.5%). Of 91 interventions, the pharmacists contacted the consultants for 24 (30%) interventions, postgraduate medical officers/registrars 34 (42.5%), nursing staff 21 (26.25%) and the patients/attendant 12 (15%). 15 (18.75%) interventions were approved by concerned prescribers. Conclusion: To minimize the risks of DRPs and prevent their occurrence, drug therapy requires pharmacist′s timely and effective interventions at all levels

Comparative analysis of potential drug-drug interactions in a public and private hospital among chronic kidney disease patients in Khyber Pakhtunkhwa: A retrospective cross-sectional study.

IntroductionChronic kidney disease (CKD) is a significant public health challenge due to its rising incidence, mortality, and morbidity. Patients with kidney diseases often suffer from various comorbid conditions, making them susceptible to potential drug-drug interactions (pDDIs) due to polypharmacy and multiple prescribers. Inappropriate prescriptions for CKD patients and their consequences in the form of pDDIs are a major challenge in Pakistan.AimThis study aimed to compare the incidence and associated risk factors of pDDIs among a public and private sector hospital in Khyber Pakhtunkhwa, Pakistan.MethodA retrospective cross-sectional study design was conducted to compare pDDIs among public and private sector hospitals from January 2023 to February 2023. Patients profile data for the full year starting from January 1 2022 to December 302022, was accessed All adult patients aged 18 years and above, of both genders, who currently have or have previously been diagnosed with end-stage renal disease (ESRD) were included. For assessing pDDIs, patient data was retrieved and checked using Lexicomp UpToDate® for severity and documentation of potential drug-drug interactions.ResultsA total of 358 patients' data was retrieved (with n = 179 in each hospital); however, due to incomplete data, n = 4 patients were excluded from the final analysis. The prevalence of pDDIs was found to be significantly higher in private hospitals (84.7%) than in public hospitals (26.6%), with a p-value ConclusionThe prevalence of pDDIs was higher among CKD patients at private hospitals, and most of the pDDIs were of moderate severity. A considerable number of patients also experienced major pDDIs. The risk of experiencing pDDIs was found to be higher in older patients and among those prescribed a higher number of drugs

Process optimisation for the biosynthesis of cellulase by <i>Bacillus</i> PC-BC6 and its mutant derivative <i>Bacillus</i> N3 using submerged fermentation

<div><p>This study deals with optimisation of cultural conditions for enhanced production of cellulase by <i>Bacillus</i> PC-BC6 and its mutant derivative <i>Bacillus</i> N3. Influence of different variables including incubation time, temperature, inoculum size, pH, nitrogen sources and metal ions has been studied. The optimum conditions for cellulase production were incubation period of 72 h, inoculum size 4% incubation temperature 37°C, pH 7, 0.25% ammonium sulphate, 0.2% peptone as inorganic and organic nitrogen source in case of <i>Bacillus</i> PC-BC6. In case of mutant <i>Bacillus</i> N3, optimal conditions were incubation period of 48 h, incubation temperature 37°C, inoculum size 3%, pH 7, 0.2% ammonium chloride and 0.15% yeast extract. Presence of MnSO₄ and CaCl₂ enhances the enzyme production by <i>Bacillus</i> PC-BC6 and mutant <i>Bacillus</i> N3, respectively. This study was innovative and successful in producing cellulase economically by using cheap indigenous substrate <i>Saccharum spontaneum</i>.</p></div