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Objectives: This study aimed to analyze the general public's awareness of medicine information, safety, and adverse drug reactions in Quetta, Pakistan. Methods: A cross-sectional descriptive study was conducted using randomsampling from April 2020 to April 2021 in Quetta. Samples were collected from respondents who met the inclusion criteria and had visited community pharmacies. The analysis was done using SPSS version 23. Bivariate and multivariate analyses were performed to assess factors associated with good knowledge. Results: Multivariate analysis revealed that purchase on prescription was a determining factor of knowledge regarding knowledge of pharmaceutical products and their provided information, medicines usage and safety, and Medication ADRs. Patients who bought medicines on prescriptions were more likely to have better knowledge. Patients having education were more likely to have better knowledge. Conclusion: Public awareness about medicine information, safety, and the information provided by manufacturers is crucial to ensuring that patients have access to accurate information about their medications and can make informed decisions about their health. Healthcare providers and regulatory bodies must work together to improve access to information and promote safe medication practices. [ABSTRACT FROM AUTHOR]

The aim of the current research work was to fabricate polymeric nexus for controlled delivery of metoprolol tartrate by using free radical polymerization. Polymer (aloe vera, sodium carboxymethyl cellulose, and meggletose) was crosslinked with monomer (acrylic acid) by using N,N methylene bisacrylamide. Swelling behavior was studied in pH 1.2 and 7.4. Sol gel fraction depicted gel fraction increased with the increase in feed ratio (polymer, monomer, and crosslinker). Optimized formulation was evaluated via Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). FTIR confirmed compatibility of metoprolol with formulated system. Moreover, pH-dependent swelling was observed, experiencing significant swelling at higher pH. SEM depicted porous architecture which is responsible for swelling, drug loading, and release. Dissolution studies showed percentage drug release was significant in pH 7.4. Hence, the current research work demonstrates sustained delivery of metoprolol by employing varying concentration of polymer, monomer, and crosslinker. These fascinating properties made hydrogel a promising carrier for sustained drug delivery. [ABSTRACT FROM AUTHOR]

In current research study, novel chitosan-based hydrogel was formulated via crosslinking graft copolymerization of acrylic acid (AA) and chitosan. Potassium persulfate was used as free radical generator in the presence of crosslinker (methylene bis acrylamide (MBA)). FTIR spectroscopy was employed to elucidate structure of hydrogel. Moreover, sample morphology was examined by scanning electron microscopy (SEM) and thermal analysis was conducted by using thermogravimetric analysis (DSC/TGA). The influence of reaction variables such as concentration of chitosan (CS), acrylic acid (AA) and MBA was optimized to attain hydrogel with significant swelling capacity. Chitosan-g-AA hydrogel depicted pH responsive attributes and swelling–deswelling pulsatile behavior was recorded at pHs 1.2 and 7.4. This on–off switching makes hydrogel ideal candidate for controlled drug delivery. [ABSTRACT FROM AUTHOR]

The core objective of this work was to formulate compressed tablets containing captopril-loaded microspheres for controlled delivery. Captopril is rapidly absorbed orally and has a bioavailability of ∼75%. The duration of action after a single oral dose is 6–8 h. Due to its relatively short half-life, a controlled released captopril formulation would bring benefits to patients, including reduction in frequency of administration, increased patient compliance and effectiveness of treatment, reduction in plasma concentration fluctuations, as well as a reduction in side effects. Double emulsification technique accompanied by solvent evaporation was employed for manufacturing captopril-loaded microspheres. Developed polymeric carriers were characterized for particle size analysis, entrapment efficiency, DSC, TGA, XRD, EDS, SEM, swelling index, and release studies. Microspheres have displayed spherical geometry and a size within micrometric range. They have shown high encapsulation efficiency (95%) at polymer to drug ratio (1:5:5). All the ingredients were compatible with each other. Optimized formulation ST1 has depicted zero-order drug release. [ABSTRACT FROM AUTHOR]

Background: In Pakistan, drug promotion practices, ethical or unethical, have rarely been in the spotlight. We aimed to assess the perception and barriers of medical representatives (MRs) and doctors (MDs) regarding ethical promotion of pharmaceuticals in Pakistan.Methods: A cross sectional survey was conducted in seven major cities of Pakistan for 6-months period. Self-administered questionnaire was used for data collection. Logistic regression and five-point Likert scale scoring was used to estimate the perceptions and barriers.Results: Compared to national companies (NCs), the medical representatives (MRs) of multinational companies (MNCs) strongly believed that their companies follow World Health Organization (WHO) (OR; 5.31, p = 0.0005), International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) (OR; 6.45, p = 0.0005) and national codes of ethics (OR; 5.84, p = 0.0005). MNCs trained their MRs (OR; 6.68, p = 0.0005), provide accurate and valid scientific data (OR; 4.01, p = 0.007) with adequate system of accountability and controls on product samples (OR; 1.96, p = 0.047), while, NCs sponsor social or entertainment activities, seminars and conferences, and all sort of facilitation in form of gifts of their choice and clinic renovation for medical doctors (MDs). MDs perceptions were similar to MRs mentioned above, yet strongly agreed that companies offer cash payments or equivalents to MDs. The MRs of NCs/MNCs and MDs agreed/strongly agreed that no external accountability, profiteering, pressure on sale targets, job insecurity, condoning unethical promotion by high-ups' and business promotion by junior MDs were the predominant barriers.Conclusion: In conclusion, MRs of MNCs and MDs believed that MNCs follow certain codes of ethics in the promotion of pharmaceuticals, while NCs tend to be more profit oriented and even condone unethical promotion. All stakeholders, MRs, MDs and companies, might pose certain barriers, intentionally or unintentionally, in ethical promotion. [ABSTRACT FROM AUTHOR]

Background: The role of a pharmacist in primary health care settings of Pakistan is still obscure. Thus, we aimed to demonstrate the pharmacist-led improvements in glycemic, blood pressure and lipid controls in type 2 diabetes mellitus (T2DM) patients of Lahore, Pakistan.Methods: The first open label, randomized control trial conducted at a primary health care facility of Lahore, Pakistan by enrolling 244 uncontrolled type 2 diabetes (hemoglobin A1 c, (HbA1c); 10.85 ± 1.74) patients. The pharmacological intervention included identification of drug related problems, drug interactions, change in dose, frequency and therapy switches in collaboration with physician, while non-pharmacological intervention consisted of diet, lifestyle and behavior counseling. Outcome measures were glycemic (HbA1c), blood pressure and lipid controls.Results: In intra-group comparison, compared to control arm (C, n = 52), subjects in the intervention arm (I, n = 83) demonstrated significant differences in process outcome measures; baseline vs final, such as HbA1c (C; 10.3 ± 1.3 vs 9.7 ± 1.3, p <  0.001, I; 10.9 ± 1.7 vs 7.7 ± 0.9, p <  0.0001), systolic blood pressure (SBP) (C; 129.9 ± 13.9 vs 136 ± 7.1, p = 0.0001, I; 145 ± 20.4 vs 123.9 ± 9.9 mmHg, p <  0.0001), diastolic blood pressure (DBP) (C; + 4, p = 0.03, I; - 7 mmHg, p <  0.0001), cholesterol (C; 235.8 ± 57.7 vs 220.9 ± 53.2, p = 0.15, I; 224 ± 55.2 vs 153 ± 25.9 mg/dL, p < 0.0001), triglycerides (C; 213.2 ± 86.6 vs 172.4 ± 48.7, p = 0.001, I; 273 ± 119.4 vs 143 ± 31.6 mg/dL, p < 0.0001) and estimated glomerular filtration rate (eGFR) (C; 77.5 ± 18.6 vs 76 ± 14.2, p = 0.5, I; 69.4 ± 21.3 vs 93.8 ± 15.2 ml/min/1.73m2, p < 0.0001). Likewise, inter-group improvements were more significant in the subjects of intervention group at final follow up in comparison to control for various process outcome measures; HbA1c (p < 0.001), SBP (p < 0.0001), DBP (p = 0.02), cholesterol (p < 0.0001), triglycerides (p < 0.0001), SCr (p < 0.001), eGFR (p < 0.001). Moreover, both male and female subjects exhibited similar responses towards intervention with similar improvements in outcome measures.Conclusion: These data suggested that pharmacist intervention in collaboration with physician in primary health care settings may result in significant improvements in glycemic, blood pressure and lipid controls in Pakistani population.Trial Registration: The trial was registered retrospectively with International Standard Registered Clinical/soCial sTudy Number (ISRCTN) registry on July 26, 2017 under nutritional, metabolic, endocrine category with assigned registration # ISRCTN22657497 and can be assessed at https://doi.org/10.1186/ISRCTN22657497. [ABSTRACT FROM AUTHOR]

ABSTRACT The objective of study was to design bilayer matrix tablet of metoprolol tartrate and lisinopril maleate. The direct compression method was used for preparation of both layers. Precompression and postcompression parameters were evaluated. USP Type II dissolution apparatus was used for the in vitro drug release study using 0.1 N HCl for immediate release of lisinopril maleate layer for 2 h and phosphate buffer at pH 6.8 for 10 h for metoprolol tartrate sustained layer. In vitro data were fitted into various kinetic models. Precompression parameters showed good flow properties of powder blend. Postcompression parameters were within compendia range. L7 (2% SSG and 3% CC-Na) was selected for formulation of immediate release layer that showed 91.6% drug release after 10 min, and for sustained release formulation, M4 (9% pectin, 9% acacia, and 20% Eudragit L100) showed 92.5% drug release for 10 h. Most formulations of sustained layer followed Higuchi drug release kinetics. Bilayer matrix tablet of metoprolol tartrate and lisinopril maleate can be formulated for the treatment of postmyocardial infarction. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cells hold the promise to treat not only several congenital and acquired bone degenerative diseases but also to repair and regenerate morbid bone tissues. Utilizing MSCs, several lines of evidences advocate promising clinical outcomes in skeletal diseases and skeletal tissue repair/regeneration. In this context, both, autologous and allogeneic cell transfer options have been utilized. Studies suggest that MSCs are transplanted either alone by mixing with autogenous plasma/serum or by loading onto repair/induction supportive resorb-able scaffolds. Thus, this review is aimed at highlighting a wide range of pertinent clinical therapeutic options of MSCs in the treatment of skeletal diseases and skeletal tissue regeneration. Additionally, in skeletal disease and regenerative sections, only the early and more recent preclinical evidences are discussed followed by all the pertinent clinical studies. Moreover, germane post transplant therapeutic mechanisms afforded by MSCs have also been conversed. Nonetheless, assertive use of MSCs in the clinic for skeletal disorders and repair is far from a mature therapeutic option, therefore, posed challenges and future directions are also discussed. Importantly, for uniformity at all instances, term MSCs is used throughout the review. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the frequency of gingival recession and its severity in association with local contributing factors in patients visiting Khyber College of Dentistry, Peshawar. Study was conducted from September 2016 to January 2017.One hundred and seventy-five patients of both genders were selected using convenient sampling technique. The participants involved in this study were examined in Periodontics Department, Khyber College of Dentistry Peshawar, using mouth mirror, triple syringe, and WHO probe under dental unit light. Miller's classification was used for measuring various grades of gingival recession. Data were analyzed using SPSS, V-22. The maximum age of patient was 53 years and minimum 18 years and the mean age was calculated as 32 years (SD 9.71). Calculations showed that 50% (n=87) of all the patients were male and remaining 50% (n=88) were females age ranged from 18 to 53 years. Males with gingival recession were 25% (n=44) and females were 32% (n=58). Out of the total 175 patients, those with Miller Class I were 28.6 % (n=50) followed by Miller's class II, 27.4 % (n=48), Miller's Class III 5.7 % (n=10) and Miller's Class IV 2.9 % (n=5). The recommendations of this study is that every patient should be educated and instructed about the correct brushing technique, the correction of malaligned teeth, the discontinuation of inju-rious oral habits especially snuff dipping, frequent use of mouthwashes and interdental cleaning aids e.g. dental floss etc. as all of these aids will lead to prevention of plaque accumulation and thus the prevention of periodontal disease which causes gingival recession. [ABSTRACT FROM AUTHOR]