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Purpose: To assess the adherence of cardiologists to JNC7 and the impact of pharmacists in reducing clinical inertia by managing high blood pressure in the cardiology out-patient department of the Armed Forces Institute of Cardiology, Rawalpindi, Pakistan. Methods: This was a pre- and post-interventional prospective study in which data was abstracted from patients’ history notes or prescription of selected patients at baseline and follow-up visits by applying a reliable tool. The data were abstracted again from the same patients to evaluate the cardiologists’ adherence with the same parameters after 2,4 and 6 months. The sample size for this study was 116 patients and descriptive statistics were used for categorical variables. For the comparison of cardiologist’s adherence to JNC7, means and paired ‘t’ test were used at the level of 0.05 significance. Results: At baseline, the mean overall percentage of cardiologists’ adherence to JNC7 was 46.7 ± 18.9 %. This significantly improved to 98.8 ± 6.0 % after 2 months of the pharmacist intervening by way of discussions with cardiologists. The cardiologists’ adherence was further improved to 100 % after 4 and 6 months. Conclusion: Improvement in cardiologists’ adherence to JNC 7 guidelines and involvement of the pharmacist enhance the documentation of BP goal, lifestyle modifications and uncontrolled BP. All these helps to overcome clinical inertia that ultimately leads to better BP control and rational use of medicines. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate α-glucosidase and α-chymotrypsin enzyme inhibitory activity of Jatropha gossypifolia as a probable remedy for the management of diabetes and ulcer. Methods: Different extracts and fractions of the root, leaf and stem bark of the plant were screened for their α-glucosidase and α-chymotrypsin inhibitory activity using standard in vitro inhibition assays. Acarbose and chymostatin were used as positive control, respectively. Results: n-Butanol and ethyl acetate fraction showed maximum enzyme inhibition for α-glucosidase with 67.93 ± 0.66 and 67.67 ± 0.71 % and half maximal concentration (IC50) of 218.47 ± 0.23 and 213.45 ± 0.12 μg/ml, respectively. Dichloromethane and ethyl acetate leaf fractions exhibited maximum α-chymotrypsin inhibition activity of 85.08 ± 0.38 and 83.87 ± 0.70 %, and IC50 of 133.1 ± 0.68 and 134.5 ± 0.12 μg/ml, respectively, Acarbose exhibited enzyme inhibition activity of 92.14 ± 0.38 % with IC50 of 38.24 ± 0.1 μg/ml, while chymostatin exhibited 93.67 ± 0.38 % enzyme inhibition and IC50 of 8.24 ± 0.11 μg/ml. Conclusion: The presence of bioactive secondary metabolities with enzyme-inhibiting activity lends some support for the traditional use of this plant in the management of diabetes and ulcer. However, further investigation of the plant including identification of its active components is required. [ABSTRACT FROM AUTHOR]