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Objectives: This study aims at measuring compliance to iron supplements because iron deficiency anemia (IDA) is worldwide problem among pregnant women, so Iron supplements are advised usually in once daily regimen but compliance to iron supplements therapy is a major problem due to possible side effects and long-term duration of therapy. Study Design: Retrospective questionnaire-based study. Setting: Mola Bakhsh Hospitals, Sargodha, Pakistan, Period: From February to December, 2018. Material & Methods: This study was design to check compliance to iron supplementation during pregnancy and various factors related to directly and indirectly noncompliance to iron supplementation. A total of 267 pregnant females were recruited in study. Data was collected through a questionnaire translated in local language. On this basis sample population was divided into three groups compliant, partially compliant and non-compliant major factors associated with the prevalence of anemia and non-compliance to iron supplements were education, side effects, financial issues, forgetfulness, personal beliefs, disliking of pharmaceutical preparation etc. Results: After thorough analysis it was found that iron deficiency anemia is prevalent in about 64% of females in the third trimester. Improvement in Hb level in third trimester compared to 1st trimester was taken as parameter for measurement of compliance. Conclusion: side effects due these iron supplements and certain human habits act as hurdle to fight anemia during pregnancy and to eradicate these hurdles certain steps like education of women about anemia, its causes, health implication and imparting nutritional education with special emphasis to improve dietary intake of proteins and iron.

Objectives: To evaluate drug prescribing practices at Medical Unit, ICU andNephrology Unit, using WHO prescribing indicators, in order to promote rational drug use.Study Design: A retrospective cross sectional study. Place and Duration of Study: BolanMedical Complex Hospital Quetta, Pakistan, from July to December 2015. Methodology: Drugprescribing trends in 218 prescriptions were scrutinized thoroughly. Data was collected bywell-trained pharmacy personals by using prescriptions and prescription registration booksof patients. Descriptive statistics were calculated on SPSS version 16.0. Results: The averagenumber of drugs prescribed per prescription were 4.11 whereas, WHO recommends that itshould be 2.00 or less. Alternatively, percentage of drugs prescribed by generic name and froman essential drug list were 14.73% and 78.35% while, in accordance with WHO it must be 100%and 70% correspondingly. On the other hand, percentage of encounters having antibiotics orinjections prescribed were 18.33% and 32.79% but according to WHO it should be20% or lessand 10%respectively. Nevertheless, proper diagnosis was stated in 89.44% of prescriptionsand 72.11% prescriptions had complete relevance between treatment and diagnosis. Alongwith, appropriate drug dosage and their administration was instituted in 65.16% of prescriptionsand 73.21% of prescriptions had accurate duration of therapy. Conclusion: The prescribingpatterns in Bolan Medical Complex Hospital Quetta reflect the practice of polypharmacy, whichis more of an irrational type in contrast to WHO recommendations. Thus, there is an urge tobring about some interventions to improve the pharmacotherapy.

Objective: The aim of current research was to highlight the abilities of patients tounderstand and follow prescription. Study design: Cross sectional study. Setting: District HeadQuarter (DHQ) hospital Sargodha, Punjab, Pakistan. Duration: Data was collected betweenApril to June, 2015. Methods: Study was conducted by well-trained pharmacists regardingprescription understanding and following. A well structured questionnaire was designed to gatherinformation from 150 patients that comprised of questions based on all factors to be evaluated forprescription understanding and following. Results: The findings of this critique reveal that, 30%of patients understood instructions given on prescription where as, 12% of patients were able tocomprehend physicians writing and 23% were those who even didn’t understand prescriptionabbreviations. Similarly, correct method of drug administration, compliance with frequencyof dose and dosage form and accurate dose intake were acknowledged by 66%, 65%, 73%and 80% patients, respectively while, 28% patients were able to make clear understandingwith precautions written on prescription. However, 20% of patients reported that medicineshave disturbed their routine life, 29% recognized their dependency on prescribed medications,22% consulted with a third person for prescription interpretation, 36% reduced their dose tohalf due to side effects, 35% stated that prescribed brands were available to them and 65%missed their doses due to high cost of brands. Moreover, 76% patients showed consciousnessregarding value of therapy and only 31% patients acknowledged that prescribed brandswere economical. Conclusion: There is a lot of room for improvement in factors related toprescription understanding and following. Enhanced literacy rate, generic prescribing practicesand cost-effectiveness should be considered for prescription consideration. Most importantfrom Pakistan’s point of view, role of pharmacist should be implemented in every health sectorof country to mimic most of prescription related problems.

Objective: Diabetes mellitus is wide spread non transmissible disease but its prevalence is increasing everyday so this study was conducted with an aim to investigate the factors that are modifying diabetes mellitus among patients at DHQ (District Head Quarter) Hospital Sargodha. Methodology: A prospective study was carried out by well-trained pharmacists in DHQ Sargodha, Pakistan to assess the factors modifying diabetes mellitus. Data was collected from 110 patients randomly by using convenience sampling method. A well structured questionnaire was designed to collect information from patients and entire procedure was conducted with the permission of concerned authorities of Hospital management. The factors that are considered in present study are medication, treatment, patient physician interaction and society attitude towards diabetic patients which are helpful in halting the progression of diabetes and prevention of co morbidities. Results: The results of study disclose that 74.5% diabetic patients felt better after treatment whereas 56% diabetic patients were satisfied with the information provided by physician to them but still 70% patients were suffering from co morbidities. The survey indicated that 62.7% patients said that exercise proved to be healthy activity in improving diabetes. However 59% diabetic patients were following a proper diet plan which was helpful in modifying their diabetes. Conclusions: The diabetic patients must be informed about importance of regular follow-up in averting long-standing complications. Patients should be guided about importance of dietary recommendations, exercise and strict metabolic control, that can holdup or avert the series of complications allied with diabetes.

Objectives: The objectives of the study was to determine differentmicroorganisms responsible for causing urinary tract infections UTI in children and to evaluatesensitivity and resistance pattern of different antibiotics used in UTIs. Setting: Study wasconducted in Children Hospital Complex (CHCM), Multan, Pakistan. Methods: Total 125 childrenhaving UTI were taken to determine the antibiotic sensitivity and resistance pattern againstmicroorganisms causing urinary tract infections in children. The urine samples were collected inurine bottles and smears were made within 2 hours of sample collection. Urine sample wasinoculated on agar media and then incubated for 24 hours. A smear was prepared on a slide formculture of microorganisms and gram testing was conducted. The microorganisms were thencharacterized by use of API (Analytical Profile Index) MICROBACT TM 24E of Oxoid England. Theantimicrobial susceptibility testing of various antibiotics was performed by disc diffusion method.Results and Conclusions: The percentage of Gram +ve bacteria causing urinary tract infectionsin children was 28%, Gram –ve 62.4% and Yeast 9.6%. The most prevailing species are S. aureus,S. epidermidis and E.coli. Results showed that female children are more prone to UTI than malechildren. Norfloxacin is effective in S. Aureus UTI while cefaclor is effective in S.epidermidis UTI.Amikacin, Norfloxacin and Cefuroxime are effective in UTI caused by E.coli.

As in most developing countries, incidence of cancer is also increasing inPakistan. It is important that information on the frequency and epidemiology of malignant tumorsbe updated, as it is the basis of future health planning for the population at risk. This retrospectivestudy was carried out to find the prevalence of various cancers in the population of Sargodhadistrict (central Punjab, Pakistan) and to compare the regional and international studies, so as toplan and develop the oncology setup of Sargodha Medical College on a rationalized basis ofdisease prevalence. Data from July 2010 to June 2013 was retrieved from the department ofstatistics of the hospital and variables of interest were collected and analyzed using SPSS 10.0. Itwas observed that the most frequent cancer in our patients was breast cancer (n=172) whilecarcinoma of lungs was the most frequent carcinoma in male population (n=24). However ourobservations were a bit different from the international studies published on the subject, theprobable reason being the availability of treatment facility and easier access in the nearbydistricts of Faisalabad and Lahore where many patients still go directly. More over the illiterateand poorer faction of the society does not come to the hospitals for management of the diseasebut rather go to the quakes and faith healers to relieve them of their sufferings. It is concluded thatthe department of clinical oncology should arrange cancer awareness programs for the generalpopulation to avoid delays in getting consultation, as at present they report to the hospital whenthe disease is quite advance and surgery is often not possible. Our study also revealed asomewhat different pattern of malignancies in our community raising a need for further studies toevaluate the reasons for this changed pattern in relation to various etiological factors.

Objective: To evaluate the prevalence, diagnostic criteria and microbialspectrum of spontaneous bacterial peritonitis (SBP) and its variants in cirrhotic patients with ascites. Design: A hospitalbased prospective study carried out in cirrhotic patients with ascites. Place and duration of Study: The study wasconducted in the Department of Medicine Military Hospital Rawalpindi during October 2000 to March 2002. Subjectand Methods: One hundred and eighty consecutive patients of cirrhotic liver between the ages of 20-65 yearspresenting with ascites reporting to outdoor patient department of Military Hospital Rawalpindi were included in thestudy. The diagnosis of cirrhosis was made on history, clinical examination and the ultrasonographic findings. Thesepatients were subjected to ascites fluid tap and the patients were divided into SBP and non-SBP groups in the light ofresults of ascitic fluid routine examination and culture. The SBP group was further categorized into culture positive SBP,culture negative neutrocytic ascites (CNNA) and bacterascites (BA) on the basis of culture results and total leukocytecount, absolute polymorphonuclear leukocyte count per cubic mm of ascitic fluid. Results: The study included 144males and 36 females having cirrhosis with ascites. The mean age of these patients was 52.32±7.87 years. On thebasis of routine examination and culture of tapped ascitic fluid from these cases 57 of 180(31.66%) patients werediagnosed to have SBP or its variants. In addition to classic SBP in 18(31.58%) patients, its variants namely culturenegative neutrocytic ascites and bacterascites were detected in 37(64.92%) and two (3.5%) cases respectively. E. coliwas the most frequently cultured organism. It was isolated in 12 cases of SBP (60%). In 4 cases (20%) Klebsiella wascultured whereas Proteus mirabilus and Streptococcus were reported in two cases (10%) each. Conclusion: This studyindicates that spontaneous bacterial peritonitis is common and potentially fatal complication in cirrhotic patients withascites. E. coli is the most frequent offending organism.

Objective: Chronic Cholecystitis is one of the commonest diseases presenting in surgical department and is subjected to cholecystectomy each time. A suspicious gall bladder on ultrasound initiates further investigations to rule out carcinoma of gall bladder yet some times a benign looking gall bladder on ultrasound turns out to be carcinoma of gall bladder on histopathology. Design: Descriptive study. Place & Duration of study: District Head Quarters Hospital, Sargodha, from September 2007 to March 2009. Patients & Methods: 200 patients who underwent both open and Laparoscopic cholecystectomy for cholelithiasis were subjected to this study. All relevant data was documented on a standardized data form. Patients were between the ages of 28-74. Patients already diagnosed as Gallbladder Carcinoma, empyema gall bladder, mucocele and gall bladder polyp were excluded from the study. Gall bladders removed after each surgery ware sent to laboratory for histopathological evaluation. Results: A total of 200 cases were studied (161 females, 39 males; M: F ratio 1:4). The mean age was 45 years (range 28-74 years). The most common presenting complaint was pain right hypochondrium with nausea and vomiting (85%).The average operating time was 50 minutes in case of open cholecystectomy and 1 hour in laparoscopic cholecystectomy. Complications included biliary leak in 2 patients (1%), Wound Infection in 3 patients (1.5%) and death in one case (0.5%). The overall rate of complications was 3%. There were a total of 5 patients of laparoscopic cholecystectomy who required extension of the incision, for Carcinoma Gallbladder. Conclusions: Carcinoma of gall bladder is a very aggressive malignancy and usually presents at a very advance stage as its symptoms mostly are marked by symptoms of cholecystitis. Detection of gall bladder carcinoma is very difficult in early stages on ultrasound. Any findings in ultrasound suggesting malignancy should be confirmed on further investigations like CT scan .Carcinoma of Gall bladder is not very common in cases of cholecystectomy for chronic Cholecystitis but once found should be dealt with extreme precision following established operating protocols.