The objective of study was to evaluate the pattern and practice of consultants especially antimicrobials in the allopathic health sector in Pakistan to assess the magnitude of the problem and suggesting corrective measures. A cross-sectional survey in various cities of Pakistan was conducted which was developed in line with WHO and has so far been implemented in 12 developing countries. A total of 4923 prescriptions of 197 consultants were collected and analyzed. Drugs dispensed were 480142; average number of drugs per prescription for all disciplines was 3.13±1.5. The number of encounters with antibiotics in medicine department was 20.17% of the total antibiotic while ophthalmology had no encounter with injectables. Cost of 23.79% of prescriptions was below Rs.100 and 4.9% above 500 rupees. Therapeutic categories of the drugs prescribed were 14.6% antimicrobial followed by 12.5% cardiovascular or renal drugs. The age of the patient, severity of disease, socio-economic status, previous experience of treating similar patients were important factors that determined choice of drugs. EDL was not available in most of the facilities. Around 80% drugs were prescribed by brand name. The drugs prescribed from the essential list were around 30%. Concern of losing patients to others practitioners was considered among the top three factors by only 18% of providers. Age of the patient, severity of disease, socio-economic factors were important factors that determined choice of drugs. Prescribing and dispensing practices are inappropriate and irrational in Pakistan like many developing countries. Managerial and regulatory interventions are proposed to improve the rational use of drugs.

Purpose: To determine knowledge regarding hypertension, adherence to medication and HealthRelated Quality of Life (HRQoL), and their associations in hypertensive patients in Pakistan. Methods: A cross-sectional study was conducted among 384 hypertensive patients attending a tertiary health care public sector hospital in Islamabad, Pakistan. Data were collected using knowledge questionnaire regarding hypertension, Morisky Medication Adherence Scale, and EuroQol (EQ-5D) scale. Results: The mean systolic and diastolic blood pressures of the 384 patients were 140.39 ± 15.485 and 88.74 ± 10.683 mmHg, respectively. The coefficient of correlation between knowledge regarding hypertension and adherence was 0.638 (p < 0.001), showing a positive association. The correlation coefficient between knowledge and HRQoL was 0.709 (p < 0.001), suggesting a good association. The correlation coefficient between adherence to medication and HRQoL was 0.545 (p < 0.001), which indicated a positive correlation. Conclusion: These results indicate that there are statistically significant associations between hypertension knowledge and HRQoL, hypertension knowledge and medication adherence, and between adherence and HRQoL in the hypertensive patients studied.

Background: Conyza bonariensis is known to have anti-cancer properties. Objective: The study investigated the in vitro pro-apoptotic properties of Conyza bonariensis (C. bonariensis) towards human lymphoblastic leukemia Jurkat cells. Methods: C. bonariensis are extracted with non-polar solvent by maceration. MTS cell viability assay was employed to determine the cytotoxic activity of the extract towards human leukemia Jurket cells and normal Peripheral Blood Mononuclear Cells (PBMCs) cells. The phytochemical composition of the extract was chemically characterized using HPLC. Flow cytometric studies (FACS) were conducted to explore the pro-apoptotic potential of the extract. Western blot studies were employed to identify the molecular targets involved in the induction of apoptosis. Results: The n-hexane extract showed selective cytotoxic activity towards Jurkat cells. FACS analysis indicated that the extract induced early and late apoptosis in Jurkat cells. Western blot studies revealed that the extract down-regulated the expression of DNMT1, SIRT1, and UHRF1 with a simultaneous up-regulation of the expression of p73 and caspases-3 proteins. HPLC characterization of the extract revealed the presence of phenolic compounds. Conclusion: Overall these findings demonstrate that the anticancer effects of a Conyza bonariensis extract towards human lymphoblastic leukemiais due to the modulation of the activity of multiple oncogenic and tumor suppressor proteins and that its phenolic content is involved are proposed to be responsible for these activities.