Health related quality of life (HRQoL) is used to measure both the present health status and the impact of health care interventions on the patients. The aim of the present study is to evaluate the improvement in health related quality of life of the hypertensive patients after pharmaceutical care provided by pharmacist in Pakistan. A repeated measure prospective intervention study was conducted at Armed Forces Institute of Cardiology, Rawalpindi, Pakistan. 286 hypertensive patients were enrolled at baseline, out which 116 patients kept enrolled till the end of the study. After taking the demographic data at baseline, the health related quality of life was measured by using the Urdu version of generic EQ-5D instrument of Euroqol Group at baselines and follow up visits after 2 months, 4 months and 6 months. All the data was entered and analyzed by using SPSS version 16. Paired t test and Pearson's correlation coefficient were performed to compare EQ-5D values and association between baselines and follow up visits. The EQ-5D Index score and EQ-5D VAS score were 0.8789 ± 0.17993 and 65.56 ± 16.67 at baseline which were raised to 0.9276 ± 0.1392 and 78.00 ± 12.649 respectively after 6 months. The study showed that health related quality of life of these hypertensive patients were significantly improved after pharmaceutical care interventions.
The objective of the study was to evaluate different types of cancer and its chemotherapy in various ethnic groups of Pakistan. Ethnic groups includes, Pukhtoons, Punjabis, Sindhis, Muhajirs, Siraikis, Memoons, Hazaras, Hindkos, Baltis, Gilgitis, Kashmiris, and Afghanis. The data was collected from well reputed hospitals located in the different provinces of Pakistan. The collected data was taken from 15 hospitals where around 8500 patients visited during 2010 to 2017. From the visited patients, 8356 were analyzed for their ethnicity, age and sex while, 144 patients (male 77 and female 67) were excluded from analysis due to incomplete information or loss of follow-up. Among 8356 patients, 3762 were male (45%) whereas, 4594 were female (55%). The chemotherapy was carried out as per National Comprehensive Cancer Network guidelines (NCCN-guidelines). The most common five prevalent cancer among these ethnic groups were Head and Neck, Blood, Respiratory, Genito-urinary and Breast cancer. The most common cancer in female was breast cancer while, head and neck cancer was more prevalent in male. It can be concluded that the prevalence of cancer in Pakistan is very alarming, which may be due to lack of awareness, illiteracy, lack of national cancer control programs, and economics issues.
Background: There are concerns with inappropriate prescribing of antibiotics in hospitals especially broad spectrum in Pakistan and the subsequent impact on antimicrobial resistance rates. One recognized way to reduce inappropriate prescribing is for empiric therapy to be adjusted according to the result of culture sensitivity reports. Objective: Using culture sensitivity reports to optimize antibiotic prescribing in a teaching hospital in Pakistan. Methods: A retrospective observational study was undertaken in Ghurki Trust Teaching Hospital. A total of 465 positive cultures were taken from patients during the study period (May 2018 and December 2018). The results of pathogen identification and susceptibility testing from patient-infected sites were assessed. Additional data was collected from the patient’s medical file. This included demographic data, sample type, causative microbe, antimicrobial treatment, and whether empiric or definitive treatment as well as medicine costs. Antimicrobial data was assessed using World Health Organization’s Defined Daily Dose methodology. Results: A total of 497 isolates were detected from the 465 patient samples as 32 patients had polymicrobes, which included 309 g-negative rods and 188 g-positive cocci. Out of 497 isolates, the most common Gram-positive pathogen isolated was Staphylococcus aureus (Methicillin-sensitive Staphylococcus aureus) (125) (25.1%) and the most common Gram-negative pathogen was Escherichia coli (140) (28.1%). Most of the gram-negative isolates were found to be resistant to ampicillin and co-amoxiclav. Most of the Acinetobacter baumannii isolates were resistant to carbapenems. Gram-positive bacteria showed the maximum sensitivity to linezolid and vancomycin. The most widely used antibiotics for empiric therapy were cefoperazone plus sulbactam, ceftriaxone, amikacin, vancomycin, and metronidazole whereas high use of linezolid, clindamycin, meropenem, and piperacillin + tazobactam was seen in definitive treatment. Empiric therapy was adjusted in 220 (71.1%) cases of Gram-negative infections and 134 (71.2%) cases of Gram-positive infections. Compared with empiric therapy, there was a 13.8% reduction in the number of antibiotics in definitive treatment. The average cost of antibiotics in definitive treatment was less than seen with empiric treatment (8.2%) and the length of hospitalization also decreased. Conclusions: Culture sensitivity reports helped reduced antibiotic utilization and costs as well as helped select the most appropriate treatment. We also found an urgent need for implementing antimicrobial stewardship programs in hospitals and the development of hospital antibiotic guidelines to reduce unnecessary prescribing of broad-spectrum antibiotics.
Introduction The human papillomavirus (HPV) is the most prevalent viral sexually transmitted infection globally, with cervical cancer being primarily caused by persistent HPV infection. Early diagnosis and monitoring of women with HPV infection can significantly improve treatment outcomes and lower mortality rates. This study aimed to determine the prevalence of HPV in cervical specimens sent to Aga Khan University Hospital Clinical Laboratories for diagnostic testing. Methods A retrospective review of 1062 test records from 2017-2022 was conducted, with high-risk HPV DNA testing performed by DNA Hybrid Capture 2 method. Results Out of 1062 patients, 764 underwent a Pap smear test, with 14.9% having abnormal epithelial lesions. High-risk HPV DNA was detected in 180(16.9%) cases, and biopsy findings were available in 118 specimens (11.1%). Squamous intraepithelial lesions were the most common biopsy finding, followed by non-specific cervicitis (36, 30.5%), squamous cell carcinoma (16, 13.6%), and adenocarcinoma in (6 ,5.1%) women. HPV positivity was correlated with cervical cytology and biopsy findings. Conclusions The data shows a strong correlation between hrHPV positivity and neoplasia in women tested in Pakistan, suggesting a delay in HPV detection. Routine HPV testing is strongly advised for women to screen for cervical cancer. Early diagnosis of high-risk HPV strains can improve triage, treatment, and follow-up of infected patients. Raising public awareness of the value of routine testing, early detection, and treatment of cervical cancer and HPV can significantly lower morbidity and mortality rates.
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