Background: Lack of appropriate treatment for COVID-19 infection led the general population of Pakistan toward self-medication and symptomatic treatment; almost 80% of the population collected medications for future use during pandemic. Thus, the current study aimed to assess the use of medication as symptomatic treatment preventive strategy. Methods: This descriptive cross–sectional study was conducted on a local population of Hyderabad and Karachi, Sindh, Pakistan. The study duration was six months (April– September 2020). A total of 698 responders were selected via random sampling method. The number of participants were recruited based on 95% confidence interval with 5% margin error. Data were transferred into analysis sheet descriptively. Results: Most participants responded to the use of different over-the-counter (OTC) products for headache. The use of antibiotics with prescription due to allergic conditions, cough, respiratory tract infections including sore throat, and urinary tract infections was also found among the majority. Few respondents had self-medication practice with sedatives due to difficulty in falling asleep, and 9.5% had self-medication practice due to pain. About 20.8% of the population agreed that lockdown was a contributing factor in the self-medication practice. Conclusion: Pharmacists and healthcare professionals are advised to counsel the general public regarding the use of medication. A close collaboration is required at this stage to fight against COVID-19 and preventing the situation from worsening. Keywords: self-medication, covid-19, Hyderabad, Karachi, Pakistan

Background: Drug stores in Pakistan are run by dispensers with varied knowledge, qualification, and experience. The current study was sought to explore the knowledge, qualification, experience, and dispensing practices among dispensers working in drugstores in South Karachi, Pakistan. Methods: A cross-sectional survey was carried out using a structured questionnaire. Data were collected from medical stores in South Karachi which were then categorized, coded, and analyzed using SPSS version 23. Relationship among different study variables with pharmacist’s availability and personal experience was assessed using statistical non-parametric Chi-square test. A total of 385 samples obtained using a simple random sampling method were included in the study. However, only 210 responses on questionnaire were complete which were then selected for study analysis between October and December 2018. Results: Of the 210 surveyed drugstores, 9% of their staff had studied only till primary school, 5.7% till the eighth grade, 25.2% up to secondary school level, 26.7% till higher secondary school level, 15.7% had non-professional education, and 8.1% were professional graduate. Only 9% of them had a degree in Pharm. D or B. Pharm, while 0.5% had a post-graduation qualification. Furthermore, 44.8% of pharmacies had a valid pharmacy license but the pharmacist was physically absent in 91% of the drugstores. Majority of pharmacies did not maintain appropriate temperature (refrigerator and/or room temperature). Majority of dispensers did not review prescription particulars before dispensing medications and also dispensed medications on older prescriptions as well as without prescription. Conclusion: In conclusion, the overall knowledge and practices of dispensers working in drugstores was poor. However, the presence of pharmacist was associated with good dispensing practices to a certain extent.

To study and compare the features of the course of ACS in patients who underwent COVID19 infection. Material and Methods:The study included ACS patients with ST segment elevation admitted from January 2021 to February 2022. Patients were compared with a group of patients who did not suffer from COVID 19 infection and were hospitalized for ACS in a similar period of time. The study included 114 patients. In all patients, the presence of IgG antibodies to the agent of the coronavirus infection COVID-19 was determined, which indicates that the person has already had a coronavirus infection or not. Patients were divided into 2 groups: 1 -patients who had COVID19 infection; 2 -not recovered from coronavirus infection. All patients were assessed the following indicators: the presence of coronary artery disease before hospitalization, the incidence of cardiogenic shock, the presence of STEMI, as well as the number of deaths during hospitalization. Results:In the first group, only 39.5% (45) of patients were examined, of which men -80.0% (36). Prior to hospitalization, coronary artery disease was present in 64.4% (29) of patients. STEMI was present in 75.5% (34) of patients. The incidence of cardiogenic shock in 4.4% (2) of patients. The number of deaths during hospitalization is 4.4% (2). In the second group, only 60.5% (69) of patients were examined, of which 78.3% (54) were men. Prior to hospitalization, CAD was present in 55.07% (38) of patients. STEMI was recorded in 59.4% (41) of patients. The incidence of cardiogenic shock is 1.45% of patients. The number of deaths during hospitalization was 1.45%. Conclusion:Before hospitalization, CAD was present in the majority of patients 39.5% (45) who had COVID 19, who did not have COVID19 patients 60.5% (69). STEMI was present in 75.5% (34) of patients who had COVID19 and 59.4% (41) of those who did not have COVID 19 infection (p < 0.05). During the pandemic, there is a high incidence of cardiogenic shock in 4.4% (2) of patients who have had COVID19 and 1.45% (1) of those who have not been ill. The percentage of deaths during hospitalization in COVID19 survivors is higher compared to 4.4% with 1.45% who did not recover.

Pharmacoeconomics deals with the cost and consequences of pharmaceutical products and services. It helps in determination of drug therapies or treatments that gives maximum benefit at lower cost. The aim of this study is to evaluate prescribing trends of antibiotics and to analyze their cost effectiveness. This prospective, observational and non-interventional clinical study was led for a period of 6 months from April 2018 to September 2018 at Government hospital (Liaquat University hospital Hyderabad) and various private clinics of Hyderabad. Through purposive sampling technique 400 samples were gathered. 400 samples with various bacterial infections were included in which 170 patients had Urinary Tract Infections, and 216 had Respiratory Tract Infections 14 patients were suffering from H. Pylori. Levofloxacin was the most recommended class in UTI, while Macrolides was the most recommended class in RTI. Out of 400 patients 152 patients were recovered, 16 patients left therapy due to GIT symptoms and allergic reactions and remaining patients were out of reach. Costs of antibiotics were calculated according to the duration of therapy prescribed. Antibiotics were mostly prescribed for the duration of 7 days. To conclude, Cost of antibiotics therapy was high which puts a considerable burden on the patients.

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