Objective:To identify and evaluate the frequency, severity, mechanism and common pairs of drug-drug interactions (DDIs) in prescriptions by consultants in medicine outpatient department.Methods:This cross sectional descriptive study was done by Pharmacology department of Bahria University Medical & Dental College (BUMDC) in medicine outpatient department (OPD) of a private hospital in Karachi from December 2015 to January 2016. A total of 220 prescriptions written by consultants were collected. Medications given with patient's diagnosis were recorded. Drugs were analyzed for interactions by utilizing Medscape drug interaction checker, drugs.com checker and stockley`s drug interactions index. Two hundred eleven prescriptions were selected while remaining were excluded from the study because of unavailability of the prescribed drugs in the drug interaction checkers.Results:In 211 prescriptions, two common diagnoses were diabetes mellitus (28.43%) and hypertension (27.96%). A total of 978 medications were given. Mean number of medications per prescription was 4.6. A total of 369 drug-drug interactions were identified in 211 prescriptions (175%). They were serious 4.33%, significant 66.12% and minor 29.53%. Pharmacokinetic and pharmacodynamic interactions were 37.94% and 51.21% respectively while 10.84% had unknown mechanism. Number wise common pairs of DDIs were Omeprazole-Losartan (S), Gabapentine- Acetaminophen (M), Losartan-Diclofenac (S).Conclusion:The frequency of DDIs is found to be too high in prescriptions of consultants from medicine OPD of a private hospital in Karachi. Significant drug-drug interactions were more and mostly caused by Pharmacodynamic mechanism. Number wise evaluation showed three common pairs of drugs involved in interactions.

Background: We aimed to estimate pregnancy outcome after ICSI in terms of oocyte parameters, embryo quality, endometrial thickness, hormone and cytokine levels in women stratified on the basis of follicular output rate (FORT). Methods: Quasi experimental design was carried out after approval from "Ethical review board of Islamabad clinic serving infertile couples" from July 2010 to August 2013. One thousand and fifty females were selected with the criteria of age between 21-40 years, infertility of more than 2 years, body mass index of 18-35 kg/m 2 , menstrual cycle of 25 ± 7 days, both ovaries present with normal uterine cavity, serum FSH levels less than 8 IU/ml and normal thyroid-stimulating hormone levels. Females on short agonist or antagonist protocol with diagnosis of polycystic ovarian syndrome, fibroids or in their male partner sperms retrieved by testicular biopsy were excluded from the study. Down regulation of ovaries was followed by controlled ovarian stimulation, Ovulation Induction (OI), oocyte pick up, in vitro fertilization, Embryo Transfer (ET) and confirmation of pregnancy was done by serum beta hCG of more than 25 mIU/ml and cardiac activity on trans vaginal scan. Enzyme linked immuno sorbent assay was used for peak and mid luteal estradiol (E2), progesterone (P) and interleukin I-β estimation on OI and ET days respectively. FORT (ratio of preovulatory follicle count to antral follicle count × 100 on OI day) stratified females into low under the 33 rd percentile, medium between the 33 rd and the 67 th percentile and high above the 67 th percentile. Characteristics of groups were compared by one way analysis of variance. Results: Females 276 (33%), 288 (34%) and 282 (33%) comprised of low, medium and high FORT groups respectively. The number of retrieved, mature and fertilized oocytes, cleaved embryos, endometrial thickness and number of gestational sacs in the high FORT group was significantly high (P <0.001). High peak and midluteal E2 (P = 0.0025, 0.0001), low P (P = 0.0001) and high peak interleukin-1β (P = 0.0001) was observed in high FORT in comparison with medium FORT with resultant greater number of clinical pregnancies 183 (65%). Conclusions: The FORT in non PCOS patients may reflect good reproductive outcome after ICSI with maximum clinical pregnancies in high FORT group.

Objective: To evaluate anti-inflammatory activity of Salvadora persicain rats.Materials & methods: The anti-inflammatory activity of Salvadora persica was assessed in 63albino rats of both sexes, weighing 400 gm. They were divided into three groups, A (control), B(crude drug), C (standard drug) with twenty one animals. Each group was divided into threesubgroups with seven animals. Groups B &C were given crude drug and aspirin diluted in one mlof distilled water once daily orally, in doses of 300, 500, & 700 mg/kg body weight respectively,prior to induction of edema and Group A was given same volume of saline. Inflammation wasinduced in hind paw of rat by sub-planter injection of 0.1ml of 1% carrageenan. Paw volume wasmeasured in terms of milliliters using plethysmometer, immediately before injection & then hourlyup to 5 hours& mean was calculated. The inhibition of edema was calculated for each subgroupwith respect to control group. Results: After carrageenan injection mean paw volume of controlgroup was 5.43 ml, while that of drug treated subgroup was 4.32 ml & standard group was 4.49 mlat the dose of 700 mg/kg body weight. Comparison of crude drug with the control was found to bestatistically significant only at 700 mg/kg & was comparable with the standard drug aspirin.Conclusions: Salvadora persica has shown anti-inflammatory activity by decreasing the pawvolume of carageenan induced edema.

Type 2 diabetes mellitus (DM) is a chronic disease which deteriorates the quality of life with time. Type 2 DM accounts for more than 90% cases of diabetes mellitus as compared to other types of this disease. There is significant oxidative stress in type 2 DM which plays an important role in the pathogenesis of disease. In order to combat this oxidative stress antioxidant supplements have to be added as add on therapy along with treatment of type 2 DM. Vitamin C is the safest antioxidant which plays significant role in diminishing the oxidative stress. The vitamin C supplementation have good control of FBS and HbA1c and therefore helps in achieving better glycemic control along with prevention of lipid abnormalities.

Objective: To compare pitavastatin 4 mg (high dose) with pitavastatin 2 mg (moderate dose) and ezetimibe combination on LDL-C in type II diabetics. Study Design:                         Setting: National Medical Center (NMC) and PNS Shifa Hospital. Period: January and June 2022. Material & Methods: Fifty diagnosed type II diabetics on metformin, 25 in the monotherapy group (group A) and 25 in the combination therapy group (group B). Glycosylated hemoglobin and lipid profile tests were conducted in labs pre therapy and 3 months post therapy. LDL-C levels were recorded and compared. Result: Average LDL-C level drop of 13.51% occurred in the monotherapy group and 17.48% in the combination therapy group. Chi square test showed that LDL-C target levels (< 130 mg/dl) were reached in 33% patients in the monotherapy group and in 64% patients in the combination group. Conclusion: Pitavastatin monotherapy and combination therapy both lowered LDL-C levels, however, combination therapy with ezetimibe lowered levels by a greater degree and in a larger number of people.