Objective:This study finds out drug usage trends in Stage I Hypertensive Patients without any compelling indications in Karachi, deviations of current practices from evidence based antihypertensive therapeutic guidelines and looks for cost minimization opportunities.Methods:In the present study conducted during June 2012 to August 2012, two sets were used. Randomized stratified independent surveys were conducted in doctors and general population - including patients, using pretested questionnaires. Sample sizes for doctors and general population were 100 and 400 respectively. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Financial impact was also analyzed.Results:On the basis of patients’ doctors’ feedback, Beta Blockers, and Angiotensin Converting Enzyme Inhibitors were used more frequently than other drugs. Thiazides and low-priced generics were hardly prescribed. Beta blockers were prescribed widely and considered cost effective. This trend increases cost by two to ten times.Conclusion:Feedbacks showed that therapeutic guidelines were not followed by the doctors practicing in the community and hospitals in Karachi. Thiazide diuretics were hardly used. Beta blockers were widely prescribed. High priced market leaders or expensive branded generics were commonly prescribed. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.
Objective:To determine the use of information technology (IT) & electronic media for improving compliance rate to doctors’ advice in hypertensive patients in Karachi.Methods:Total 400 persons (200 males & 200 females) were randomly selected in six districts of Karachi. Data was collected through a pretested questionnaire. Following was sample criteria: age above 15 years, living in Karachi and ambulatory. Persons admitted in a hospital, individuals who were doing some physical activity during survey e.g. exercise, labor work etc., individual in stressed condition, non-cooperative individuals – not willing to get BP checked and fill questionnaire, and pregnant women were excluded. Those who did not sign the consent form were also excluded. SPSS was used for data analysis and descriptive statistics was employed for sensitivity analysis.Results: For healthcare awareness, people look for health programs on radio and TV channels. Short Message Service (SMS) and phone are highly appreciated by patients for reminders. To increase compliance to doctors’ advice, less educated people prefer phone calls over SMS whereas educated individuals favor SMS. Although price of medicine has not emerged as a major contributing factor for non-compliance, discount on medicinal products is highly appreciated by the patients.Conclusion:The study concludes that there is a widespread awareness of high blood pressure in the sample population of Karachi e.g. 72.5%. People consider reminder message system i.e. Calls and Short Messaging Service (SMS) would help them in improving compliance to doctors’ advice.
Catharanthus roseus, or Vinca rosea belongs to the family Apocynaceae, the other common names are periwinkle, madagascar periwinkle, sadabahar. The plant is easily growing and commonly available in the sub-continent. Catharanthus roseus has a variety of medicinal properties, such as antibacterial [1], antifungal [2] and antiviral [3]. The alkaloids from C. roseus are famous for their anticancer activity [4][5]. Studies revealed its wound healing action in the rats [6]. It is also known to possess antidiabetic action via peroxisome proliferator-activated receptors [7][8]. Antioxidant properties are also reported in the literature [9].Biological screening of the plant was carried out for the determination of antimicrobial activity both in vivo and in vitro. In the present study the well plate method was used to determine the antimicrobial activity of Catharanthus roseus, for this reason wells were made on petri plates filled with nutrient agar containing a culture of a particular bacterial species [10] Catharanthus roseus belongs to the family Apocynaceae, is an erector procumbent herb or undershrub containing latex. It possesses known antibacterial, antimicrobial, antifungal, antidiabetic, anticancer and antiviral activities. In the present study we carried out the screening of this plant for its antibacterial potential adopting the antibacterial assay. The different parts of C. roseus (leaf, stem, flower and root) were used and extracts were subjected to antibacterial assay. The extracts of C. roseus did not exhibit antibacterial activity against Staphylococcus aureus. Moreover, leaf, stem and flower extracts were also ineffective against Pseudomonas aeruginosa. The leave extract did not exhibit activity against Corynebacterium diphtheriae, similarly, the crude extract of stem did not shown activity against Shigella boydii. The most effective was the root extract, which exhibited broad-spectrum antibacterial activity against Salmonella typhi and S. boydii with the zone of inhibitions measuring 24 mm and 22 mm, respectively. The flower extract also showed activity against C. diphtheriae.
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