Objectives: The study was conducted with the aim to evaluate the prescribers’ approach of interaction with medical representatives for drug promotion. Methods: An explanatory, cross-sectional design was used to evaluate prescribers’ interactions with the medical sales representatives (MSRs) through an anonymous, self-filled questionnaire from June to December 2017. Data presented as means±SEM or as percentages and statistically analyzed by one way ANOVA, using significance level of 0.05. Results : A response rate of 82.8% was achieved. More than 70% agreed that knowledge obtained from MSRs is reliable and useful. A large proportion of respondents acknowledged that MSRs are a key link between pharmaceutical companies and health care professionals, and their interactions are beneficial as MSRs perform an important teaching function. More than 45% agreed that gifts are influential; however, physicians cannot be compromised with very expensive gifts. The majority of the respondents (76%) considered that promotional items are ethically appropriate; however, 66.21% thought that promotional items influence the practice of prescribing. More than half (52.18%) deemed a promotional material more reliable than a printed advertisement. More than 80% of the respondents opined that medication samples are considered appropriate; however, they should only be given to those patients who cannot financially afford them. Around 69% thought that company-sponsored meetings promote their own drugs under the disguise of CME programs. Conclusion: The present study emphasizes the importance of employing scientifically sound prescribing decision by prescribers in their day to day practice without being influenced by pharmaceutical company’s promotional activities. There is a need for restricting unprincipled practices by the concerned regulatory authorities to evade preventable harm to the patient’s well-being.
Background: Metabolic syndrome (MetS) is a multifactorial disease, whose main stay of prevention and management is life-style modification which is difficult to attain. Combination of herbs have proven more efficacious in multi-targeted diseases, as compared to individual herbs owing to the “effect enhancing and side-effect neutralizing” properties of herbs, which forms the basis of polyherbal therapies This led us to review literature on the efficacy of herbal combinations in MetS.Methods: Electronic search of literature was conducted by using Cinnahl, Pubmed central, Cochrane and Web of Science, whereas, Google scholar was used as secondary search tool. The key words used were “metabolic syndrome, herbal/poly herbal,” metabolic syndrome, clinical trial” and the timings were limited between 2005–2020.Results: After filtering and removing duplications by using PRISMA guidelines, search results were limited to 41 studies, out of which 24 studies were evaluated for combinations used in animal models and 15 in clinical trials related to metabolic syndrome. SPICE and SPIDER models were used to assess the clinical trials, whereas, a checklist and a qualitative and a semi-quantitative questionnaire was formulated to report the findings for animal based studies. Taxonomic classification of Poly herbal combinations used in animal and clinical studies was designed.Conclusion: With this study we have identified the potential polyherbal combinations along with a proposed method to validate animal studies through systematic qualitative and quantitative review. This will help researchers to study various herbal combinations in MetS, in the drug development process and will give a future direction to research on prevention and management of MetS through polyherbal combinations.
Objective: To observe association of Melasma with serum Iron and complete blood count indices Study Design: Case-control cross-sectional study Place and Duration of Study: Department of Dermatology, HIT Hospital Taxila from 1st May 2021 to 1st October 2021 Methodology: Fifty seven females having melasma were taken as cases and 48 non-pregnant females without melasma as control between 12-50 years of age. Women with pregnancy, history of cardiac or thyroid disease and usage of hormone therapy, phototoxic drugs or anti-convulsant drugs were not included. History and examination was done by a dermatologist. Modified MASI (m Melasma Area and Severity Index) score was used for assessing severity of melasma. Blood samples were collected and send for serum Ferritin level, TIBC and Complete blood count in both groups. Results: The mean age of females were 35±7.4 years, and 48 female patients with no melasma were selected as controls with mean age of 25.7±8.4 years. We also analyzed the effect of different hematological and general factors on mMASI score within group of melasma patient but again found no statistically significant effect of any of these on MASI score. Conclusion: There is no direct association between melasma, serum iron levels and blood indices. Keywords: Melasma, Serum ferritin levels, Complete blood count
Background: Since beauty standards have widely change over the last few decades, women feel self-conscious about having unwanted hair that leads to low self-esteem and some develop depression. Although hirsutism can be emotionally distressing, it can be treated. Females have a lot of pressure to undergo painful procedures of hair removing like plucking, treading and creams that can temporarily remove or reduce the visibility of unwanted facial and body hair. In the past two decades of digital technology, lasers have modernized their use in the treatment of many skin conditions including hirsutism. As intense pulsed light is economical and more cost effective, it can be a more suitable option for those who cannot meet the high expenses of laser treatment. Objective: To evaluate the efficiency of intense pulsed light in females with hirsutism. Study Design: Place and Duration of Study: Department of Dermatology, HIT Hospital Taxila from 1st October 2020 to 30th September 2021. Methodology: Sixty patients of idiopathic hirsutism more than 15 years of age were enrolled. Both the history and examination were done. Diagnosis of idiopathic hirsutism was made on clinical examination using and necessary investigations. Those who had photosensitivity, hormonal therapy or hormonal disturbance, infertility, white hair hirsute, pregnancy, and history of keloid or hypertrophic scar were excluded from the study. Treatment was given for six sessions, with one month apart. Parameters of IPL were adjusted according to (Fitzpatrick) skin type, the density of hair, and fluency, the fluence will be increased subsequently depending upon the response of the patient. Post treatment, participants were evaluated and a 4-point scale was used to grade the results. Patients were told to revisit after 6 months to assess the regrowth of hair on face. Conclusion: Intense pulsed light is the cheap, effective and safe option for hirsutism that a third world country like ours needed where the socio-economic status is relatively low. Keywords: Idiopathic hirsutism, Intense pulsed light (IPL), Fitzpatrick skin type
Objective: To evaluate serum levels of 25-hydroxyvitamin D (25-OHD) in patients with viral warts. Study Design: Comparative cross-sectional study. Place and Duration of Study: Dermatology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Jul to Dec 2020. Methodology: One hundred patients were included in the study, 50 with viral warts (Group-1) and 50 without warts (Group2). Our study included both male and female patients of 10 to 60 years of age. Three categories were made according to their serum vitamin D levels. First, all participants were tested for serum vitamin D levels using ELISA. Results: In Group-1, 20(40%) had insufficient, and 25(50%) had deficient vitamin D levels. A statistically significant decrease in serum 25-OHD levels (p = 0.004) was found in patients with viral warts. In Group-2, 9(18%) had insufficient, and 2(4%) had deficient vitamin D levels. The mean serum vitamin D level was 22.61±10.11 in Group-1 and 45.12±24.60 in Group-2, resulting in a significant difference between patients with viral warts and those without viral warts regarding serum vitamin D levels (p=0.004). Conclusion: Patients with viral warts have deficient vitamin D levels.
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