BackgroundThe rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan.MethodsThis was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outpatient medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected. The drugs were classified according to the pharmacological class and their teratogenic potential.ResultsAll the pregnant women attending the antenatal clinics received a prescription containing at least one drug. A total of 3769 distinct prescriptions given to different women were collected. Majority of the women who received the prescriptions belonged to third trimester (55.4%) followed by second (33.6%) and first trimester (11.0%). On an average, each prescription contained 1.66 ± 0.14 drugs. The obstetricians at Civil Hospital, Karachi and Chandka Medical College Hospital, Larkana showed a tendency of prescribing lesser number of drugs compared to those in other hospitals. Anti-anemic drugs including iron preparations and vitamin and mineral supplements (79.4%) were the most frequently prescribed drugs followed by analgesics (6.2%) and anti-bacterials (2.2%). 739 women (19.6%) received prescriptions containing drugs other than vitamin or mineral supplements. Only 1275 (21.6%) of all the prescribed drugs (n = 6100) were outside this vitamin/mineral supplement class. Out of these 1275 drugs, 29 (2.3%) drugs were prescribed which are considered to be teratogenic. Misoprostol was the most frequently prescribed (n = 6) among the teratogenic drugs followed by carbimazole (n = 5) and methotrexate (n = 5). Twenty nine pregnant women (0.8% of all the women studied) were prescribed these teratogenic drugs.ConclusionLess than one percent of the pregnant women attending tertiary care hospitals in Pakistan are prescribed teratogenic drugs. The prescribing practices of Pakistani physicians are similar to those in western countries.

The authors measured prevalence of byssinosis in spinning and textile workers of Karachi, Pakistan, and examined association of the disease with demographic and environmental factors. This was a cross-sectional study conducted in 3 spinning and textile mills and 3 colonies inhabited by spinning and textile workers. A precoded questionnaire was administered to the workers and followed by physical and clinical examination. Among 362 textile workers, the authors found the prevalence of byssinosis to be 35.6%. Educational status of the workers and section of the mill were significantly associated with prevalence of the disease. The authors conclude that there is a high prevalence of byssinosis in spinning and textile workers of Karachi. Furthermore, low education level and work in the spinning section of the mill appear to contribute significantly to the high prevalence of the disease in Pakistan.

BackgroundScientists from less-developed countries (LDC) perceive that it is difficult to publish in international journals from their countries. This online survey was conducted with the primary aim of determining the opinion of corresponding authors of published papers in international Pharmacology journals regarding the difficulties in publications and their possible solutions.MethodsThe titles of all Pharmacology journals were retrieved from Pubmed. 131 journals were included in study. The latest issue of all journals was reviewed thoroughly. An online survey was conducted from the corresponding authors of the published papers who belonged to LDC.Results584 out 1919 papers (30.4%) originated from the LDC. 332 responses (response rate; 64.5%) were received from the authors. Approximately 50% the papers from LDC were published in journals with impact factor of less than 2. A weak negative correlation (r = -0.236) was observed between journal impact factor and the percentage of publications emanating from LDC. A significant majority of the corresponding authors (n = 254; 76.5%) perceived that it is difficult to publish in good quality journals from their countries. According to their opinion, biased attitude of editors and reviewers (64.8%) is the most important reason followed by the poor writing skills of the scientists from LDC (52.8%). The authors thought that well-written manuscript (76.1%), improvement in the quality of research (69.9%) and multidisciplinary research (42.9%) are important determinants that may improve the chances of publications.ConclusionsThe LDC are underrepresented in publications in Pharmacology journals. The corresponding authors of the published articles think that biased attitude of the editors as well as the reviewers of international journals and the poor writing skills of scientists are the major factors underlying the non-acceptance of their results. They also think that the improvement in the writing skills and quality of research will increase the chances of acceptance of their works in international journals.

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