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Objective: To find out the frequency of anemia, agranulocytosis and thrombocytopenia in hyperthyroid patients after the use of propylthiouracil. Study Design: Cross sectional study. Place and Duration of Study: Out Door Patients Department and Pathology Laboratory in Liaquat University Medical & Health Sciences, Hospital Hyderabad/Jamshoro, from May 2016 to Apr 2017. Methodology: Two hundred cases, comprising of adult patients were categorized into five groups, age group 15-30 years 79 (39.5%) patients presenting the highest out of total, age group 31-45 years 68 (34%) patients, age group 46-60 years 36 (18%), age group 61-75 years 14 (7%) patients, age group >75 years 3 (1.5) patients. Complete blood count was analyzed on Sysmex Kx21 and thyroid profiles were analyzed on Elecysis 2010 from the Pathology Department. SPSS version 22 was used for data analysis. Result: Out of total patients, 32 (16%) were males and 168 (84%) were females with mean age of 37.44 ± 14.82 years. Majority of patients 68 (34%) were anemic, while 4 (2%) had agranulocytosis and 11 (5.5%) had thrombocytopenia. Headache was reported in 111 (55.5%), exophthalmos in 106 (53%), sore throat in 172 (86%), fever in 136 (68%) and weight loss in 95 (47.5%) patients. Conclusion: Propylthiouracil causes defective hematopoiesis in hyperthyroid patients because propylthiouracil has adverse suppressive effects on bone marrow.

Objective: To assess the adverse drug reactions due to anti hypertensive therapy among hypertensive patients at teaching hospital of Hyderabad, Sindh, Pakistan. Methodology: The current study was performed in a teaching hospital of Hyderabad, Sindh, Pakistan. A cross sectional study was conceded in medicine and cardiac outpatient department during the period of study. A total of 1271 hypertensive patients were enrolled during the period of 2 years by purposive sampling procedure. A series of questions were asked by the hypertensive patients. The questionnaire contains the demographic details of the patients, prescribing trend and various ADRs found in patients due to antihypertensive therapy. The written consent was also taken from the health care professionals as well as patients. Results: Out of 1271 patients, 57.99% belong to male gender, 79.78% to urban areas, 69.16% enrolled from cardiac OPD, 32.33% were aged between 49-58 years of age, 21.40% had 1 parent positive history of hypertension and 44.22% had 3-5 years duration of hypertension. Maximum patients were on dual therapy i.e. 42.64% and the most common combination therapy was valsartan+amlodipine i.e. 11.99%. Moreover the most common combination therapy that caused maximum ADRs was telmisartan+hydrochlorothiazide i.e. 17.54%. Conclusion: The existing passive pharmacovigilance department should be active again under Drug regulatory authority of Pakistan. A council will create under the Drug regulatory authority of Pakistan that helps to communicate with international organizations such as Uppsala monitoring center under World Health Organization, Food and Drug Administration etc. Moreover council will also establish a system of ADRs reporting throughout the country and then data will share with all stake holders.

ABSTRACT… Introduction: Drug-drug interaction refers to an altered or impaired response of drug as a resultant of the other drug's activity. However, recently advancement in field of therapeutics has leaded the therapy toward more rational and logical trend in order to improve the patients' health with respect to cost effectiveness. Objective: To assess the various levels of DDIs in Prescriptions at public sector teaching hospital of Hyderabad, Pakistan. Study Design and Settings/Methodology: A descriptive observational questionnaire based study has been conducted by collecting initially 250 random prescriptions of various patients prescribed with multiple drugs. Tertiary care hospital OPD and In-patient wards were visited for a period of 06 months. The Prescriptions (℞) so collected were analyzed and assessed individually for drug interactions using Standard drug interaction software i.e.. Lexi-comp's Lexi-Interact, Drug Information Handbook, Hansten and Horn's drug interactions. Results: For this study, a total 250 Prescriptions were collected. It was observed that 30 (12%) prescriptions contained with single medication, 10 (4%) prescriptions were unreadable, 210 (84%) prescriptions were contained more than one medication. Moreover, 210 (84%) poly-pharmacy prescriptions focused keenly. Subsequently, 51 (24%) prescriptions ensured the prevalence of DDIs and 159 (76%) were NonDDIs prescriptions. Similarly, 13 ℞ contained four or more than four drugs, 32 ℞ contained three drugs and 06 prescriptions contained two drugs correspondingly. Conclusion: It was clearly concluded that the most potential reason of DDIs are Poly pharmacy. So it is of utmost need to enhance the health care policies in overall healthcare system in order to antagonize DDIs associated morbidity and mortality among society.

Background: Propylthiouracil (PTU) is a thyro-suppressive medication commonly used for the treatment of hyperthyroidism, but may cause agranulocytosis, which rises the mortality of patients. Objective: To evaluate the prevalence of agranulocytosis in hyperthyroid patients after the use of Propylthiouracil. The aim of the current research is to access the drug utilization and investigation of PTU which aids in accessing rational therapy and other aspects related to the patient’s safety. Methodology: A cross- sectional study conducted from May 2016 to April 2017 at Liaquat University of Medical and Health Sciences, Hospital Hyderabad/ Jamshoro. 150 prescriptions were collected by non-probability consecutive sampling technique from the adults with Hyperthyroidism patients using Propylthiouracil. Thyroid function tests were conducted using Immunoassay Elecysis 2010. The blood profile tests were evaluated on Sysmex kx21. The collected data was evaluated using the Statistical Package for Social Sciences (SPSS). Results: The data revealed that the propylthiouracil-induced agranulocytosis in 4 hyperthyroid patients (n=2 males, n=2 females) and the prevalence of Propylthiouracil-induced agranulocytosis was 2.7%. Conclusion: It was observed that Propylthiouracil damages the hematopoietic stem cells and precursors of granulocytes in bone marrow can cause agranulocytosis.