4th Annual International Pharmacy Scientific Symposium & Poster Exhibition

Theme: “Research Trends in Nanotechnology & Health Practices” May 11-12, 2018

Abstracts Presented in Symposium

Venue: University of Central Punjab, 1-khayaban-e-Jinnah Road, Johar Town, Lahore, Pakistan

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4th Annual International Pharmacy Scientific Symposium & Poster Exhibition

EVENT ORGANIZERS

Prof. Dr. Muhammad Zafarullah (Patron-In-Chief) Pro-Rector, University of Central Punjab

Prof. Dr. Muhammad Jamshaid (Chairman Organizing Committee) Dean, Faculty of Pharmacy, University of Central Punjab

Prof. Dr. Mahmood Ahmad (Co-Chairman Organizing Committee) Ex. Dean, Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur

Prof. Dr. Naveed Akhtar (Co-Chairman Organizing Committee) Dean, Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur

Mr. Irfan Bashir Secretary Organizing Committee Assistant Prof., Faculty of Pharmacy, University of Central Punjab

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4th Annual International Pharmacy Scientific Symposium&Poster Exhibition Organizing Committee Prof. Dr. Muhammad Zafarullah Pro-Rector, University of Central Punjab (Patron-In-Chief) Prof. Dr. Muhammad Jamshaid Dean, Faculty of Pharmacy, University of Central Punjab (Chairman Organizing Committee) Prof. Dr. Mahmood Ahmad Principal, Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan (Co-Chairman Organizing Committee) Prof. Dr. Naveed Akhtar Dean, Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur (Co-Chairman Organizing Committee) Dr. Abdul Qadir Khokhar Director, Remington Pharmaceutical Industries (Pvt) Ltd. Prof. Dr. Abdullah Dayo Dean, Faculty of Pharmacy, University of Sindh Jamshoro Prof. Dr. Bashir Ahmad Ch. Dean Faculty of Pharmacy, BZU Multan Prof. Dr. Nisar –Ur-Rehman Chairman, Department of Pharmacy, COMSATS, Abbottabad Prof. Dr. Sajid Bashir Dean, Faculty of Pharmacy, University of Sargodha Dr. Faheem Ahmad Siddiqui Assistant Prof., Faculty of Pharmacy, University of Central Punjab Dr. Tariq Mahmood Assistant Prof., Faculty of Pharmacy, University of Central Punjab Mr. Irfan Bashir Assistant Prof., Faculty of Pharmacy, University of Central Punjab (Secretary Organizing Committee) Scientific Posters Committee Mr. Imtiaz Majeed Mr. Nadeem Alvi Dr. Nasira Saif-Ur-Rehman Assistant Prof., Faculty of Pharmacy, UCP Program Director/Assistant Prof., Faculty of Pharmacy, UCP Chairperson, Lahore College of Pharmacy (LMDC) Prof. Dr. Tahir Javaid Khan Dr. Talha Jamshaid Dr. Zeba Shuja – ur- Rehman Principal, Akhtar Saeed College of Pharmacy Assistant Prof., Faculty of Pharmacy & Alternative Medicine, The Director, Schazoo Zaka Islamia University of Bahawalpur Dr. Yasser Shahzad Mr. Waqas Akram Mr. Asad Mahmood Assistant Prof., Institute of Pharmacy, COMSATS Lahore Lecturer, Faculty of Pharmacy, UCP Lecturer, Faculty of Pharmacy, UOL

Registration Committee Syed Zeeshan Abid Mr. Abdul Latif Sheikh Dr. Ayaz Ali Khan President, Foundation for Young Researchers Director, Ex. Drug Controller/ Director Pharmacy, Pharmacy Services & Outreach Programs, Directorate of Health Services Punjab, Lahore The Agha Khan University Hospital, Karachi. Prof. Dr. Nisar Ali Shah Prof. Dr. Hafeez Ikram Prof. Dr. Azmat Rasheed Chairman, Department of Pharmaceutics, BZU Multan Head of Pharmacy Department, Leads University, Lahore Principal, College of Pharmacy, Superior University, Lahore Poster Exhibition Committee Dr. Khalid Saeed Bukhari Dr. Rizwan Mahmood Mr. Shoaib Hakeem Country Medicine Advisor, USP Executive Director Quality Operation, Plant Director, CCL Pharmaceuticals Pvt. Ltd. Servier Pharmaceuticals, Lahore. Mr. Nadeem Iqbal Mr. Amjad Ali Java Ms. Ambreen Ishaq Ex. General Secretary (PPA) Pakistan Director, Wilshire Pharmaceuticals Lecturer, Faculty of Pharmacy, UCP Scientific Workshop Committee Dr. Abid Mahmood Yousaf Dr. Khalid Idrees Khan Dr. Atif Raza Assistant Prof., Institute of Pharmacy, COMSATS Lahore Associate Prof., Faculty of Pharmacy, UCP Assistant Prof, University College of Pharmacy, University of the Punjab Mr. Ayyaz Kiani Mr. Shafique-Ur- Rehman Mr. Shamoon Ch. Executive Director, Devnet Pvt Ltd Assistant Prof., Faculty of Pharmacy, UCP Ex. Secretary Punjab Pharmacy Council Member, Pakistan Pharmacy Council Mr. Usman Munir Mr. Hassan Ahmad Mr. Zafeer Naeem Wain Lecturer, Faculty of Pharmacy, UCP Lecturer, Faculty of Pharmacy, UCP President, UCP Health Club Stage Management Committee Mr. Imran Sajid Prof. Dr. Nazar Muhammad Ranjha Dr. Tahir Aziz Mughal Assistant Prof., Faculty of Pharmacy, UCP Faculty of Pharmacy, BZU Chief Operating Officer, SKMCH Peshawar Dr. Najeeb Ullah Amjad Prof. Dr. Muhammad Iqbal Mr. Omer Ikhlaq Bhutta Dean Faculty of Pharmacy, USA Dean, Faculty of Pharmacy, Quaid-e- Azam College of Information Principal Pharmacist, SKMCH Lahore Technology, Sahiwal Mr. Rizwan Ali Ms. Rabia Ali Ms. Humna Dastgir Vice-President UCP Health Club Lecturer, Faculty of Pharmacy, UCP Female Coordinator, UCP Health Club Souvenir Distribution Committee Prof. Dr. Khalid Janbaz Prof. Dr. Mahboob-e- Rabbani Ms. Rabia Saleem Ex. Dean, Faculty of Pharmacy, BZU Dean, Faculty of Pharmacy, Insitute of Southern Punjab, Multan Assistant Prof., Faculty of Pharmacy, UCP Mrs. Sarah Ahmad Mr. Umair Ikram Ms. Sana Jameel Lecturer, Faculty of Pharmacy, UCP Assistant Professor, LCPS Lahore Assistant Prof., Faculty of Pharmacy, UCP Ms. Tooba Mehboob Ms. Naila Tabassam Mr. Ali Raza Lecturer, Faculty of Pharmacy, UCP Lecturer, Faculty of Pharmacy, UCP General Secretary, UCP Health Club

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4th Annual International Pharmacy Scientific Symposium&Poster Exhibition Program Layout (Day 1) 11th May, 2018 Timing Presenter Topic 2:30 -2:35 P.M. - Recitation 2:35 -2:40 P.M. - National Anthem 2:40 -2:45 P.M. - FOP-UCP Event Highlights 2:45 -2:55 P.M. Prof. Dr. Muhammad Zafarullah Welcome Address Patron-In- Chief 2:55 -3:05 P.M. Prof. Dr. Muhammad Jamshaid Chairman Welcome Address Organizing Committee 3:05 -3:15 P.M. Chief Guest Inaugural Speech Scientific Session 1 3:15-3:40 P.M. Dr. Abdul Lateef Sheikh Plenary Speech First Asian and only Pakistani Pharmacist to receive the Donald E Francke Medal 3:40 -4:10 P.M. Mr. Nadeem Zia Community Pharmacy Practices in Pakistan vs Clinical Pharmacist, Fraser Health European Countries Surrey Hospital, British Columbia 4:10 -4:35 P.M. Prof. Dr. James E. Dixon Stem Cell Technologies UKRMP Senior Research Fellow in Stem Cell Technologies Center for Biomolecular Sciences School of Pharmacy University of Nottingham 4:35 -5:00 P.M. Dr. Muhammad Haneef Pharmacokinetics evaluation of pH sensitive Associate Professor, Department of alginate-pectin polymeric rafts for controlled Pharmaceutics, BZU Multan delivery of pantoprazole sodium sesquihydrate 5:00-5:20 P.M. Dr. Yeltay Rakhmenov Orphan Drugs and Gene Therapy MAGI Research Group, Italy 5:20-5:40 P.M. Prof. Dr. Abdul Rauf Shakoori Osteogenic potential of Cissus quadrangularis Director, School of Biological Sciences, University of the Punjab 5:20-5:35 P.M. Dr. Mukhtar Ansari Medication Errors: A concern of SA-LA Assistant Professor Medicines Department of Clinical Pharmacy College of Pharmacy University of Hail Saudi Arabia 5:35 -6:15 P.M. Panel Discussion Professionalism among Pharmacy students and Dr. Abdul Qadeer Khokhar, Prof. Dr. graduates Muhammad Jamshaid, Prof. Dr. Mahmood Ahmad, Prof. Dr. Naveed Akhtar, Dr. Lateef A. Sheikh, Prof. Dr. Sajid Bashir 6:15 -6:30 P.M. Concluding of Session Prof. Dr. Muhammad Jamshaid Maghreb Prayer & Dinner

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4th Annual International Pharmacy Scientific Symposium&Poster Exhibition Program Layout (Day 2) 12th May, 2018 Timing Program Venue 9:30 -9:35 A.M. Recitation UCP Auditorium 9:35 -9:40 A.M. National Anthem UCP Auditorium 9:40 -9:45 A.M. Day 1 Event Highlights 9:45 -9:55 A.M. Welcome Address By Co-Chairman Organizing UCP Auditorium Committee 9:55 -10:05 A.M. Welcome Address By Guest of Honor UCP Auditorium 10:15 – 1:30 P.M. Inauguration of Scientific Poster Exhibition Prayer & Lunch Break 3:00 P.M.- 6:00 P.M. Scientific Session 2 UCP Auditorium Nanotechnology & Recent Research Trends Dr. Muhammad Sohail Arshad(BZU), Dr. Rizwan Mahmood (CCL), Prof. Dr. Tayyab Ansari(UOL), Mr. Shoaib Hakeem(Servier Pharmaceuticals) , Dr. Muhammad Zaman(BZU), Ms. Rabia Aslam Sheikh (UCP), Ms. Mariyam Shabbir(UOL), Ms. Rabia Ali (UCP), Ms. Sarah Ahmad (UCP), Ms. Ayesha Aslam (UOL), Ms. Fizza Ilyas (UCP), Dr. Muhammad Naeem Aamir (GCUF), Dr. Muhammad Irfan (GCUF), Dr. Tahir Ali Chohan (IPS-UVAS) 3:00 P.M.-6:00 P.M. Scientific Session 3 Examination Hall, UCP Pharmacists as Community Health Professionals Mr. Nadeem Zia, Mrs. Uzma Yousaf(Ganga Ram Hospital), Mr. Faraz Ashraf (CH&ICH), Mr. Ehsan Elahi (SKMCH), Ms. Rukhsana Yousaf (CH&8ICH), Ms. Azeema Tayyab (UOL), Mr. Muhammad Ali Syed (UOL), Ms. Tooba Mehboob (UCP), Ms. Naila Tabassam (UCP), Ms. Sana Jameel (UCP) 6:00 -6:10 P.M. Souvenir Distribution UCP Auditorium 6:10 -6:20 P.M. Concluding Words UCP Auditorium 6:20 -6:30 P.M. Vote of Thanks UCP Auditorium

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Swelling Behavior, Acid Neutralization Capacity and Effect of Raft Structure on the Neutralization Profile of Alginate-Pectin Polymeric Rafts Ghulam Abbas1, 2, Muhammad Hanif1 1. Faculty of Pharmacy Bahauddin Zakariya University Multan, Pakistan 2. Faculty of Pharmaceutical Sciences Government College University Faisalabad, Pakistan Corresponding Author Muhammad Hanif Email: [email protected] Contact# +923336103668 Faculty of Pharmacy Bahauddin Zakariya University Multan, Pakistan Abstract The present work investigates the swelling behavior, alginate and pectin contents within the raft, acid neutralization capacity (ANC), neutralization profile and effect of raft structure on the neutralization profile of alginate-pectin rafts. Thermal stability of sodium alginate, pectin and raft were assessed by differential scanning calorimetry (DSC). Accelerated stability studies were also performed on R1 optimized formulation. Raft was effectively formed in simulated gastric fluid (SGF) pH 1.2. R1 formulation showed 97 % swelling at 8 h (p=0.001). The percent contents of sodium alginate and pectin of R1 formulation were 98 % and 94 % respectively checked by newly developed HPLC method. The acid neutralization capacity (ANC) of R1 formulation was 6.8 (p value is less than 0.001). R1 formulation showed longer duration of neutralization i.e. 90 min and nature of raft was absorbent. DSC thermograms showed the thermal stability of sodium alginate and pectin within the raft. Stability studies showed the R1 formulation remains stable after 6 months. Three reactions were observed in alginate-pectin rafts; sodium alginate and pectin were transferred to gel, antacid mixture reacting to form carbon dioxide and generation of calcium ions from calcium carbonate that chemically crosslinked with alginate and pectin to form stable raft. Keywords: Swelling; acid neutralization capacity; neutralization; raft structure; stability studies.

Views and Reviews of Health Professionals regarding Diabetic Peripheral Neuropathy Ammara Khalique1, Dilshad Zulfiqar1, Muhammad Jamshaid1, Irfan Bashir1, 2, Faheem Ahmed Siddiqui1,Imtiaz Majeed1, Waqas Akram1 1. Faculty of Pharmacy, University Of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author Ammara Khalique Email:[email protected] Contact#+92-42-35880007 Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Diabetic peripheral neuropathy (DPN) is a long-term complication of diabetes that affects up to 50% of all diabetic patients, and results in peripheral nerve dysfunction. Inappropriate

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management of DPN has led to an increase in morbidity and health care costs. This study was conducted for determining the views of health professionals regarding DPN, and the ways suggested by them for its appropriate management. A structured questionnaire comprising of 15 closed ended questions was prepared to collect the data from physicians (75%) and pharmacists (25%). The data was analyzed using descriptive statistical tools in SPSS-20. Results of the study showed that in view of physicians (68%) and pharmacists (28%) DPN mostly occurs in patient above 50 years of age. Most common symptoms include numbness (41% physicians, 6% pharmacists) and cold/burn sensation (17% physicians, 8% pharmacists). According to physicians (57%) and pharmacists (11%) impaired glucose tolerance is the most common risk factor for DPN. Preferred diagnostic tests include nerve conduction studies (44% physicians, 11% pharmacists) and quantitative sensory testing (18% physicians, 2% pharmacists). Foot ulceration (38% physicians, 9% pharmacists) and amputation (20% physicians, 7% pharmacists) are the leading complications of DPN. Precautionary measures like regular exercise, routine examination and dietary measures are recommended by physicians (71%) and pharmacists (21%). Pharmacological therapy like antidepressants (34% physicians, 12% pharmacists), anticonvulsants (19% physicians, 4% pharmacists) and non-pharmacological therapy like healthy life style (24% physicians, 13% pharmacists) are suggested for managing DPN. Symptomatic treatment (65% physicians and 23% pharmacists) is mostly recommended in case of emergency situation. The study concludes that in order to overcome the morbidity and mortality resulting from diabetic neuropathy it is important to understand its manifestations, prevention, and treatment. Pharmacological therapy for treating neuropathic pain and non-pharmacological approaches including physical activity and metabolic control are beneficial for managing DPN Key words: Diabetic peripheral neuropathy, Impaired glucose tolerance, Foot ulceration, Symptomatic treatment, Neuropathic pain

Formulation, characterization and kinetic modeling of sustained release tablets of Lisinopril and Hydrochlorothiazide combination Sarah Ahmad1, Muhammad Jamshaid1, Rizwan Mehmood2, Irfan Bashir1, Rabia Ali1, Sana Jameel1, Faheem Ahmed Siddiqui1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Executive Director Quality Operations, CCL Pharmaceuticals, Lahore. Corresponding Author Sarah Ahmad E-mail: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract The objective of the current study was to formulate sustained release tablets of Lisinopril and Hydrochlorothiazide combination and to evaluate tablets by in-vitro characterization and kinetic modeling. Guar gum, Eudragit L-100 and Hydroxy propyl methyl cellulose were used as polymers alone as well as different combinations. FTIR studies were conducted to determine drug polymer interactions. Matrix tablets were formulated by direct compression method. The average weight was set at 200 mg. Pre-compression as well as post-compression parameters were estimated and were found to be within official limits. Results indicated that in single polymer preparations, formulations F9 to F12, were sustained up to 10 hours indicating Eudragit L-100 had better sustained release properties than other two polymers. Formulations F15 and F 16 (with

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HPMC and Eudragit L-100 combination) were best for sustained effect that lasts up to 12 hours. All three polymers were combined in formulations F19 to F20 and drug release pattern suggested that a combination of three polymers works better than single polymers or combination of two. To evaluate release kinetics of drug, data obtained from in-vitro dissolution were fitted in zero- order, first-order, Higuchi model and Korsmeyer Peppas model that showed that all the formulations followed zero order kinetics. Higuchi model indicated drug release by diffusion while Korsmeyer Peppas model suggested that all the formulations followed the non-fickian release behavior which means drug was released by both diffusion and erosion controlled mechanisms. Keywords: Eudragit, Matrix Tablets, Guar Gum, Kinetic Modeling

Comparative Sustained Release Behavior of Natural & Synthetic Polymers in Gliclazide Tablets Rabia Aslam Sheikh1, Muhammad Jamshaid1, Tariq Mahmood, Irfan Bashir1,2, Muhammad Imran Sajid1, Faheem Ahmed Siddiqui1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author Rabia Aslam Sheikh +92-42-3588007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Sustained release matrix tablets release the drug slowly over an extended period of time. Sustained release formulations are used for the management of the type II diabetes mellitus due their benefits over the conventional formulations. The present study was conducted to investigate the effects of natural and synthetic polymers with various drug to polymer ratios on the release profile of gliclazide from sustained release matrix tablets when these polymers are used in combination or alone. Natural polymers guar gum and pectin were used as sustaining agent due to its benefits over the synthetic polymers in many aspects that includes being economical, biocompatible and easy availability. The sustained release tablets were prepared by entrapping the drug in various polymer mixtures by direct compression method. Twenty (F1-F20) formulations were prepared to evaluate the comparative release profile of the drug from various polymer mixtures. Prepared tablets were evaluated by physical and chemical characteristic including FTIR. appearance, hardness, friability, diameter and weight variation tests. The dissolution of matrix tablets was conducted by USP apparatus II (Paddle Apparatus) in 900 ml phosphate buffer at pH 7.4 for 12 hours. The release profiles were evaluated by kinetic models which include Zero order, First order, Higuchi and Krosmeyer Peppas model. In formulation F4 guar gum was used as sustaining agent (drug: polymer, 1:4), formulation F5 in which pectin was employed (drug: polymer, 1:05) , Formulation F15 in which pectin and PVP were used in combination (drug: polymer: polymer, 1:0.75:0.75), and formulation F19 in which guar gum and pectin were used in combination in (drug: polymer: polymer, 1:0.75:0.75) showed sustained release behavior nearly similar to that of Diamicron MR, the commercially available product. The results of the dissolution release profile for all test formulations F1-F20 as compared to the Marketed product Diamicron MR showed that formulation in which blend of natural and synthetic polymers both were used in higher ratios showed more sustained release effect as compared Diamicron MR marketed product. Natural polymers have good sustained release properties. Keywords: Modified Release, Sustained Release, Dissolution Studies, Kinetic Modeling

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Interventional Role of Pharmacist in Diabetes Associated Complications: Case Study of Public Sector Hospitals of Lahore 1 3 1, 2 Tooba Mehboob1, Muhammad Jamshaid , Mahmood Ahmad , Irfan Bashir , Imtiaz Majeed1, Naila Tabassam1, Faheem Ahmed Siddiqui1 1. Faculty Of Pharmacy, University Of Central Punjab, Lahore, Pakistan 2. Foundation For Young Researchers, Lahore, Pakistan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author Tooba Mehboob Email:[email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Diabetes is chronic metabolic disorder with continuous progression affecting about 285 million people worldwide. Evidences show by the end of 2030 this number would be doubled. . Estimated prevalence of diabetes in Pakistan is 11% and it is increasing at an alarming rate. Not being a curable disease, one needs to manage it lifelong. Macro and micro vascular complications associated with prolonged and uncontrolled hyperglycemia contribute major burden in terms of cost and reduced quality of life. Non pharmacological management and life style modification with diabetes self-management and education can delay or even prevent diabetes related complications. In contrast to past, pharmaceutical services are not restricted to dispensing only and they are now more patient centric. Affordability, low educational status and limited access to pharmacist are major hindrances in getting optimize treatment. The aim of the study was to determine the extent and benefits of interventional role of pharmacist in management of diabetes associated complications in public sector hospitals of Lahore. Structured questionnaire was developed in English and after validation translated into Urdu language. Medical records of patients were also evaluated. Four major government hospitals of Lahore (Mayo, Ganga Ram, Lahore general and Sheikh Zaid hospital) were targeted to collect data. Total 151 patients (female n= 89, male n= 62) having type 2 diabetes were included in this study. Improvement in symptoms associated with diabetes complications after intervention of pharmacists were analyzed through SPSS statistic 21. 60.92% patients were having hypertension, 32.4% hypertensive patients reported they were counselled by pharmacist and 25.1% reported that they felt improvement in disease after counselling. 21.8% patients complained they have burning sensations and 32.4% have numbness in feet, 19.2% and 15.2% patients interacted with pharmacist and counselled regarding their symptoms of neuropathy respectively. Symptoms of burning feet improved in 13.9% patients and numbness is reduced in 11.2% patients. Due to diabetes 21.1% patients were suffering from micro albuminuria, Pharmacists made intervention in 15.8% of population and 15.2% of total patients reported the reduced amount of protein in urine. The results of the study revealed that an appropriate system with the amalgamation of the clinical pharmacist should be introduced in diabetic OPDs to provide comprehensive diabetes education and self-management trainings which will improve the quality of life with diabetes by reducing their major burdens. Key words: Diabetes, Optimized Treatment, Self-Management, Dispensing

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Role of pharmacist in tuberculosis control: pharmacist perspective 1, 2 1 1 Dua Javed1, Irfan Bashir , Muhammad Jamshaid , Naila Tabassam , Faheem Ahmed Siddiqui1, Imtiaz Majeed1 1. Faculty Of Pharmacy, University Of Central Punjab, Lahore, Pakistan 2. Foundation For Young Researchers, Lahore, Pakistan Corresponding Author Dua Javed Email:[email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Tuberculosis is a global prevailing disease resulting in an increased death rate especially in Pakistan. The World Health Organization has declared tuberculosis as a serious public health issue and increased efforts are being made to control the disease. The main purpose of this research study was to analyze the treatment strategies employed by the health care professionals and the role of pharmacist in the management of tuberculosis in Pakistan as compared with international standards. Pharmacists can play an important role at different stages for the control of tuberculosis. It was a cross-sectional study design and the data was collected through a survey form filled in, specifically by 100 professional pharmacists, providing services in private and public sector hospitals of Lahore. The collected data was analyzed with the help of SPSS 21. Results showed that a high number of professional pharmacists, including both male and female, considered the role of pharmacists as an important approach in the management of TB for the control and prevention of this fatal disease. Around 90% participants responded that pharmacists can play a better role in TB control through appropriate dispensing, efficient counselling and responsible monitoring of the patients. Pharmacists can play a crucial and essential role in the treatment and prevention of tuberculosis by promoting patient compliance, drug and dosage regimen monitoring and patient counselling. Key words: Tuberculosis, World Health Organization, Patient Compliance

Mental Health Assessment of Christian Families in Lahore, Pakistan Memona Abdul Jabbar1, Muhammad Jamshaid1, Mahmood Ahmad3, Irfan Bashir1, 2, Faheem Ahmed Siddiqui1, Imtiaz Majeed1, Waqas Akram1, Tooba Mehboob1 1. Faculty Of Pharmacy, University Of Central Punjab, Lahore, Pakistan 2. Foundation For Young Researchers, Lahore, Pakistan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author Memona Abdul Jabbar E. mail: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract The World Health Organization (WHO) has defined Mental Health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community”. Many people at some point in their lives, experience psychological problems like depression, anxiety and bipolar disorder. According to WHO, 40% countries have no policy for improving MHD. The purpose of mental health assessment is to

10 gather information from the patients having mental illness so that we can assess the psychological state of the patient. The purpose of this study is to determine the prevalence of mental health issues among Christians and to check whether their life style needs any modification to improve their health and to make them aware about the disorder and its precautionary measures. According to research, the Prevalence of anxiety and depression in the Pakistan is 34%. It is a cross sectional study conducted in Yohanabad, United Christian Hospital and Dharampura Lahore, Punjab, Pakistan. The questionnaire was designed to gather information about mental health through the closed ended questions. The data was collected from 342 people included both genders of all ages and was analyzed using SPSS version 19. The participants from the Christian community were assessed based on their symptoms they face in their daily life, frequency and correlation tests were conducted on the results. According to the results, 50-60% people were having symptoms of MHD but not to that suicidal extent. There were moderate risks for mental health complication in Christian community because they were suffering from sleep apnea and other mood issues. Key words: Psychological conditions, Precautionary measures, MHD, WHO

Drinking Water Storage Practices among Inhabitants of Lahore, Pakistan Zunaira Butt1, Zoha Asghar1, Amna Javed1, Mushtaq A. Saleem1, Irfan Bashir1,2, Ambreen Ishaque2 1. Faculty of Life Sciences, University of Central Punjab, Lahore, Pakistan 2. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Zoha Asghar Faculty of Life Sciences, University of Central Punjab, Lahore, Pakistan Email: [email protected]

Abstract Approximately, 70% of the Earth surface is covered with water, but out of 70%, only 3% of freshwater is available out of which human consumes 0.01% only. With the rapid urbanization and pollution, available freshwater is contaminated. One of the major issues with drinking water is inappropriately managed water storage practices. In the developing countries, water pollution is the major threat to public health. In Pakistan, drinking water related issues are the main cause of poor health. A number of people get affected by diarrhea, cholera, dysentery, typhoid, hepatitis C and many more diseases because of the consumption of contaminated water. Study aims to highlight the water storage practices followed by the inhabitants of Lahore and to create awareness among them to avoid water borne diseases. A Structured questionnaire was designed to gather the information from 200 adult persons living in different areas of Lahore mainly Model Town, Johar Town, Sabza Zar, Sodiwal, DHA, Township, Allama Iqbal Town and adjacent areas. Information was acquired from the patients pertaining to size of storage container, number of water storage days, use of disinfectant and water boiling practices for drinking purposes. Results of the study revealed that only 46% of the individuals were storing the drinking water for one day only but majority (54%) was storing the water for multiple days to be used for drinking purposes, while 9 % of the individuals were involved in use of chemical disinfectants commercially available in market while 16 % of the study participants revealed that they use boiled water only for drinking purposes and never store it for more than a day. It was observed that out of 54% individuals storing water for multiple days, 13% were having a history of suffering from some type of water borne disease during previous 6 months. Awareness was made about water storage practices and importance of water boiling among all study participants to stay safe from water borne diseases.

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Keywords: Diarrhea, Dysentery, Boiled Water, Disinfectant

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Knowledge and attitude about diabetes among patients in remote areas of Lahore Naila Tabassam1, Muhammad Jamshaid 1, Mahmood Ahmad3, Irfan Bashir1, 2, Tooba Mehboob1, Imtiaz Majeed1, Waqas Akram1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation of Young Researchers, Lahore, Pakistan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan

Corresponding Author Naila Tabassam Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan ______Abstract Diabetes mellitus is a persistent metabolic disorder with multifarious complication. IDA reported that 387 million individuals were suffering from diabetes worldwide and this figure would be increased up to 592 million in 2035. In Pakistan diabetes mellitus consistently increasing, approximate prevalence of diabetes mellitus in Pakistan is 11%. Evidence proved that diabetic patients of rural areas of Pakistan have poor glycemic control due to lack of awareness, illiteracy, poverty, negative attitude and beliefs. Diabetes is untreatable yet it can be controlled by the principal markers of awareness, knowledge and attitude. The objective of this study is to access the knowledge and attitude about diabetes among patients in remote areas of Lahore. The five major rural health centers Barki, Kahna, Raiwind, Manga Mandi, Chung were selected for gathering data. For data collection, a validated questionnaire has been developed in English and further translated into Urdu. The comprehensive data of 160 respondents of type I and II diabetes (females n=88, males n= 72) has been interpreted statistically and graphically by SPSS 21.0. The results showed that only 29.4% diabetics of rural areas of Lahore have knowledge about diabetes. According to 11.9% respondent’s diabetes is curable. Only 13.3% knew how to maintain their blood sugar levels. Majority of patients (77.5%) didn’t know the ideal glycemic targets. Life style modification was only limited to 15.6% patients. Knowledge and attitude are parallel to each if one is improved the other one is also ameliorate Diabetic patients of rural areas have poor disease knowledge and pessimistic approach toward their diabetes. Prevention and management of diabetes at selected government health sites require implementation of awareness campaigns to improve the attitude and knowledge of patients regarding their disease.

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Formulation &In-vitro Characterization of Isotretinoin loaded Solid Lipid Nanoparticles Usama Jamshaid2, Muhammad Jamshaid1, Tariq Mahmood1, Mahmood Ahmad4, Irfan Bashir1,Muhammad Imran Sajid1,Tehseen Riaz1,Talha Jamshaid3 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. University of Strassburgh, France 3. Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur, Pakistan 4. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author Usama Jamshaid University of Strassburgh, France Email:[email protected] Contact:+92-333-6566176 Abstract Objective of the current study was to develop physically optimized and stable topical Isotretinoin loaded solid lipid nanoparticles and to evaluate the impact of homogenization speed on prepared SLNs. Different trials of nanoparticles were prepared to achieve appropriate composition of the formulation. Stability of the drug loaded solid lipid nanoparticles was observed by determining Zeta potential which was negative in all the formulations and their particle size was also monitored with the help of zeta size ranges from 97.6±0.4 nm to 112.9±0.7 nm in the selected formulations. Drug entrapment efficiency was determined and found to be 93.48%±0.23, 96.54%±0.17, 87.59%± 0.30 and 89.31%±0.13in formulations namely G1, G2, G3 & G4 respectively. Impact of surfactant concentration and homogenization speed was also observed, which showed that both are important factors for the preparation of solid lipid nanoparticles with significant effect on to the drug entrapment & particle size distribution. The data gathered during the study clearly indicated the impact of technique and homogenizer speed on to the preparation of solid lipid nanoparticles as well as drug entrapment efficiency.

Key Words Solid lipid nanoparticles, Isotretinoin, Entrapment efficiency, Skin targeting, Zeta potential

Neurofeedback Therapy in Addiction: Comprehensive Literature Review Humna Dastgir1, Muhammad Jamshaid1, Mahmood Ahmad3, Irfan Bashir1,2, Faheem Ahmed Siddiqui1, Waqas Akram1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author: Humna Dastgir +92-42-3588007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Adolescence is a particularly vulnerable developmental period for the onset of mental illness and substance use disorders (SUDs). Addictive drugs belong to several classes and initiate their addictive actions directly or indirectly at several targets in several brain sites. Neurofeedback therapy has

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incorporated an operant conditioning technique to up skill body and mind in order to improve emotional, cognitive and behavioral experience in more optimal way. The purpose of this review is to illustrate the ways in which molecular neurobiological investigations will contribute to an improved understanding of drug addiction and, ultimately, to the development of more effective treatments. The psychological and neuropsychological facets of addiction has gained more scientific attention in recent past that’s why this will play a vital role in comprehending the interactions between the brain, drug and behavior in humans to determine its success and relapse rate and to check the effectiveness of behavioral therapy along with its pharmacological treatment. A very promising future direction for neurotherapy in the treatment of dissociation involves multiple channel training and present authors have reported on using EEG (Electroencephalography) phase and linear channel combination training. Neurofeedback is effectively used as an “add on” behavioral therapy for treatment success and to enhance therapeutic effectiveness. It is emerging as a promising alternative due to impacts such as effective reduction in drug seeking symptoms, enhanced psychological and neurophysiological variables and longer intervals of abstinence that have been reported in the literature after neurofeedback treatment. Keywords: Neuropathy, Relapse, Behavioral Therapy, Addiction

Standard Operating Procedures for the Pharmacists in the Pulmonology Department of Hospitals in Lahore Tayyaba Rana1, Irfan Bashir1,2, Faheem Ahmed Siddiqui1, Imtiaz Majeed1, Waqas Akram1, Naila Tabassum1, Rabia Aslam1, Muhammad Jamshaid1 1. Faculty of Pharmacy, University of Central Punjab. 2. Foundation for Young Researchers, Lahore, Pakistan. Corresponding Author: Tayyaba Rana Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract: SOPs are the instructions that provide the guidance about performing the daily activities of an institution. Purpose of a SOP is to carry out the operations correctly and always in the same manner. This project is based on the concept of eliminating operational errors in pharmaceutical care delivery services and ensuring the best management of disease in the pulmonary department of the hospital by following the SOPs. This study aims to enhance the role of pharmacists in the hospitals, which can in turn reduce the medication errors and increase adherence to the medication. The pharmacist can identify the drug interactions that can decrease various side effects thus increasing the patient compliance. The study was done during the years 2017 to 2018. Ten hospitals located within Lahore were selected, seven of these hospitals were public sector and the other three were private sector. The pharmacists in these hospitals were interviewed and were asked to fill a checklist by the help of which the answers were analyzed afterwards. The data was analyzed by means of IBM SPSS 21. According to the data analysis, all the 10 hospitals have pharmacists working in them by following the SOPs properly. Compounding is taking place in only 1 percent of the hospitals and the pharmacists are involved in compounding. 70-80 percent of the hospitals have proper coordination between the pharmacist and physician and the patients. 80 % and 70 % of the pharmacists are involved in TDM and ADR reporting respectively. Only 50 % of pharmacists are involved in ward rounds. 90 % of the pharmacists are involved in counselling to the patients. 90 % of the pharmacists are playing ideal roles in most of the hospitals of Lahore. It was observed that the pharmacist can aid to produce better patient outcomes. These hospitals have outpaced the other health systems without pharmacists. Keywords: SOPs, Pharmacists, Pulmonology, Hospitals

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SOPs for Pharmacists Working in Tuberculosis Wards of Hospitals in Lahore Hira Ijaz1, Irfan Bashir1, Tooba Mehboob1, Imtiaz Majeed1, Waqas Akram1, Ambreen Ishaque1,Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab. Corresponding Author: Hira Ijaz Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract According to World Health Organization (WHO), tuberculosis (TB) is the most important cause of mortality from infectious diseases, with 10.4 million cases of disease and 1.4 million cases of death, reported in 2015. TB is neither highly contagious nor easily transmitted and is treatable. Therefore, necessary efforts should be made timely to detect and treat it. Since T.B is a fatal disease, it should be treated with great care. This research will help to standardize and optimize patient centric approach in health care facilities and in communities to establish persistent TB clinical practice with the participation of pharmacist. For this research, SOP’s of TB wards from different hospitals of Pakistan were analyzed and compared with international standards. Structured performa was made including different parameters i.e. existence of TB wards, presence of pharmacists, role of pharmacists, and their coordination with physicians and patients. Different hospitals of Lahore were targeted to collect data i.e. Gulab Devi, Children, Shalimar, Ittefaq, Jinnah, Fatima memorial, Family hospital. Data was analyzed in SPSS software. Results showed that existence of TB wards in hospital was 100%. Availability of pharmacists in TB wards was also 100%. Presence of SOP’s was 66.7% and their follow up was 50%. Compounding of drugs and compounding by pharmacist in hospital was 16.7%. Appropriate coordination between pharmacist and physician was 33.3% and pharmacist with patient was 83.3%. 100% responded to Therapeutic Drug Monitoring (TDM) by pharmacist while those involved in ADR reporting and counseling of patients were 83.3%. From the above results, it is clear that there is a need of improvement in compounding of drugs; follow up of SOP’s, proper coordination among pharmacists, patients and physicians. Key Words: Therapeutic Drug monitoring, ADR, tuberculosis. Pharmaceutical Care for Hepatitis C Patients Sehrish Jamil1, Irfan Bashir1, Tooba Mehboob1, Imtiaz Majeed1, Waqas Akram1, Faheem Ahmed1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Sehrish Jamil1 University of Central Punjab, Lahore, Pakistan Email: [email protected] Contact: +92-3310434557 Abstract Pharmaceutical care is the care provided by pharmacist to enhance the patient health, reduce adverse event and reduce morbidity and mortality. Hepatitis C is the liver disease caused by the hepatitis C virus. It is not affected only Pakistan but also globally but data about hepatitis C in Pakistan is limited. Unscreened blood, transfusion of blood, IV drug users, and alcohol users are at increased risk of HCV transmission. Hepatitis C is the fastest growing disease in Pakistan .The aim of study is to reduce morbidity and mortality caused by hepatitis C in Pakistan .To observe the Pharmacist role in disease management, ADR reporting programs, counselling with patient, patient compliance with the treatment, efficacy and safety of treatment, drug-drug interactions, side effects associated with treatment regimen and to notice what extent of work has been done in Pakistan to improve quality of life. Study was conducted in Lahore. Check list was prepared and filled from pharmacist available at the hospital.

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Checklist include counselling with patient, disease management, ADR reporting program, patient compliance, patient education about treatment etc. The result was analyzed through SPSS analysis. According to the survey conducted in six hospital, the data shows about 100% presence of pharmacist and presence of SOPs. Among them approximately 83.3% SOPs were following and 16.7% SOPs were not following. About 50% pharmacist show coordination with the patient. Pharmacist involved in wards round were 33.3% which should be improved in the hospital. About 33.3% pharmacist involved in TDM and 66.6% were not involved. Out of 100%, only 50% ADR reporting were following in the hospital. About 33.3% of pharmacist engaged themselves in counselling with patients. It is concluded that pharmacist imparts a great role in the prevention of disease but there is less number of pharmacist available in the hospital.so its mean less number of patient provided with adequate care. Key words: Pharmaceutical care, Hepatitis C , ADR, TDM

Hypertension Patterns among Families in Lahore due to Increased Cholesterol Levels Sumballah Tazeen Ansari1, Muhammad Jamshaid1, Irfan Bashir1,2, Faheem Ahmed Siddiqui1, Waqas Akram1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Corresponding Author Sumballah Tazeen Ansari Email: [email protected] Contact:+92-42-5880007 Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. ______Abstract The escalating pace of the society has led to the outbreak of many ailments, which have close association with our lifestyle. Hypertension is one such issue, which is strengthening its roots in many families due to its close connection with genetic hypercholesterolemia. Hypercholesterolemia shares a strong relation with hypertension and if this hypocholesterolemic hypertension is, genetic it becomes more troublesome and increase care has to be sought to shield family members from this hereditary burden. . The objective of the study was to figure out how many people have been inflicted with this disease genetically in Lahore. It is a questionnaire base study. 50 participants from Johar town and Samnabad, Lahore were given prepared questionnaires which asked questions about the family members suffering from hypertension or hypercholesterolemia and genetic hypocholesterolemic hypertension. It was destined to assess the number of people who were facing hypocholesterolemic hypertension genetically. Multifold findings were obtained through questionnaires. 32.1% people faced hypertension due to cholesterol and 3.6% people were those who had genetic hypercholestrolemic hypertension. 57.1% of the people were those whose relatives were either suffering from hypertension or hypercholesterolemia. 53.6% people were those whose relatives were suffering from hypertension and 39.3% people relatives were hypocholesterolemic. It is concluded that there is a significant relation of hypertension with hypercholesterolemia but hypercholestrolemic hypertension is very rare genetically. Intake of fruits and vegetables, routine check of blood pressure and cholesterol and compliance to the physician’s instructions are the ways, which can aid to weaken the bond between hypertension and hypercholesterolemia. Keywords: Hypertension, Hypercholesterolemia, Lahore, Hereditary.

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Pharmacoeconomic Considerations and Quality of Life Assessment in Hepatitis-C Patients Khadija Sarwar1, Muhammad Jamshaid1, Irfan Bashir1,2, Faheem Ahmed Siddiqui1, Waqas Akram1, Muhammad Nadeem Alvi1, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Corresponding Author Khadija Sarwar Email:[email protected] Contact:+92-42-588007 Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. ______Abstract Gradual liver damage occurs due to hepatitis C virus (HCV) that may result in liver fibrosis and cancer of liver cells. It is a physical as well as psychosocial disease. Numerous studies conducted throughout the world have revealed a significant reduction in the patient’s quality of life with Hepatitis C. Pakistan is a developing country with the second highest prevalence of hepatitis C ( 4.5-8%). This is because the average income in rural areas is very low and they are unable to afford the treatment. The aim of the present study was to check the quality of life of patients affected with hepatitis, to create general awareness about the disease and to determine pharmacoeconomic considerations of hepatitis C treatment. It was a cross-sectional study conducted in village Wali Pur Bura of District Nankana sahib, Punjab, Pakistan. The data was collected through questionnaire by keeping in view socioeconomic status and quality of life parameters. This data was collected from 100 respondents. 58% patients took loan to get the treatment. There was strong positive correlation (0.845) between monthly income and patients who took treatment through loan. Only 39% patients were aware of Punjab Government’s participation in hepatitis free treatment plan. 60% patients showed marked reduction in quality of life and the reason were painful interferon therapy. It was concluded that due to hepatitis C virus, health as well as socioeconomic and family life is badly affected. Quality of life and financial status of hepatitis C patients usually declines. Costly treatment is beyond the reach of majority of rural population that increases the incidence of depression among patients and their families. Keywords: Hepatitis C, Quality of life, Sociocoeconomic, Rural areas

Trafficking of Narcotic Drugs from Afghan Border in Pakistan Wajeeha Sarfraz1, Irfan Bashir1,2, Mahmood Ahmad4, Maria Ali3 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan 3. Regional Directorate, Anti-Narcotics Force Punjab, Pakistan 4. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author Wajeeha Sarfraz +92-42-3588007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Pakistan has become a serious victim of drug trafficking over the recent years. This has elevated the risk to the prosperity of Pakistan and has made it more vulnerable to nuisance such as corruption. Afghanistan is the largest producer of opium, and it is the major contributor in the expansion of highly lucrative business of drug trafficking. The annual global market for illicit opiate drugs is approximately at $65 billion. According to a report, about 43% of

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Afghan drugs are smuggled through Pakistan. Drug smuggling has become more frequent because of permeable outskirts of Pakistan with Afghanistan. These drugs are trafficked into Pakistan through various routes surreptitiously. Various methods are adopted for safe drug trafficking like concealment by wrapping around bodies, heroine packed in cleanser bottle. These are then disseminated by hiring families, which are exploited as carriers. The trafficking route from Afghanistan to Pakistan is Torkham border crossing. However, the route is not permanent as drug rackets keep changing them continuously to escape from confiscation. People of Pakistan have become more prone to addiction because of increasing unemployment, shear depression and false delight received from utilization of opium; which encourages drug trafficking. After reaching Pakistan, from the province of Balochistan the drugs are smuggled to Turkey and Western Europe. Seacoasts of Pakistan also serve as major trafficking routes for drugs to Gulf States and further. Effective enforcement of law, reduction in the demand of narcotics and creation of job opportunities are some of the remedies, which can help to bring recovery to this malignant blight. Pakistan has been suffering from the torment of drug menace which makes it urgent to counter the narcotics smuggling so that supply of drugs can be curbed efficiently and masses can be protected. Keywords: Narcotics, Opium, Drug trafficking, Afghanistan, Pakistan

Review Article: Platelet Boosting Factors in Dengue Management Noora Nasir1, Muhammad Jamshaid1, Irfan Bashir1,2, Faheem Ahmed Siddiqui1, Waqas Akram1, Nadeem Alvi1,Muhammad Shafeeq-ur-Rahman1,Asad Mahmood1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Noora Nasir +92-42-3588007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Dengue fever is a viral infection. It is characterized by eyes pain, fever, headache, arthralgia, myalgia and rash. This disease is known for more than 200 years. Thrombocytopenia is a common and serious complication in a dengue infection. Bleeding in dengue fever is prevented by using prophylactic platelet transfusion. Thrombocytopenia treatment by drugs and blood products is very costly. This review helps the people to treat dengue fever conventionally. Traditionally mature leaves or extract of leaves of Carica papaya are used to treat this condition. Different studies have shown that the juice of leaves of the Carica papaya belongs to the family Caricaceae helps to increase the platelet levels in dengue patients. For the effective treatment of dengue to boost, the platelet count Caripill is used which is a Carica papaya leaf extract tablets. Carica papaya leaves extract was administered orally to the patients to confirm the already reported claim of increasing thrombocyte counts by the Carica papaya leaves extract. Haematological evaluation showed a little decrease in haemoglobin followed by decline in platelets count and in white blood cells. The continuous rise in platelet counts is seen with every successive administration of the leaves extract. Boerhavia diffusa (punarnava) also boost the synthesis of red blood cells and haemoglobin. Aloe vera and Phyllanthus emblica Linn. from the family Euphorbeaceae, (gooseberry or Amla) also helps to boost the immunity. Amyron (nutritional supplement) provides all the essential measures for speedy recovery from dengue fever. So it is concluded that all these herbs will help to reduce the economic burden faced by victoms of dengue fever. Keywords: Dengue fever, platelet, thrombocytopenia, Carica papaya

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Pre-Natal Care Services in Lady Willingdon Hospital, Lahore, Pakistan Kanzah Sultan1*, Ghulam Jilany Khan1, Ammara Ijaz2, Irfan Bashir1, Anam Shabbir3, M. Abdullah Bashir3 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. DHQ Hospital, Qasur. 3. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Kanzah Sultan Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract In Pakistan, new natal deaths and miscarriages are serious problems due to lack of proper prenatal care. Antenatal care is a routine based health assessment as well as management and provide appropriate control of assumedly healthy pregnant women who even lack any characteristic disease symptoms. Improper prenatal care refers to a serious medical problem in pregnancy. Objective of our present study is to provide the basis for improvement in prenatal care via multiple services and facilities at hospitals in Pakistan. The study was conducted at Lady Willingdon Hospital, Lahore Pakistan. Nature of the questioner was patient based, that was filled by pregnant women. Questionnaire was consisted of 20 questions and for the ease of patients questions were in Urdu language. A total 86 patients were enrolled in the study while the patient while the results were analyzed by using SPSS. Our results showed that most prevalent age group was 25-29 years old that comprises 53.5% of the studied group. A very low fraction of prenatal care was found in middle economy class patients while the patients suffering from distance factor (unavailability of the hospital facility at their nearby place) was 33.7%, in addition to that unsatisfied healthcare services for patients were found quite alarming that accumulatively were reported by 46.5% patients. Our studies concludes that a closer observation by the hospital management and administration is quite necessary to improve pre-natal care services, in addition to that, more professionally qualified staff in government hospitals is also another alarming need for the betterment in public health. Keywords: Antenatal care; Miscarriages; Gynecology; Pregnancy; Neonatal Death

Patient Medical Records; an important tool for quick health status assessment Zafeer Naeem Wain1*, Muhammad Jamshaid1, Mahmood Ahmad3, Irfan Bashir1,2, Waqas Akram1,Muhammad Shafeeq Ur Rehman1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author Zafeer Naeem Wain Email:[email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Patient medical records are the documented information about the patient wellbeing status recorded by a qualified medical practitioner or other healthcare provider, either personally or at his or her directions. It

20 contains adequate information to distinguish the patient, physical examination and investigations, which support the diagnosis based on history, justify the professional management given, record the treatment course and results thereof, and ensure the continuity of care provided by practitioners and other healthcare workers to that particular patient. Medical records are used in the planning and management of health care facilities and services for the production of health care statistics and medical research. Present review highlight the importance of medical records and its documentation and also describes the functions, general principles and WHO guidelines for medical record documentation. Broadly, medical records are of two types paper based medical records and electronic medical records. Paper based records often become bulky with time, which leads to lack of overview but still represent the usual medium for collecting and recording patient data. While, electronic medical records (EMRs) enhance readability, availability, and data quality. Despite potential benefits of electronic medical records (EMRs), healthcare practitioners face a change in their practice habits which is the major barrier of its implementation. Medical history, Laboratory test results & diagnostic test results, Problem lists, Clinical notes and Treatment plans are five major components of medical record. Patient medical record is a legal and confidential document. There is no general policy for retention of medical records. Different countries adopt unique and different strategies and laws with respect to the retention time of health records. WHO guidelines describes who, what, when, why and how medical records are documented. Each of the components available in patients’ records are important and filling them indicates the importance put by the documenting personals. Complete medical records are a keystone in the quality and effectiveness of patient care during the hospitalization and in subsequent follow-up visits, as they can provide a complete and accurate chronology of treatments, patient results and future plans for patient care. Keywords: Legal documents, Patient Diaries, Hospitalization, Medical history

Burn injuries risk assessment among females of Pakistan Rimsha Khursheed1*, Irfan Bashir1, Ghulam Jilany Khan1, Tabinda gohar2, Muhammad Jamshaid1, Faheem Ahmed Siddiqui11, Waqas Akram1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Jinnah Burn Centre, Jinnah Hospital, Lahore. Corresponding Author: Rimsha Khursheed Email:[email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract According to the WHO, burn injuries are classified by site of injury "burns and corrosions" mainly caused by exposure to smoke, fire and flames, contact with heat and hot substances, exposure to electric current, and acids. People with burn injuries undergo significant physical and emotional trauma, initially from their injury, and subsequently from the dressing changes. Our present retrospective study was designed to evaluate the incidence of burns and to find common complications and traumas related to burns as well as to evaluate the circumstantial considerations of incident in married females. The study was conducted in Jinnah Hospital Burn Unit and the data was collected through questionnaire-based performa from 102 patients of burns. The data were analyzed through SPSS. The result showed that women between the age of 15-25 suffered 35.2% of burn cases, women from age 26-40 had 61.0% burn injuries while 73% of the incidences happened in kitchen by utensil or stove in addition to that, it was also found that most of the patients were less educated and were married. Conclusively we report that appropriate education is an important factor in reducing burn cases. It is concluded that, as compared to men, women are more susceptible to burn injuries that may be prevented by providing awareness about using different electrical and heating kitchen appliances. Keywords: Burn injuries; Electric kitchen appliances; stove handling;

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Mental health assessment and drug use behavior among university students Rahima Khan1*, Mahmood Ahmad, Irfan Bashir1, Maria Ali2, Faheem Ahmade Siddiqui1, Muhammad Shafeeq-ur-Rahman1,Muhammad Jamshaid1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Regional Directorate, Anti-Narcotics Force, Punjab 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author: Rahima Khan Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract There is an increasing trend in the use of alcohol and other illicit drugs among university students. This is mostly associated with various types of psychological and social conditions. This study aims to assess the mental health of university students and determine their drug use habits. In view of the increasing trends of mental health problems leading to drug addiction among university students, there is a need for surveys to be conducted in order to determine the relationship between mental health problems and drug use behavior in students. We report such a survey. This is cross-sectional descriptive study using a total of 107 university students aged 18-30 years who were selected through a randomized sampling process. The study was conducted at private and public-sector universities. Information regarding drug habits, mental and social behaviors and risk factors for addiction was obtained from the participants by using a structured questionnaire. Data was analyzed using SPSS. Findings of the statistical analysis indicate that 57% of participants were males and 43% were females. 13.1% and 29% of participants have positively responded to questions regarding poor economic situation and love breakups. Lack of confidence and depression has been reported by 42.1% and 48.6% of participants respectively. 15% and 7.5% of respondents have reported daily use of cigarettes and chars respectively. About 35.4% of respondents who are not interested in studies have bad grades. Various factors such as depression, emotional disturbance, and economic situation are significantly correlated with the increasing trend of drug use among university students. There is a need for further research and awareness programs in this field in order to educate the youth. Keywords: Smoking, Depression, Emotional Instability, Economic Factor, Educational Grades

Illicit sale at community pharmacies/ medical store of Lahore, Pakistan Tanzeela Iqbal1*, Irfan Bashir1, Muhammad Jamshaid1, Waqas Akram1, Maria Ali2, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Regional Directorate, Anti-Narcotics Force, Punjab

Corresponding Author: Tanzeela Iqbal Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract

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Illicit or illegal sale of drugs at pharmacies means the drugs sale without the appropriate and legal prescription which results in harmful clinical effects that include severe life-threatening complexity, physical craving and addiction recall syndrome. Illicit drugs are a worldwide problem with unwanted and well-reported outcomes for worldwide health and patient safety, which includes drug counteraction and obstruction and can lead to patient death. This malpractice affects the public health in both rich and poor nations alike. The reason for doing this project is to observe the extent of illicit sale at pharmacies in Pakistan. Illicit sale at pharmacies and medical stores is a serious issue in our country which leads to the other serious conditions which effect a person’s life and community as a whole. The basic aim of the study is to get knowledge and information about the illicit sale at pharmacies and measures the parameters which can be used to check the sale at the pharmacies. This Study is conducted at 5 medical stores and 5 pharmacies around Data Darbar area and 5 medical stores and 5 pharmacies around Lahore Railway Station. Checklist was prepared that includes certain question about illicit sale of drugs at pharmacies and filled by the investigator. The data was then analyzed by SPSS tool. According to the analysis the frequency about drug dispensing at 10 medical stores and pharmacies of Data Darbar and 10 medical stores and pharmacies at Lahore Railway Station. In 50% of pharmacies pharmacist were actually involved in patient counseling whereas, absence of pharmacist increases the illicit sale at pharmacies that results in increases illicit sale of medicines. Pharmacist can control this type of sale by strictly following rules and regulations as mentioned in drug laws and only allowing the sale of medicines through proper prescription prescribed by the health care professional and can check such alarming situations and promote a healthy and safe environment. It can be concluded from the result that the presence of pharmacist imparts a great role to control the illicit sale at community pharmacies through patient counseling and improves the check and balance over selling this type of sale. Furthermore, pharmacist can improve healthy environment of the society. Keywords:Illicit Drug Market Prevention; Pharmacist; Drug Regulation; Prescription

Incidence and Knowledge about Hypertension among University Male Students of Lahore, Pakistan Azhar U Din1*, Ammara Ijaz2, Irfan Bashir1, Muhammad Jamshaid1, Muhammad Shafeeq-ur-Rahman1,Ghulam Jilany Khan1, Waqas Akram1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. DHQ Hospital, Qasur.

Corresponding Author: Azhar U Din Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Hypertension (HTN) is foremost health problem worldwide. According to WHO statics, HTN is causing more than 50 % deaths worldwide. Pakistan is a country with a total population of 191.7 million is facing an intensifying prevalence of cardiovascular diseases and affects 18% of adult. HTN is the leading cause of many cardiovascular disease (CVD) mortality worldwide. The objective of the study was to determine incidence of hypertension among the university students and to estimate the knowledge regarding hypertension. It was a cross-sectional study conducted at University Of Central Punjab. 227 Male students age of 20-30 were included in study during period of data collection. Female students, Faculty staff, Workers and Guards were excluded from study. Hypertension was assessed by using pre-validated questionnaire. Yes and No were the choices given against each item. Data were analyzed by descriptive analysis plan through SPSS 24. The prevalence of hypertension was 15.9% among study subjects. The awareness rate was 88.5%. The students with the 77.4 % positive family history were found. 90.3 % were conscious that diet control improve B.P but only 22% follow the diet plan. A positive significant

23 correlation was found between smokers, diabetics and family history which is 23.1%, 15.1%, 0.5% respectively. Study concluded that, given the young age of the respondents, this incidence is quite high and suggests that health education program about keeping a healthy lifestyle should be organized for university students. Keywords: Hypertension; Cardiovascular Diseases; Diabetes Prevalence and Risk Factors of Asthma among Male Students of University of Central Punjab, Lahore. Rizwan Ali Masood1*, Irfan Bashir1, Muhammad Jamshaid1, Waqas Akram1, Muhammad Shafeeq-ur-Rahman1,Muhammad Nadeem Alvi1, Uzma Yousaf2 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Ganga Ram Hospital, Lahore, Pakistan Corresponding Author: Rizwan Ali Masood Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Asthma is recognized as one of the most chronic diseases, affecting morethan 300 million people around the world. According to a WHO reports asthma will be the third leading cause of death globally by the year 2020. Pakistan is listed 6th most populous country with more than 20 million adults facing asthmatic complications. The aim of this study was to determine the prevalence and contributing risk factors of asthma in a population of male students of University of Central Punjab Lahore, Pakistan. A cross-sectional study was conducted by enrolling 132 male students, aged 19–29 years, of University of Central Punjab, Lahore. Participants self-completed the questionnaire on risk factors and clinical history of asthma. Prevalence ratios and risk factors were estimated by applying SPSS version 18. 5.3% students were identified to have asthma, 18.9% found to have history of recent wheeze, and 24.2% had wheezing at night. 38.6% of the participants had family history of smoking; prevalence of active smoking in the study subjects was 39%. 9.8% of all subjects had exposure to tobacco smoke, 26.5% subjects had exposure to dust while allergies due to pets at home were found in 5.3% of the cases. From the data obtained it was established that statistically significant association exists between smoking and asthma. The study results suggested that most important factors that predispose male students at University of Central Punjab, Lahore to asthma and related respiratory complications include ever increasing trend of smoking, genetic family history, increased urbanization with thickly populated areas, increased industrialization, air pollution due to pollen overload and smoke emitted by heavy vehicles. Use of allergenic cosmetics, body sprays and perfumes were also found to be involved in few of the cases of asthma. Keywords: Asthma; Tobacco Smoke; WHO; Allergies Prevalence and Assessment of Breast Cancer Awareness among Young Women of Pakistan Muhammad Nouman1, Irfan Bashir1 Ghulam Jilany Khan1, Usama Jamshaid1, Muhammad Imran Sajid1, Muhammad Shafeeq-ur-Rahman1,Muhammad Jamshaid1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Muhammad Nouman Email: [email protected]

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Contact# +92-345-6859697 Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Breast cancer is most common type of cancer among females. The metastasis of breast cancer arises from two most common types are ductal and lobular cancer. Currently Pakistan has highest incidence rates of breast cancer in reported within Asia affecting every 9th women of the country during her life time. Our present cross sectional study that include the females of age between 18-37, was designed to assess that how many females have information about the signs, symptoms and complications of this deadly disease, in addition to that number of females who have gone through some screening tests like breast self-examination, clinical breast examination and mammography were also included in the study for the assessment of their understanding level; moreover, awareness about risk factors, preventive measures, and treatment of disease among females was also evaluated. Respondents were selected from multiple institutes and were well informed about the objective of the study as well as written consent was also obtained from each studied respondent. Sample size was calculated by Daniel’s equation resulting 125 respondents and were assessed through 13 closed-ended questions. Collected data was analyzed by SPSS 21. Our results showed that 85.2% participants had information about breast cancer and 68.8% knew that breast self-examination is a useful tool for early detection while 67.2% females had no idea about the procedure signs of breast self-examination. Moreover our study also indicated that 96.8% participants had never gone through mammography. Upon asking about the awareness level regarding the disease, 28.8% thought that an awareness campaign is very much necessary to promote awareness on breast cancer while 60% females thought that contraceptives do not cause breast cancer. Conclusively, our study reports that young women of the Pakistan, regardless of the education level, are not very well aware of the disease its risk factors and screening methods like breast self-examination, mammography, which are helpful tools for detection of disease at early stage. In order to reduce the growing incident rate of breast cancers, a thorough awareness program should be designed to improve and direct the appropriate awareness in young women of Pakistan. Keywords: Breast cancer; contraceptives; breast self-examination; mammography

Precocious Puberty: A Dire Need to Look Into Food Regulations of Pakistan. Gohar Shahbaz1,Mahmood Ahmad2, Irfan Bashir1, Waqas Akram1, Ghulam Jilany Khan1, Usama Jamshaid1, Muhammad Imran Sajid1, Uzma Yousaf3, Muhammad Jamshaid1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan 3. Ganga Ram Hospital, Lahore, Pakistan Corresponding Author: Gohar Shahbaz Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Precocious puberty is a worldwide threat due to high consumption fast food amongst children. This high demand is leading to use of prohibited drugs in animal feeds to get fast and pronounced growth, which in turn leads to precocious puberty in children consuming meat grown through such harmful feeds. In Pakistan, there is also a high trend of fast food consumption, with an underdeveloped food regulatory system the threat of Precocious puberty is potentiated and inevitable. This study focuses on causes,

25 incidence, control and awareness regarding Precocious puberty amongst population of Lahore, Pakistan. In West the incidence of precocious puberty is 1:5000 - 10,000 individual, but in Pakistan this threat increases 3 times. Girls are 5 - 10 fold more frequently affected with female to male ratio of a 3:1. This indicates that Pakistan is far behind the world in controlling this menace and children are more prone to this disease in Pakistan than of developed world. This clearly indicates a dire need to investigate, study and analyze causes behind this problem so that effective control and prevention of disease can be made possible, which justifies the need for this study. Our present cross sectional study includes the parents having children who consume fast food regularly. The data was gathered through filling of 118 questionnaires by parents and was analyzed using SPSS software. The results showed that more than 50% of parents do not know about precocious puberty. More than 50% of parents mentioned that they experienced physical, mental and sexual changes indicating towards puberty before time in their child. More than 50% parents were not satisfied by role of government in spreading awareness against this disorder. Overall our findings indicate that population of Lahore, Pakistan is poorly aware of precocious puberty, its causes and effects. A high amount of children are showing physical, mental and sexual changes indicating towards puberty before time and government as well as food regulatory department is not playing an appropriate role in spreading awareness against precocious puberty. Keywords: Food Regulation Authority; Growth Abnormalities; Psychological Disturbance; Sexual Inappropriateness, Animal Feed; Hormonal Aberrations.

Incidence of Premature Births among Low Socio-Economic Status Families Muneeba Anwar1*, Irfan Bashir1, Muhammad Jamshaid1, Tooba Mehboob1, Naila Tabassam1, Rabia Aslam1, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Muneeba Anwar Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract According to WHO, preterm birth is defined as birth before 37 weeks of gestational. Extensive research during past years shows evident relationship between PTBs and low socioeconomic factors such as poverty, lack of education, lack of awareness, illiteracy, poor communication between spouses and stress. PTBs impose a serious threat to newly born infant’s health increasing the chances of morbidity, mortality and also leads to maternal complications. The consequences of premature births are complex and powerful. It complicates 5-15% of pregnancies, the rate varies from country to country and it is the major cause of perinatal morbidity and mortality. Almost 15 million births are PTB annually out of which 1 million infants die due to complications including respiratory, circulatory, neurological disorders etc. By understanding the relationship between low socio-economic factors affecting maternal health and birth and PTB, the unfavorable outcomes of PTB can be reduced by appropriate interventions and preventive care which is evidence based. This was a cross sectional study. The study was conducted in small towns of Lahore such as Thokar niaz beg, lalazar, walled city etc. and local hospitals of Lahore including Jinnah and Lady Willingdon hospitals. The sites were chosen because number of low status families living in these areas and visiting these hospitals were large. The sample size was 227 calculated using Daniel’s equation. All women who have had been pregnant or who are currently pregnant, can understand Urdu, and are local natives of Lahore were included. Rest of the women were excluded. Data was collected using questionnaires containing 30 close ended questions. Finally, the data was analyzed using SPSS. the study showed that among 150 women (77 women were excluded), 44.7% of women delivered normal babies and 55.3% had delivered preterm baby at least once. The major causes were identified as obesity, stress or anxiety, malnutrition, underlying disease and infections which are directly related to low socio- economic status. Additionally, among these women 52.7% were suffering from depression and 50.7%

26 were also suffering from gynae problems along with depression. The relation between low socio- economic status and rate of preterm births is predictable especially by depression and gynecological problems, therefore we suggested that special economical care programs should be developed for detection and management of depression and gynecological problems during prenatal care to prevent PTBs in those women who can’t afford the treatment due to their low socio-economic status. Keywords: Premature Births, Low-Socioeconomic Factors; Gynecological Problems

Risk Assessment of Depression among Teenagers in Lahore, Pakistan Anila Ayub Anjum1*, Irfan Bashir1, Muhammad Nadeem Alvi1, Muhammad Imran Sajid1, Shafeeq-Ur-Rehman1, Rabia Aslam1, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Anila Ayub Anjum Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Depression is a global problem, leading to many stressful, unhappy lives but teenagers are at stake the most. In Pakistan also, depression amongst teenagers is constantly showing an increase. Social, psychological, physiological, environmental, emotional or even genetic factors are responsible for it. This serious condition indicates a dire need to investigate the reasons, to look for dynamics of the condition and also to look for better ways of diagnosis, treatment, and awareness amongst the mass, which is the prime objective of my study. Thus, my study would lead to better awareness and also to some extent help to improve the quality of life amongst depressed teenagers in the course reducing the suicidal tendencies. It is a cross-sectional study. To conduct this study I have chosen students, lying in age of 16-19 years, of four educational institutes. Sample size calculated from Daniel’s equation came out to be 172. Close ended Questionnaire based on 19 questions was formed and filled by teenage students. The data was then analyzed by SPSS tool. The study found that among 172 teenage students 74% were satisfied from their lives. Among 25% of unsatisfied teenage students 58% showed their depression due to low grades in exam. When environmental factors interpreted, family conflicts and disputes were also the major cause of depression followed by the facet of losing loved one. 36% students encountered with suicidal thoughts whereas 29.1% harmed themselves. Factors of depression are predictable and thus can be lessen by awareness and counselling. The severity of depression can be alleviated by altering the social circle, diet habits and with the utility of appropriate medical care. Keywords: Depression, Global Problem, Suicidal Thoughts, Environmental Factor, Teenagers

Assessment of discomfort and dependency level associated with limb amputation among patients of Lahore, Pakistan Anam Naz1, Irfan Bashir1, Ghulam Jilany Khan1, Usama Jamshaid1, Muhammad Imran Sajid1, Muhammad Jamshaid1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Anam Naz Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract

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The amputation or limb loss is one of the oldest described surgical procedures with the history of more than 2500 years. Amputation itself is a change in body structure but has great influence on performing daily activities including household chores, hobbies and social relationships. It impacts negatively on mobility, social function and quality of life. The study was conducted to determine the ordeals being faced by the victims of limb loss, in coping with life after amputation; and how come they can add quality to their life. 5.99% people’s life in Pakistan is affected due to limb amputation. As compared to other developed countries Pakistan is lacking new technologies in treating them well. Therefore, there is a need to implement strategies that help in increasing their quality of life. In our present cross sectional study, both primary and secondary data was used to gather information. The primary data was collected through survey method i.e. questionnaires and interviews from 86 respondents including close ended questions. Whereas, secondary data was based upon data available from previous studies or databases. The data was analyzed through SPSS. The study was conducted at Pakistan Society for the Rehabilitation of Disabled Lahore (PSRD), Hope Rehabilitation Centre and Milestone. Our results showed that 45.3% respondents were having some trouble in walking and moving around by their own, 50% respondents said it was difficult for them in doing self-care routine i.e. washing or dressing themselves, 46.5% respondents agreed to the fact that they were facing difficulties in performing daily activities, 57% respondents considered themselves in moderate pain or discomfort after amputation and 48.8% respondents stated that limb amputation gave them moderate level of anxiety or depression. It was concluded that as compared to other developing countries, people having limb amputation in Pakistan are having much trouble in performing usual activities and in mobility due to the pain or discomfort. There is need to implement some strategies or to introduce some latest techniques that can help them to increase their quality of life. Keywords: Amputation, limb loss, rehabilitation, quality of life, prosthesis. Risk Assessment of Dehydration among Labor Community in Lahore, Pakistan Qurat-ul-Ain1*, Irfan Bashir1, Muhammad Imran Sajid1, Waqas Akram1, Rabia Aslam1, Ambreen Ishaque1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Qurat-ul-Ain Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract According to WHO, dehydration is defined as the condition that result from excessive loss of body water. Dehydration exists as a potential risk to laborer’s health, as conditions in Pakistan are poor regarding laborer rights. During few past years remarkable changes occurred in Asian climate which have major effects on outdoor workers.16.3% of world population is affected by dehydration. The main purpose of this study is to determine how many laborers are affected by dehydration and to describe their potential risk factors. To improve the life of laborers at workplaces and to protect them from threat of dehydration. By understanding the relationship between their low socio-economic factors, lack of education, and lack of awareness, illiteracy and stress. It is retrospective and mixed method approach study. Study was conducted in Lahore at different construction sites like Multan road, Thokar naiz baig and UCP construction site. The sites were chosen because large numbers of laborer are working at these places. The calculated sample size was 399 using Daniel’s equation. Data was collected using questionnaires containing 15 closed ended questions and in-depth interviews. Finally, the data was analyzed using SPSS software. According to survey, the study showed that among 130 laborers about 97%participants are affected by dehydration due to less water intake and unavailability of water. 54% of them are not aware of laborers’ rights and 70-75% are not even aware of dehydration precautions. It is concluded from the study that dehydration is a major health problem in outdoor workers. Majority don’t have knowledge about how much water they should intake. There is dire need to spread awareness amongst laborers regarding dehydration, water and salt intake and other presentations related to dehydration.

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Key Words: Dehydration, Labor, Water-intake.

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Incidence of Asthma and COPD among Females with Respiratory Diseases in Lahore, Pakistan Maria Saeed1*, Irfan Bashir1, Waqas Akram1, Rabia Aslam1, Imtiaz Majeed1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Maria Saeed Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Pulmonary disorders act on females differently and at a greater intensity than males. The reasons for such gender discrepancy is instituted on ecological, socio-cultural, professional, and infectious scenarios, as well as medical health belief. According to WHO evaluation done in 2016, 383 000 deaths occurred due to asthma in 2015. WHO states that, COPD will move to fourth leading cause of death by 2030 globally. In the USA, death rates for COPD have doubled between 1970 and 2002.The aim of the study is to find out the prevalence of asthma and COPD among females of Lahore and to understand various risk factors responsible for incidence of asthma and COPD among females. It is a cross-sectional type of study. Consisting of 206 females of all age, having respiratory disease, smokers and non-smokers, living in Lahore. The study was conducted in Gulab Devi Chest Hospital and Lahore General Hospital, Lahore. Participants were asked to fill a structured questionnaire comprising of 15 close-ended questions, on symptoms and risk factors of asthma and COPD. Prevalence and risk factors were estimated by using SPSS version 18. 43.7% of females with respiratory disease had asthma while 28.6% were diagnosed with COPD. In a sample size of 206 patients, where 13.5% had family history of COPD. 82.6% were found to have history of recent wheeze, and 88.9% had shortness of breath. 34.8% of the participants were smokers or had a history of smoking; while 39.6% were living/working in a place with constant exposure to environmental irritants and dust. Only 62.8% were on medication and 8.2% knew about the risk factors of asthma and COPD. As it is seen that the prevalence of both asthma and COPD is high so it is very important to work on reduction of its incidence. In a population size of 206 females only 62.8% were on medication so counselling is required to increase the patient compliance. Only 8.2% knew about the risk factors, so awareness programs should be started to educate females about the preventive measures. Keywords: COPD; Pulmonary diseases, Ecological, socio-cultural scenario, Infectious

Anger, Depression and Stress: Risk Assessment of Suicidal Attempts in Young Women of Lahore, Pakistan Hafsa Ihsan1*, Irfan Bashir1, Maria Ali2, Waqas Akram1, Ammara Ijaz3, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Reginal Directorate, Anti-Narcotics Force, Punjab 3. DHQ Hospital, Qasur Corresponding Author: Hafsa Ihsan Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Suicidal poisoning is a trend that is increasing day by day especially among females. It is disturbing to know that there are a large number of emotionally and mentally unstable people who find no option other than suicide. Since the majority of the population of Pakistan is uneducated and illiterate, psychological issues like depression are not bothered. It is necessary to minimize or eliminate suicidal thoughts and to provide counseling to the patients.

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Generally, women tend to be more susceptible to emotional instability than men. The percentages of men and women attempting suicide are 49% and 51% respectively. The aim of this study is to highlight the various factors and aspects associated with suicidal poisoning among females. The study was conducted in two hospitals: Jinnah hospital, Lahore and Ganga Ram hospital, Lahore. A questionnaire comprising of six close-ended questions was prepared and filled by the patients (after their consent). The questions were translated into Urdu for the ease of understanding and verbal explanation was also provided where required. The sample size was 150 according to Daniel's equation and the inclusion criteria was 20 – 45 year old women. The results of the data gathered through this study were interpreted by using the SPSS software. Data analysis showed that 45% of the patients were 20-28 years old, 40% of the patients were 29-37 years old and 15% of them fell in the age range of 38-45 years old. Reasons of suicide attempts were categorized into 3 groups; sudden anger (43%), depression (32%) and stress (25%). The most frequently used poisons for suicide were any drug or pill (53%), bleach (32%) and pesticides / rodenticides (15%). Only 23% of the patients had talked to professionals before their suicidal attempt where as 56% were not interested in seeking professional help and the rest 21% had no access to professional aid. There were 22% patients who had a previous record of suicide attempts and 49% had never attempted suicide before. The percentage of patients who regretted their action was 38% while 22% of patients still had suicidal thoughts however 40% of them were still confused regarding their problem. Women should be addressed about their suicidal thoughts and society needs to take proper steps like motivating them to get proper guidance. Even if someone attempts suicide, counseling should be given to them during and after the treatment. Other than that, government should take steps to control the selling of prescription drugs. Keywords: Suicidal Poisoning, Depression, Stress, Drug Abuse, Drug Regulation, Patient Counselling

Prominence of Pharmacists in Providing Pharmaceutical Care to Hypertensive Patients Hafiz Rehan Tariq1*, Irfan Bashir1,2, Zeeshan Abid2, Faheem Ahmed Siddique1, Abdullah Bashir2, Sarah Ahmad1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Hafiz RehanTariq Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Hypertension is a chronic disorder that needs repetitive medication that increases the risk of drug related problems (DRP’s) which can be controlled by effective management of DRP’s by pharmacists. The prevalence of hypertension is 18% in young adults and 33% in adults above 45 years of age and only 12.5% of hypertension cases were adequately managed. The aim of the study was to evaluate the provision of pharmaceutical care for hypertensive patients as well as the management of DRP’s by pharmacists across various public and private sector hospitals of Lahore, Pakistan. It was a retrospective study which was conducted in various public and private sector hospitals in Lahore. Check list was prepared and filled by the hospital pharmacist. Check list include pharmacological interventions aimed at optimizing treatment, preventive pharmacological interventions, non- pharmacological interventions, use of antihypertensive drugs, changes in clinical parameters of hypertensive patients receiving care in hospital. The results were analyzed through SPSS analysis. According to the survey in eight hospitals, the results show 100% presence of pharmacist in hospitals. 75% of pharmacists had less than 2 years of experience and 25% of pharmacists had 2-5 years of experience. 37.5% of the pharmacist recommended the method of administration. 75% of the pharmacists took steps to improve patient adherence with the drug therapy. Only 12.5% of the pharmacists ever initiated any therapy. 87.5% pharmacists reviewed pharmacotherapy. 75% of the pharmacists took steps to prevent possible drug interactions. 62.5% of the pharmacists confirmed medical prescription. 62.5% of the pharmacist took steps to prevent ADR’s. 62.5% of pharmacists recommended monitoring. 25% of pharmacists ever discontinued the drug therapy of the patient. 37.5% of pharmacists provide counselling for lifestyle changes. 25% of pharmacists referred the patients to another professional. 37.5% of pharmacists provide counselling on diabetic foot care. 75% of pharmacists counselled on the use of compression stockings. 87.5% of patients were prescribed monotherapy, 75% with combination of 2 drugs. 100% of the patients receiving pharmaceutical care were improved. It was concluded from the study that DRP's can be effectively managed by the

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presence of pharmacists in hospitals though it is improving day by day still the provision of pharmaceutical care has a long way to go for bringing an observable community health improvement. Keywords:Pharmaceutical Care, Hypertension, Hospital Pharmacist, Community Pharmacy, Pharmacy Practice Central Role of Pharmacist in Pharmaceutical Care for Cancer Patients Isma Majid1, Irfan Bashir1, Waqas Akram1, Ghulam Jilany Khan1*, Usama Jamshaid1, Muhammad Imran Sajid1, Muhammad Jamshaid1. 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. Corresponding Author: Isma Majid Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract It is important that professional and public education service be combined with latest access for treatment and diagnostic facilities. Improving services to patients with programs and appropriate follow-up services may not only enhance the quality of life but can also be helpful in increasing the progression free survival of the cancer patients. Pharmacist is the most easily accessible source of information, advice and instructions to cancer patients with consultation of other healthcare members to minimize adverse drug reactions (ADR's) and to identify drug interactions. In our present retrospective study we investigated patient preference for an effective and appropriate dispensing and compounding role of pharmacists for the pharmaceutical care point of view for cancer patients. The questionnaire was prepared comprising multiple close ended questions and data was collected from patients at cancer hospitals including Shaukat khanum cancer memorial Hospital and research center, Inmol hospital, Doctors Hospital, Mayo Hospital, Jinnah Hospital and Ittefaq Hospital. Our results showed that the availability of pharmacists for pharmaceutical care is 66.7% out of which 83.3 % pharmacists are involved in rationalizing chemotherapy while 66.7% pharmacists were permanently involved in counselling sessions and for providing pharmaceutical care in terms of ADRs monitoring, drug interaction assessment. Though a handsome percentage of pharmacist is available for pharmaceutical care to the patients still it can be improved by the induction of more healthcare professionals for patient health care. In this regard, government and administration is needed to induct more pharmacists so that the availability them may be 100% for pharmaceutical care that will eventually lead to an improvement in overall health care of cancer patients. Keywords: Health Care; Pharmaceutical Care; Cancer; Pharmacist; ADRs. Association of Pharmacists in Management of Addicted Patients: Public Perception Haleema Saeed1*, Mahmood Ahmad3, Irfan Bashir1, Muhammad Jamshiad1, Maria Ali2, Waqas Akram1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Regional Directorate, Anti-Narcotics Force, Punjab, Paksitan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author: Haleema Saeed Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract In the treatment and prevention of drug addiction pharmacists are involved as a part of healthcare team. Pharmacists’ role is improving worldwide in terms of management and prevention of addicted patients. According to literature review it is estimated that women have high level of drug addiction as compared to men due to the anxiety and stress. According to report the youth have high rate of addiction. To determine public perception about pharmacists’ role in addiction treatment. To evaluate how much

32 knowledge, do people have about pharmacists’ role and responsibility and their management.To determine the need of awareness among general public. To promote pharmacists should be considered important as a health care provider. Drug addiction is increasing rapidly so it is important to control and tell people how pharmacists can work on it. A cross-sectional study was conducted which included closed ended 10 questions in questionnaire. The data was collected from the students of University of Central Punjab and local public. Total 100 people were selected for this study. The data was analyzed through SPSS in the form of tables, histogram and pie charts. 71% of participants responded YES, 11% of participants responded NO and 18% of participants were neutral about the presence of pharmacists in the rehabilitation center. 68% of participants responded YES, 23% of participants responded NO regarding to awareness programs by pharmacists. 73% of participants responded YES and 42% of participants responded NO to the training provided to pharmacists and educating the people about the side effects of addiction. 54% of participants responded YES and 10% of participants responded NO for the leadership role of pharmacists in prevention of drug abuse. The study concluded that majority of the population has a little knowledge of roles and responsibilities of pharmacists while some people lacked knowledge regarding their roles and responsibility. The study not only enhanced the awareness of the role of pharmacist in public health improvement but also provided the basis for the development of appropriate strategies for bringing to the nest level.

Precocious Puberty among Broiler Chicken Users in the Locality of Lahore, Pakistan Maira Shuja, Haleema Iftikhar, Irfan Bashir1, Muhammad Jamshiad1, Maria Ali2, Waqas Akram1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Regional Directorate, Anti-Narcotics Force, Punjab. Corresponding Author: Maria Shuja Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Precocious puberty is a phenomenon characterized by the occurrence of secondary sexual characteristics before the age of 8 and 9 years in girls and boys respectively. It is generally classified into two types, namely central or true precocious puberty and peripheral or pseudo precocious puberty. The purpose of this study was to determine the correlation between the consumption of broiler chicken and the development of precocious puberty at an age earlier than normal. A cross sectional study was conducted to collect data from a random set of 30 children especially young girls with ages ranging between 5-14 years. The data collection sheets or questionnaires containing a series of multiple choice questions utilized for this purpose were completed by the participants randomly selected from different restaurants in the locality of Lahore. The results obtained through the observation of the collected data showed that 33.3% of the population was consuming broiler chicken more than 10 times a month while 73.3% of the populations had fast food as their favorite food, as a result of which 63.3% of the population had weight higher than the ideal body weight. A conclusion was made that children having a high broiler chicken consumption in a month had more weight. The analysis of the data also led to the conclusion that children having fast food as their favorite food had more weight as compared to children having vegetables or fruit as their favorite food, due to the increased use of broiler chicken in fast food restaurants. It was concluded that due to being overweight majority of the population was at a higher risk of developing precocious puberty.

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Personal Hygiene & Incidence of Infectious Diseases in Developing Countries Nida Zulfiqar1, Muhammad Jamshaid1, Irfan Bashir1,2, Khalid Idrees Khan1, Waqas Akram1, Imtiaz Majeed1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Nida Zulfiqar Contact:+92-42-3588007 Email:[email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Personal hygiene plays an important role in the control of many infectious diseases.Personal hygiene is a practice to protect health, which include the hygiene of skin, nail, hand, teeth, clothes, hair and body etc. The environmental hygiene includes the hygiene of surroundings like community, public places etc. People should maintain and promote good health by keeping themselves and surrounding clean. The need of this article is to highlight the importance of personal hygiene as good hygiene is the only way to inhibit the spreading cycle of infections. Community acquired diseases can be prevented by adopting community hygiene practices. Polluted water supply and poor sanitation systems play an important role in spreading of fecal oral diseases. Sanitation is directly or indirectly related to community hygiene because it is an important feature of community. Personal hygiene is important for good health, if not followed properly, may result in spreading of diseases like: Diarrhea, Food poisoning, Trachoma, Scabies, Impetigo, Rat bite fever, Hepatitis A and Hepatitis E. In both rural and urban areas of developing countries community hygiene practices are not properly followed. It is very important to conduct educational programs to highlight the need of good hygiene practices.

Keywords: Community Acquired Diseases, Community Hygiene, Trachoma, Scabies, Impetigo

Formulation and Development of Sustained Rerelease Microspheres of Metoclopramide, Tabulated Microspheres and Capsule Filled Microspheres along with Brand Comparison Azeema Tayyab1, Maryam Shabbir1, Sherjeel Adnan1 1. Faculty of Pharmacy, The University Of Lahore Corresponding Author Azeema Tayyab Email: [email protected] Abstract The microspheres of metoclopramide were prepared for maintaining constant level of drug in blood stream as sustained drug delivery system with an aim to reduce the dosing frequency and improve patient compliance. Metoclopramide is used as an anti-emetic. Metoclopramide is also used in diabetic patients who have poor emptying of their stomachs (gastroparesis). Metoclopramide works by blocking a natural substance (dopamine). It speeds up stomach emptying and movement of

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the upper intestines. Microspheres of metoclopramide were prepared by using polymers Eudragit L-100 and HPMC by Solvent Evaporation technique. Drug and polymers were taken 1:1, 1:1.5, 1:2, 1:2.5, and 1:3.. HPMC and metoclopramide were dissolved in water (internal phase) and poured to Eudragit L100 in acetone: ethanol solution (external phase). Emulsion (w/o) was added dropwise into liquid paraffin containing 1% Span 20 for the formation of w/o emulsion.The micro particles were evaluated for particle size, shape, Percentage yield, entrapment efficiency (%EE) and in vitro drug release pattern by using dissolution apparatus II in phosphate buffer (pH 7.4). The microspheres were analyzed for drug-polymer interaction by FTIR. The microspheres showed standard micromeretics property and particle size was ranged from (102.35um- 110.54um). Maximum percentage yield was of A3 that was 83.3%, Maximum drug was entrapped in formulation A1 that was 93.2%. FTIR shows structural compatibilities between drug and polymer. Microspheres were compressed in tablets and they were also filled in capsule. In-vitro dissolution profile was observed for 12hours.Kinetic models were observed, the best fit model was higuchi which showed sustained effect of dosage form. Brand comparison also showed that dosage form showed more stable and sustained effect over 12 hours. Key words: Metoclopramide, Eudragit L-100, HPMC, FTIR (Fourier Transformed Infrared spectrophotometry), % Entrapment Efficiency.

Psychosocial factors for depression in family isolated personnel and its non-pharmacological therapy Saba Akram1, Irfan Bashir1,Imtiaz Majeed1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Saba Akram University of Central Punjab Email: [email protected] Contact: +92-308-4620201 Abstract Depression is a communal psychological disorder, which in severe cases, can lead to suicidal attempts. Depression is characterized by the frequent depressive episodes. Researchers have estimated that by 2020, depression will be the 2nd leading cause of disability. According to WHO statistics, 350 million people worldwide are suffering with depression. In Pakistan, the mean prevalence of depressive disorders and anxiety are 34% and Lahore has the highest number of reported cases i.e. 53.4%. Purpose of this study is to assess the factors associated with stress and depression and measures taken by students to handle it. This is both qualitative and quantitative study. It is a multicenter study in which participants were asked to fill their questionnaire. Sample size of this study was 385. The quality of life of participants checked by the Euro QOL (quality of life) 5D. Male participants can cope with stress easily as compared to female participants and 66.8% students felt depressed because of isolation. 69.1% people find it difficult to make friends. 48% students felt their life is empty without their family. 70.81% people feel bad because of homesickness. Out of 385 hostel students 52.20% were suffering with moderate depression while 29.61% felt severe depression. According to Euro QOL 5D results 66.23% students having quality of life up to 79%, 17.40% students have quality of life ranging from 71-80%. 11.94% having QOL in 81-90% range. And only 4.4% students have QOL between 91 to 100%. Eating a balanced diet, an adequate sleep, physical exercise, family contact, increasing amount of sunlight exposure, reducing stimulants and Journaling are nonpharmacological therapies for depression. This study concluded that students are unaware of depression. And a large number of hostilities students are depressed without knowing it. It is a cause of higher mortality rate because depressed people attempt suicidal attempts because of depression, so it is important to educate people about the detrimental effects of depression on their health. Keywords: Homesickness, Depression, Non-Pharmacological Therapy

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Screening of Diabetic Patients Unaware of Their Disease among Christian Community Ayesha Rauf1, Muhammad Jamshaid1, Irfan Bashir1,2, Waqas Akram1, Muhammad Nadeem Alvi1, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Ayesha Rauf 0323-1489491 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Diabetes is one of the major disease burdens in the world, affecting millions of individuals across all age, gender, income, social groups, and countries. Despite significant innovation in diabetes education and control, many people are still unaware of this disease or its symptoms. It is hypothesized that unawareness about the disease and its potential complications can lead to significant morbidity and mortality. The main objective of this study was to assess frequency and awareness of diabetes among Christian community in Lahore and to determine the fraction of undiagnosed people and to acknowledge them about diabetes. It was a cross sectional study using questionnaire, blood glucose screening, and patient education on diabetes. A sample size of 150 was calculated, questionnaires were filled by 150 random subjects and data was analyzed and interpreted by SPSS. Data was used to obtain through questionnaire, containing closed questions regarding different symptoms leading to diabetes, its implications and its management policies. Around 150 people responded to the questions and the results concluded that about 12% of people were suffering from diabetes being undiagnosed and unaware of their disease condition. The most common symptoms with high frequency includes polyuria(87.4%) and polyphagia(84.1%) along with fatigue(86.8%) and numbness(84.1%) sometimes. This study has highlighted the need of Diabetes awareness campaigns. There is need to increase knowledge about diabetes as it is having major disease burden in the world. Acknowledgement on benefits of early detection of diabetes and its better management plans must be the integral part of campaigns. The findings indicate despite different educational campaigns the yield of screening is low. Interventions are needed to help people to recognize symptoms and consult physician for appropriate follow-up. The high prevalence of undiagnosed diabetes indicates the prevalence of diabetes will continue to increase later on if remained unchecked. Implementation of effective evidence-based prevention strategies is required to reduce diabetes epidemic. Keywords: Acknowledge, Cross sectional study, Mixed approach, Polyuria, Numbness Trends of Psychoactive Agents Use among Medical Students Maryam Noshad1, Muhammad Jamshaid1, Irfan Bashir1,2, Mahmood Ahmad3, Waqas Akram1, Faheem Ahmad Siddiqui 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan 3. Sahara College of Pharmacy & Allied Health Sciences, Narowal, Pakistan Corresponding Author: Maryam Noshad +92-42-5880007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract

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Dependence and abuse of psychoactive agents is a major health related problem. The prevention and treatment of psychoactive substance use is one of the important areas of concern. Psychoactive substance use has been related to health professionals due to their propinquity to drugs such as stimulants and opiates. Educating and training the medical students regarding the effects and side effects as well as socio-economic, religious and moral insinuations of drug misuse may help combating the problem. Strenuous routine and studies burden has been a steering factor for students to use psychoactive agents as they increase brain activity. Stimulants can elevate stamina and enhance performance that may have diminished due to fatigue. The aim of the study is to perceive the trends of psychoactive substance use including information and data collection on percentage of students using psychoactive agents, most commonly used and easily available agents, source and means of access to drugs, the knowledge and awareness of side effects and withdrawal symptoms among medical students. A cross-sectional study was conducted using a self-administered questionnaire as a data collection tool. About 100 medical students of both medicine and pharmacy department from University of Central Punjab, University of Lahore and Allama Iqbal Medical Collage participated and answered the questionnaires. The data was analyzed and computed using Statistical Package for Social Sciences software. Frequencies and percentages related to all the factors were computed and compared using this software. Among 48% of males and 52% of females with 77% of these students belonging to 21-25yr of age group, 21% of students are recorded as psychoactive agent users and 79% as nonusers. Joy-seeking and a friend’s offer has been leading factor for starting psychoactive substance use among these students. Tobacco being used 15% is highly consumed psychoactive agent second being marijuana, cocaine and methamphetamine including 7% as addicts. 8% and 11% of the students have been found to experience side effects and withdrawal symptoms among those 21% of users. The 79% of nonusers reported inability to solve routine problems (17%) as the highest cause for students to start using psychoactive agents and using drug before exams (39%) has reported to be the most probable occasion. Use of psychoactive agents by medical students is a serious problem. Tobacco smoking and use of marijuana, cocaine and methamphetamine by students is a concerning issue. Training about the management of studies burden and stress is inadequate among medical students. Keywords: Psychoactive agents, use, abuse, trends, medical students

Domestic violence among married women in the locality of Lahore. Khadija Asif 1, Muhammad Jamshaid1, Irfan Bashir1,2, Waqas Akram1, Faheem Ahmad Siddiqui 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Khadija Asif Contact:+92-42-5880007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract Protection from domestic violence in married women is a global human right and public health concern. Violence against the women demands a public health response. The purpose of this study was to evaluate the percentage/range/ratio of domestic violence, to understand the causes or reasons for domestic violence and to spread the awarness of domestic violence in the locality of Lahore. It is a descriptive study. The study includes 100 married women with age range of 18- 48 years. A validated questionnaire, comprises of 20 questions, was used as a data collection tool. Random hospitals and foundations were selected with in the community of Lahore. The

37 results were analyzed by using SPSS, 21.0. v. The literacy rate was 24%. 23% women responded that they feel their husband do not love them and 20% women bear violence because of their children. There were 5% women who wants divorce from their husband and 7% women who had knowledge about violence act. Domestic violence poses a significant challenge to our society. Violence prevention programs should focus on attitudes and knowledge of a common woman about their rights. There is need to take initiatives to improve access to education for girls and boys that play a pivotal role against violence. Keywords: Violence, Domestic, Abuse, Married.

Depression among Transgender and Its Management in Lahore, Pakistan Muhammad Usman Amjad1, Abad Ali1, Danish Tahir1, Hafiz Muhammad Ehtesham1,Irfan Bashir1, Faheem Ahmed Siddiqui1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Muhammad Usman Amjad University of Central Punjab, Lahore, Pakistan Email:[email protected] Contact:+92-3214228492 Abstract Depression is a syndrome characterized by a set of mood-related symptoms, including failure of interest, feeling guilt, lack of confidence and suicidal thoughts. An internal sense for being as male, female or outside these two categories is referred as gender identity. The gender expression of transgender individuals differs from their birth sex. Worldwide, almost 60% of the transgender are affected with depression. Transgender are specifically exposed to mental health issues. Study objective was to collect local data to produce a comprehensive description of the depression related issues among transgender in Lahore, Pakistan. Research was aimed to highlight the different causes of depression of transgender. Observing transgender feedback about their various depressed states. Recommending different management strategies to alleviate the depression among transgender.A cross-sectional study was conducted among transgender in Lahore, Pakistan. We collected data from 100 transgender individuals aged between 20-50 years. All things were then briefed to the participants. For this purpose the questionnaire was prepared and distributed. The results were then gathered to deduce a conclusion.78% of transgender individuals reported that they always felt depressed due to social victimization and violence by police forces. 78% also reported that sometimes they felt depressed that they are deprived of health care facilities. 57% reported that they were never forced to sex. Research has shown that victimization and violence by police forces are the major contributors for causing depression among transgender. Ignorance by health care professionals also causes depression to some extent. However, contrary to what is generally believed they have not reported much of sexual harassment. It is recommended that in order to manage their depression problems. Public should prohibit social victimization, provide protection especially against violence by police forces and provide access to health care services. Keywords: Depression, Transgender, Discrimination, Social Support, Gender identity, mental health, Harassment, Victimization, Violence

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Role of Pharmacist in Rehabilitation of Addicts Sana Javaid1, Irfan Bashir1,2, Faheem Ahmed1 ,Imtiaz Majeed1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Sana Javaid Email: [email protected] Contact+92-324-567314

Abstract Drug abuse is rapidly growing in Pakistan as it is the worst victim of narcotics trade in South Asia region. Many individuals are victims of drug addiction and many are at a serious risk of developing habit of drug abuse; thus this has become a communal problem. It has not only affected their quality of life adversely but has also caused deterioration of their mental faculties as they waste their talent in searching of drugs for intoxication. This rapidly growing calamity has to be addressed immediately and a pharmacist can play eminent role in preventing this problem by providing patient care and arranging community activities. The aim of this study was to assess quality of life of drug addict population as part of responsibilities of pharmacist. A cross-sectional study was conducted in which data of 60 male addicts was collected on predesigned questionnaire- Euroqol 5d and Dast-10, to assess quality of life and severity of drug misuse, from locality of Data Darbar, Lahore, Pakistan. Majority (70%) of the study population belonged to the age group 20-40 years. Varied responses were obtained but general trend of poor quality of life was common. 41.7% of the respondents reported being slightly anxious or depressed. Also 71.7% of the study population had medical problems because of their drug use. This reveals that in Pakistan drug abuse and multiple health problems associated with it are increasing day by day. Pharmacological and psychosocial interventions can help reduce this. Thus, pharmacist along with other healthcare professionals can help overcome these problems and ameliorate patient quality of life by providing assistance in prevention, treatment and education regarding drug abuse. Keywords: Euro-QOL 5D, DAST-10, Addiction, Pakistan

Facial Surgeries among Burnt Females and its Cost Analysis Hafiza Aiman Ishaq1, Irfan Bashir1, Faheem Ahmed Siddiqui1, Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Hafiza Aiman Ishaq University of Central Punjab, Lahore, Pakistan Email:[email protected] Contact:+92-3334545090

Abstract A burn is an injury to the skin or other organic tissue primarily caused by heat, electricity, friction or contact with chemicals. In many cases, burns are usually facial and need surgery. Female patients, especially in Asia are at higher risk of burns because of the use of open fires for cooking, heating and lighting. The purpose of this study is to understand the treatment plan, to assess about the cost of facial surgeries, to analyze the population affordability of treatment. The data will be analyzed statistically because prevalence of minor burns in females comes out to be 40%. Data was collected in the form of questionnaire in a retrospective study. Questionnaire contains 19 questions. Data was collected from various students, working ladies and housewives of Lahore, Pakistan. All patients were females between the ages of 15-45 yrs. The majority of the participants in this study were female students. Major cause of

39 burn was acid and heat (flame) which is usually due to lack of awareness of handling flame and stove in kitchen and neglecting SOPs of working in laboratories. 50% female students got burn due to acid and flames. 26% participants had minor injuries, i.e. 10%-25%. 64% participants had minor to moderate injuries, i.e. 26%-40%. 10% participants got severe injury, i.e. more than 60%. 54% females were middle class and only 56% can afford the treatment. Recovery of these burns with medicines comes out to be 48% and 66% in females through planned surgery. This study provides a comprehensive review about causes of burns and focuses on the most affected age group, i.e. 15-30 years and their ability to take the facial surgery for rehabilitation. Keywords: Burn, SOPs, Flames, Acid, Heat.

Awareness and Self-Assessment Tool of Breast Cancer among Female Students Nida Nasir Kiyani1,Irfan Bashir1, Muhammad Jamshaid1, Waqas Akram1, Faheem Ahmad Siddiqui1, Tooba Mehboob1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Nida Nasir Kiyani University of Central Punjab, Lahore, Pakistan Email:[email protected] Contact:+92-3319114179

Abstract Breast cancer is the most common type of cancer and the leading cause of death among women of all ethnic and age groups. According to World Health Organization (WHO ) report approximately 1.5 million women are diagnosed every year with this lethal disease. In Pakistan due to lack of awareness diagnosis is being made at advance stages. Primary prevention and earlier diagnosis of breast cancer can be made possible through education and training of females to examine themselves. The prevalence of breast cancer is 1 in 8 women all over the world. The objective of this study is to create awareness about breast cancer among female students or other female population by evaluating their knowledge regarding risk factors, symptoms and methods of screening and their perception towards the disease treatment outcomes. A cross sectional study was conducted using a self-designed questionnaire distributed among 110 female students of University of Central Punjab. Duration of study was 3 months from February to April, written consent was taken from every participant prior to initiating research. Different parameters like steps involved in breast self-examination, risk factors and how often they examine their breast was analyzed. The results for each item on questionnaire were reported, as frequencies and percentage using Statistical Package for Social Sciences software.The results showed that large number of female university students had insufficient knowledge of breast cancer. The most common reason for not doing breast self- examination was "not knowing how to perform breast self-examination". Only 39.1% females were aware of steps involved in breast self-examination. 70 % female students could identify the risk factors contributing to breast cancer.34.5 % of female students were well informed that a breast lump can be of cancerous origin. This study highlighted the need of a breast cancer awareness campaign, which should also emphasis the importance of early detection and reporting of breast cancer. Measures should be taken to increase both knowledge and awareness on breast cancer, its risk factors, signs and symptoms and breast self-examination tools for early detection and eradication of this disease in adolescent females. Keywords: Awareness, Breast Cancer, University Students

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Early Stage Screening and Prevention of Diabetes among People in the Rural Areas of Punjab Nimrah Tabassum1, Quratulain Shamim1, Faheem Ahmed1, Irfan Bashir1, Tooba Mehboob1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Nimrah Tabassum University of Central Punjab, Lahore, Pakistan Email:[email protected] Contact:+92-3314866183 Abstract Diabetes mellitus is a chronic health problem of all age groups and both genders, globally. It is characterized by defects in the levels of insulin in the body resulting in hyperglycemia. According to WHO, the incidence of Insulin Dependent (IDDM) and Non-insulin Dependent (NIDDM) types of Diabetes Mellitus is increasing and badly affecting the lives of more than 110 million people annually. According to Pakistan National Diabetes Survey, the prevalence of diabetes in Pakistan in 1998 was 12.14% in males and 9.38% in females. Individuals with undiagnosed diabetes are at higher risk of stroke, coronary heart disease, hypertension, and obesity. The purpose of this study is to manage diabetes with appropriate and evidence-based knowledge of disease, to help under privileged people in rural areas by assisting them with the tools and guidelines for a better lifestyle and to educate them about the prevention and complication of the disease. It was a cross sectional study which involved screening of diabetes among people from rural areas of Punjab. The study included 150 participants from the areas of Jagdeovillage, Sharakpur and Manga mandi in Punjab, Pakistan. The study collection tools included interviews and questionnaires in which the participants were asked closed ended questions about the early symptoms of the disease. The study involved both genders of all ages including pregnant women. The data was collected with consent from participants and was analyzed using SPSS version 21. The participants from rural areas were screened during the study based on different symptomatic aspects such as polyuria, weight loss, obesity, retinopathy and family history of diabetes. Frequency and correlation tests were applied for the results and about 74.7% of the participants were diagnosed with pre-diabetes or diabetes. The incidence is higher in men (54%) than in women (46%).The low educational status (12%) in the rural areas is the major reason for unawareness about the disease. The risk for developing diabetes and associated complications in rural areas is higher than in urban areas because of lower educational status and lack of awareness about the disease. The increasing prevalence of the disease calls for effective management and awareness for the people living in rural areas of Punjab. Keywords: Diabetes Mellitus, hyperglycemia, Non-insulin Dependent Diabetes Mellitus, Insulin Dependent Diabetes Mellitus. Depression among Christian Community in Localities of Lahore, Pakistan Haseen Fatima Niazi1, Irfan Bashir1, Muhammad Jamshaid1, Waqas Akram1, Faheem Ahmad Siddiqui1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Haseen Fatima niazi1 University of Central Punjab, Lahore, Pakistan Email:[email protected] Contact:+92-3350493522 Abstract Depression is one of the common mental disorders that are prevailing rapidly in different communities. Christian community, being a minority, experiences certain socioeconomic issues that contribute in their daily life depression. Study was conducted to determine the prevalence of disease in Christian community

41 and various actual and potential causes of disease were discussed along with its remission and severity rate. According to a research study conducted in U.S., prevalence rate of the disease in adults is 28%. Another study revealed prevalence of mild to moderate depression to be 24.8% in Lahore, Pakistan. But, this study was not yet conducted upon the Christian community specifically in localities of Lahore. Therefore, main objectives of this study were to determine the prevalence, severity, actual and potential causes of disease and creating awareness about the prevailing disease in the Christian community in Lahore, Pakistan. A cross-sectional study was conducted at Christian community areas, in localities of Lahore, Pakistan. PHQ-9 was used, with permission by Pfizer Pharmaceutical Corporation, to determine the prevalence and severity of depression among study population of 290 respondents. Detailed interviews were conducted in order to find the actual and potential causes of disease. Collected data was analyzed using the method for initial diagnosis and severity determination specified with PHQ-9. Data was also analyzed using SPSS version 21. And the analysis results were carefully observed, interpreted and discussed with co-observers. Study results have shown that; 10 out of 290 participants i.e., 3.44% were found to have severe MDD. 36 out of 290 participants i.e., 12.41% were found to have moderately severe depression. 44 out of 290 participants i.e., 15.17% were found to have mild to moderate depression. Overall, the prevalence of depression comes out to be 31% among Christian community in localities of Lahore. Socioeconomic status, job discriminations, religion biasness, domestic issues, concomitant diseases, and lack of acknowledgement being a Christian; were among the factors that led them to the prevailing depression. Further, ways should be devised and steps to be made in order to overcome these factors, effective management and prevention of disease. Proper counseling and ensuring patient compliance can also help serve the purpose. Keywords: Socioeconomic Issues, Christians, Hopelessness, Depression.

Life Saving Medicine shortages: A Study of Community Pharmaciesin Lahore Zubair Ali1, Muhammad Talha Shamas1, Irfan Bashir1, Faheem Ahmed1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Zubair Ali Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Email:[email protected] Contact:+92-3134750062

Abstract A medicine supply difficulty requires the use of a substitute agent that affects patient’s health.Medicine shortage may result incomplete medical care and patient may not receive appropriate treatment at all. Moreover, sometime expensive treatment resulted than the actual designated treatment due to shortage. The study highlighted the frequency, the reasons behind medicine shortages, extent of patient inconvenience and problems that shortage of medicine caused for the pharmacies. Cross-sectional study was conducted among 25 pharmacies in Lahore. A well-structured questionnaire was designed based on the frequency of medicine shortage, reason behind shortages, the outcome of patient inconvenience and problems for the pharmacies. Data were collected and analyzed by using SPSS, (56%) pharmacies reported that they receive advance notifications of shortages, (40%) from Distribution center, (68%) increased in the frequency of shortages over the past 12 months, (56%) pharmacies reported patient inconveniences, with (60%) customer left unsatisfied, and (76%) reported the reason behind medicine shortages were at manufacturing site. Lifesaving medicine shortages is most common in community pharmacies in Lahore. The shortages may cause significant loss for the customer or the pharmacies in term of customer dissatisfaction and increase in the workload of the pharmacy staff. Key Words: Lifesaving,Medicine Shortages, Community Pharmacies

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Food Poisoning Cases among Pediatrics in the Locality of Lahore, Pakistan Resham Nawab1, Muhammad Jamshaid1, Irfan Bashir1,2, Muhammad Nadeem Alvi1, Imtiaz Majeed1, Ambreen Ishaque1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author: Resham Nawab +92-42-3588007 Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Disease of infectious nature caused by the consumption of unhygienic food or water may result in higher incidence of food poisoning.The symptoms may include vomiting, diarrhea, abdominal pain, nausea, headache and fever. The purpose of this cross-sectional study was to find out the major food poisoning reasons in children and to determine the level of understanding of patients about food poisoning and to assess the attitudes and practices of patients adopted in treatment. The study included 100 pediatric patients with food poisoning indications. A set of questions regarding the disease were asked from patients and their attendants. The data was collected from different hospitals from the randomly selected population showing symptoms of vomiting and diarrheal episodes. The study revealed that food poisoning cases mostly occur in children under the age of 6 years. 66% of the population had the disease due to unhygienic conditions and poor personal hygiene, while 12% were suffering from food poisoning due to raw food. This study led to the conclusion that in Pakistan, food poisoning is mostly caused by unhygienic conditions. Pediatrics has weak immune system and due to unhygienic conditions, they are easily infected with this infection. So, it is suggested that hygienic conditions and proper cleanliness is necessary to avoid not only food poisoning but also to check the spread of other infectious diseases in children. Keywords: Unhygienic Conditions, Personal Hygiene, Knowledge, food hygiene

Obesity among Youngsters with Minimal Physical Activity Haris Ali1, Irfan Bashir1, Waqas Akram1, Tooba Mehboob1,MuhammadNadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Haris Ali University of Central Punjab, Lahore, Pakistan Email: [email protected] Contact:+92-3204164004

Abstract Youngsters are gaining weight faster irrespective to any age group. Gain in weight and appearance of obesity-associated comorbidities typically start off in young age. Psychological suffering and mental health related problems are frequent and enervating. Youngsters may have some physical morbidities which may aggravate in later stages of their life like obesity, polycystic ovarian syndrome or hypertension. Prevalence of obesity in Pakistan is 25% because

43 of diet, sedentary lifestyle, environment, genetics, stress and emotional factors etc. purposes underlying this study are to access occurrence of obesity in young age group with minimum physical activity and to create awareness about obesity and healthy lifestyle. A cross sectional study was conducted at different educational institutes of Lahore, Pakistan and questionnaire about obesity was distributed among obese individuals (n=200). Data on BMI, educational, socioeconomic status and sedentary lifestyle of individuals was collected. Collected data was analyzed using SPSS. 21. Study population included 55.5% and 45.5% of males and females respectively. On the basis of BMI 6% of individuals were in between 25.0-29.9, 38% fall in range of 30.0-34.5, 49.5% were in between 35.0-39.9 and only 6.5% of total population falls in category of highly obese and have BMI above 40.0. Effects of obesity on social life and uncomfortable feelings in individuals due to obesity were significantly correlated (r=0.569) to each other. 89% of total population presumes that minimal physical levels of activity in their daily routine is the main cause of their suffering from obesity. While, 11% individuals figure out to have different causes linked with their obesity. Only 15% believed that, they were suffering from obesity associated with trauma, they suffered in their childhood. Current study confirms that sedentary lifestyle is one of the major causes of obesity condition and associated risk factors in youngsters. Minimal levels of physical activity and reduced exercise are playing important role in obesity. Adequate exercise and improved diet with minimum use of junk food can reduce the prevalence of obesity in any of the age groups. As obesity is alarming condition now a days, steps should be taken to raise public awareness. Keywords: Sedentary lifestyle, Diet, BMI, Youngsters

Pharmaceutical Care for Thalassemic Patients Ali Hassan, Irfan Bashir1,2 ,Ghulam Jilany Khan1, Muhammad Jamshaid1, Waqas Akram1 1. Faculty of pharmacy, University of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan Corresponding Author Ali Hassan Contact:03314540540 Email:[email protected] Abstract Thalassemia is a disorder in which body has dysfunctional red blood cells (RBCs) due to abnormal hemoglobin chain. It leads to potentially life-threatening conditions. Many important pharmaceutical interventions like blood transfusion and administration of iron chelating agents are applied in it, therefore pharmaceutical care is vital for patients suffering from this disorder to assure proper provision of drug therapy to improve the patient’s quality of life, reduce medication related adverse events and to reduce the morbidity as well as mortality. According to world health organization (WHO) statistics the ratio of serving pharmacists to hospital beds is 10/10,000. This clearly indicates a serious scarcity of pharmaceutical care for thalassemia patients. The purpose of this study is to further evaluate provision of pharmaceutical care for thalassemia patients in hospitals and thalassemia centers and also to find common complications in treatment related to thalassemia and effectiveness of pharmacists’ intervention to overcome blood transfusion reactions thus giving a clearer view of pharmaceutical care for thalassemia patients. In our retrospective study, data was collected from multiple health care facilities, through questionnaires having questions regarding counselling of patients, disease management, adverse drug reaction (ADR) reporting, patient compliance etc. The checklist consisting of 12 questions was filled by hospital pharmacists. The data was analyzed through SPSS software. Results showed that availability of pharmacists in hospital was 57.1%, 42.9 % pharmacists were found to coordinate with the physicians actively. 57.1% was the interaction rate between thalassemia patients and the pharmacists. 42.9%

44 pharmacists were involved in ADR reporting and also 42.9% pharmacists were involved in active patient counselling. The results indicate appreciable presence of pharmacists in hospitals of Lahore, rather than thalassemia centers. The results also indicate poor coordination between pharmacists and physicians therefore the presence of pharmacists, interaction of pharmacists with physicians, interaction of pharmacists with the patients and the role of pharmacists in active counselling must be improved in order to attain optimum pharmaceutical care of thalassemia patients. Keywords: Pharmaceutical Care; Thalassemia; Blood Transfusion; Patient Care

Precocious Puberty among Fast Food Users: Myths & Realities Madiha Maqbool Hussain1, Irfan Bashir1, Faheem Ahmed1, Imtiaz Majeed1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Madiha Maqbool Hussain University of Central Punjab, Lahore, Pakistan Email: [email protected] Contact: +92-3024999038 Abstract Puberty is multifaceted developmental processes that starts in late childhood and through which reproductive capability is attained. In precocious puberty appearance of physical and hormone changes or signs occur earlier than normal. Recent studies have show that signs of early puberty usually are commencing between 6 to 8 years. But in past early puberty was considered in girls younger than 8 years. Puberty before the age of 9 years is considered precocious for boys. Several factors are attributed to this early puberty according to Scientists. As we know people are switching and our society is moving day by day faster towards ready-made products which has become a part of everyday life. It is estimated that these factors are mostly linked with precocious puberty. The study aimed finding out cause of early puberty due to fast food. The Qualitive study was conducted and it is based on questionnaire and interviews to obtain statically useful information about consumption of fast food. And data collected from number of fast food restaurant of Lahore. Sample size was 30. The result was obtained through the collected data, which indicated that the population consuming fast food in excess amount were at high risk of precocious puberty. Fast food consumption also leads an increase in the body mass index. It was observed that the fast food consumption is increasing day by day and leading to the increased in BMI as 34% of the population is consuming fast food weekly. The results indicate that precocious puberty is associated with high consumption of animal protein i.e. used in fast foods. The research shows though dietary modification and getting rid of fatness may reduce the risk of early menarche. And it indicates due to this diet average age of puberty is dropping. Keywords:Early Menarche, Dietary Modification, Dropping, Multifaceted

Antenatal Care Access to Middle Class Females Zainab Yaseen1, Irfan Bashir1, Faheem Ahmed1,Muhammad Nadeem Alvi1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Zainab Yaseen1 University of Central Punjab, Lahore, Pakistan Email: [email protected] Contact: +92-3094683371 Abstract Antenatal care is extremely important service that should be provided to female during pregnancy and neonate before and after birth, as antenatal care can identify maternal as well as fetal complications related to health. Care during pregnancy and at the time of postpartum is extremely important in order to

45 enhance the maternal and neonatal quality of life and health. The objective of this survey was to ascertain relationship between socioeconomic status and utilization of antenatal care among young pregnant middle-class females about the importance of antenatal care utilization. Qualitative type of study was conducted among young pregnant females belonging to middle class families, in a purpose to square off different factors influencing the good antenatal care utilization. Interviews were carried out from participants using structured questionnaires. Young pregnant females who had at least one antenatal visit during pregnancy were included. Pregnant females who were sick or have other problem were excluded. The analyzed data showed that there is insignificant relationship between antenatal care utilization and middle-class females as ratio of about 37.83% pregnant females of middle class families were not visiting regularly to the health care center during pregnancy mostly at the time of their 3rd trimester they visited only with concern to register themselves for the delivery rather than standard antenatal visits. I have concluded that infrequency in visits is mainly due to illiteracy, long distance from maternity hospital and long waiting hours to get their turn for antenatal checkup. There is a need to educate and spread awareness among females about the importance of standard antenatal visits. Keywords: Antenatal Care, ANC, Middle Class Females ANC, Standard ANC.

Sulforaphane Influence the Absorption of Heterocyclic Amines Sana Jameel1, Rabi Ali1, Sarah Ahmad1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Sana Jameel Faculty of Pharmacy, University of Central Punjab Email: [email protected] Phone:+92-42-5880007 Abstract The aim of the Study is to investigate the ability of isothiocyanates to prevent the absorption of the heterocyclic amine 2-amino-3-methylimidazo-[4,5-f] quinoline (IQ) in the body, by facilitating its excretion via increasing the synthesis of efflux transport proteins such as multi drug resistance proteins, MRP2 and MDR1 (downstream and upstream), which are regulated through PXR activation. PXR is known to be induced by rifampicin (drug used in the project) which subsequently activate transcription of reporter genes (MDR1 and MRP2).Sulforaphane (SFN), a potent cancer preventive agent, is a dietary isothiocyanate found abundantly in broccoli. SFN has been extensively studied as a cancer chemopreventive agent and most studies have associated its anti-cancer effects with the induction of protective phase II metabolic enzymes via induction of apoptosis, suppression of the cell proliferation and inhibition of angiogenesis.Interestingly, SFN is known to inhibit pregnane X receptor (PXR) activation. PXR functions as a xenobiotic sensor, to coordinately regulate xenobiotic metabolism via transcriptional regulation of xenobiotic-detoxifying enzymes and transporters such as Multiple Drug Resistance 1 (MDR1). For this study PXR was co-transfected into Huh7 cells with MDR1 downstream, MDR1 upstream, MRP2 and the expression of reporter gene plasmids will measure via SEAP (Secretory Alkaline phosphatase) assay, indirectly measuring the effect of these transporters. The LDH assay was also performed for the assessment of viability of cells after the treatment with isothiocyanate (SFN) and rifampicin.It was demonstrated in the study that SFN inhibits the activation of human PXR in human heptoma cell lines as well as inhibiting the expression of MDR1 (Downstream) export transporter. Furthermore, SFN antagonizes PXR activation thereby reducing MDR1 (Downstream) expression on co- treatment with rifampicin, a known agonist of PXR, reflecting its role as specific antagonist of PXR. Thus, SFN is identified as a naturally occurring antagonist for PXR, giving the view of the possibilities that SFN may compete with bioavailability of chemical carcinogens and can reduce the frequency of adverse drug reactions, which are secondary to PXR-mediated induction of drug clearance viacytochrome (CYP3A4), MDR1 and other genes regulated by PXR.

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Keywords: Isothiocyanate, Sulforaphane, Rifampicin, Cytochrome, Multiple drug resistance, pregnane X receptor

Pharmacy Services Provided to Pediatrics in Various Hospitals of Lahore, Pakistan Laiq-Ur-Rehman Khan1, Hamza Rohail1, Dr. Qurat-Ul-Ain Khan3, Dr. Sidra Khan4, Irfan Bashir1,2 1. Faculty Of Pharmacy, Univerity Of Central Punjab, Lahore, Pakistan 2. Foundation For Young Researchers, Lahore Pakistan 3. Punjab Institute of Cardiology, Lahore, Pakistan 4. Sheikh Zayed Hospital, Lahore, Pakistan Corresponding Author Laiq-Ur-Rehman Khan Email: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan ______Abstract Children are more prone to medication errors and resulting harm. Hospital settings lack trained staff oriented to pediatric care, pediatric care protocols and safeguards and easily accessible pediatric reference materials regard to medications. The aim of the study is to determine the availability of pharmaceutical services provided to pediatrics in various hospitals of Lahore, Pakistan in order to highlight the deficiency present if any on the basis of which recommendations could be made. The study broadly emphasized on pharmaceutical services including the role of hospital and clinical pharmacist and optimizing medications for pediatric population. Quantitative yet largely qualitative (mixed study) method was used in estimating the prevalence and analyzing the comparison with the help of survey bases questionnaire. Pilot study was carried out in three hospitals which adhered to both the inclusion and exclusion criteria. Survey was conducted in various well known hospitals of Lahore, including Services Hospital, Jinnah Hospital, Mayo Hospital, Shaukat Khanum Cancer Hospital, Children’s Hospital, Defense National Hospital, Sheikh Zayed Hospital, CMH, Shalamar Hospital, Family Hospital, Rasheed Hospital, Aadil Hospital, Niazi Hospital, Saadan Hospital, and Latif Hospital. The results showed that 60% hospitals had Pediatric ICU’s yet no pharmacist available in them. Frequency of a Pharmacist’s visit to Pediatric care units was only 40% and only 27% maintained patient medication profile. 40% are involved in ADR reporting. In 7 out of 15 selected hospitals, the pharmacist did take part in selection and optimization of appropriate drug treatment and 60% of them does take part in dose monitoring and adjustment. 10 hospitals had a specialized pediatric formulary and interestingly all the hospitals believe that the presence of a full time Pediatric Clinical Pharmacist is the need of time. Sadly, the level of interaction between Pharmacist and other health professions was found to be 33% only though 73% hospitals agreed the positive impact of the availability of Pharmacist and the services they get from them. Only 13% of the available pharmacists were found trained in Emergency Respiratory Resuscitation. 40% hospitals did not have a safe way of avoiding medication errors. Limited role of pharmacist is a leading barrier in providing ideal pharmacy services. There is a greater room for improvement in establishing the role of Pharmacist in pediatric critical care and for Pharmacist to acknowledge their worth and position.

Development of Cardiovascular Risk Screening Services for Community Pharmacy in Lahore, Pakistan Kanza Tariq1, Fatima Amin1 1. Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan Corresponding Author Kanza Tariq Email: [email protected] Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan

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Abstract Cardiovascular Diseases are the primary cause of sudden deaths globally and Cardiovascular Risk Screening Services help identify the people who are at high risk of cardiovascular disease. For providing cardiovascular risk screening services, community pharmacists are the most easily approachable health care professionals. Current study was conducted to assess the pervasiveness of cardiovascular disease risk among the clients visiting pharmacy, identify the attitude and common barriers of both the clients and community pharmacists for providing cardiovascular risk screening services. This study involved 400 clients and 100 community pharmacists of Lahore city. Two different data collection forms were designed and were administered on the clients and community pharmacists. Results showed significant relationship between high blood pressure and diabetes with age, high cholesterol levels, BMI, tiredness, precautionary diet and lifestyle (p< 0.050). Majority of the community respondents (83.4%) were found to have multiple cardiovascular disease risk factors. Pharmacists’ attitude as barrier for providing cardiovascular risk screening services scored by the community clients was 0.44 ± 0.3 (out of 2). A significant relationship was seen between the education of pharmacists and their knowledge of cardiovascular risk screening services (p< 0.050). Mean scores of items of job satisfaction and attitude of community pharmacists for cardiovascular risk screening services provision were 0.42 ± 0.04 (out of 1) and 4.09 ± 0.04 (out of 5), respectively. T-test results showed significant difference between gender of pharmacists and job satisfaction (t = 2.060, df = 64, p = 0.043). This study concluded that cardiovascular risk screening services by community pharmacist has the potential to decrease cardiovascular diseas risk. People have shown willingness but awareness is still needed.

Analysis of Different Tetra Packs of Milk Available In the Market Hira Majeed1, Ghulam Jilany Khan1, Irfan Bashir1,Khalid Idrees1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Corresponding Author Hira Majeed1 University of Central Punjab, Lahore, Pakistan Email: [email protected] Contact: 03247772486

Abstract Different types of tests were done for the analysis of tetra packs of milk. Sterility testing were performed by checking the growth of bacteria in the milk. Present study is focused to analyze the presence of contamination or the possibility of contamination within the tetra packed milk. A well-known tetra packs were obtained from the local market and were assessed to check the microbial growth of bacteria (in which the gram staining was done) , pH of milk ( checked by using glass electrode pH meter), and Viscosity test for milk ( checked by using Ostwald’s viscometer). Results showed bacilli types of bacteria that were grown in milk. which may be an indication of environmental contamination and may require further testing.Colonies of bacteria were observed in the samples of the milk. Bacilli bacteria were observed and colonies are counted separately according to each tetra pack. PH of milk was determined that comes out to be: Good Milk = 6.9, Prema=7, Milk pack=6.6. On the other hand, viscosity was also checked that comes out to be Good Milk=1.17cP, Prema=1.13cP, Milk pack=1.49cP. Different tests were performed and the results are then compared. pH of all brands of tetra packs of milk was in the normal range as from 6.5-6.7 it also may be neutral to 7. Viscosity calculated was also in the range of 1. Bacilli bacteria are observed which may be an indication of environmental contamination and may require further testing. Keywords: Viscometer ; Glass electrode ; Tetra pack ; Contamination

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Incidence of Drug-Drug Interactions from Poly Pharmacy Prescriptions at Tertiary Care Hospitals of Pakistan. A Retrospective Cross-Sectional Study. Azeema Tayyab1, Sana Hanif1, Omer Salman Qureshi1, Muhammad Ijaz1, Riaz Ahmad1, Farah Abid1, Muhammad Ali Syed*, Javed Iqbal1, Amir Rasheed1, Abdullah Abdo Albegali1, Tahira Iqbal1, Aatika Zafar1, Hira Khan1. 1Department of Pharmacy, the University of Lahore, Pakistan. Corresponding Author Muhammad Ali Syed Department of Pharmacy, the University of Lahore, Pakistan Tel: +923334315314, Email: [email protected]

Abstract In Pakistan, polypharmacy is frequently practiced which results in serious adverse effects and drug-drug interactions (DDIs) ultimately leading failure of pharmacotherapy. A retrospective cross-sectional study design was performed. This study was designed to evaluate the incidence of DDIs in polypharmacy prescriptions (PPRx). In this study, incidence of DDIs, types, severity, interaction level, current and previous medications, patient counselling and other factors related to DDIs were studied. Data obtained from 210 patients were coded and analyzed using SPSS version 20. From the totalof 210 PPRx, DDIs were present up to anextent of 47.5%, where males were 48.1% and females were 51.9%. Incidence of moderate and severe DDIs were 30.0% and 2.4% respectively. DDIs found in PPRx were mainly due to pharmacokinetics (34%), pharmacodynamics (35%) or both (14.8%) per PPRx. Chi-square test was applied on results to estimate the association of factors with polypharmacy. Analysis revealed that the polypharmacy DDIs were significantly associated wih gender (p<0.045), age (p<0.048), more than one concomitant disease (p<0.001).DDIs due to polypharmacy existed at a higher rate in current findings in Pakistan as there is no screening on the PPRx. The community and hospital pharmacist should be involved in such critical prescriptions that can pose adverse drug reactions to the patient’s body in order to improve the quality of life of patients. Keywords: Drug interactions, Cross-Sectional Study, Polypharmacy Prescriptions, Drug Interactions in Pakistan. Particles Stability with Different Techniques Zara Asghar1, Madeeha Akram1, Rabia Afzal1, Naveed Akhtar1, Muhammad Asadullha Madni1, Muhammad Qamar-uz-Zaman1, Talha Jamshaid *1,2,3 1. Islamia University Bahawalpur, Faculty of Pharmacy and Alternative medicines, Bahawalpur 2. University Claude Bernard Lyon 1, France 3. Foundation For Young Researchers, Pakistan. Corresponding Author Talha Jamshaid Email: [email protected] Contact# 00923328694049 Abstract

Magnetic hybrid colloidal particles can be characterized and measure there stabilities using various techniques and numerous tools leading generally to particles size, size distribution, and electrokinetic properties. However, the chemical composition of these hybrid particles can be estimated using thermal gravimetric analysis (TGA). More interestingly, the combination of this quantitative technique with the magnetization measurement leads not only to chemical composition but also to the overall polymerization

50 conversion and more precisely to the polymerization conversion on the seed particles. In fact, the TGA performed on dried magnetic particles leads to exact organic/inorganic chemical composition. Regarding the magnetization, the amount of magnetic material can be deduced, and consequently, the amount of non-magnetic material can be also estimated. Thus, TGA and magnetization measurements are considered as complementary techniques for characterization of magnetic hybrid colloidal particles Colloidal Particles for in-vitro Applications Saba Ijaz1, Sana Arshad2, Naveed Akhtar1, Haji Muhammad Shoib Khan1, Talha Jamshaid *1,2,3 1. Islamia University Bahawalpur, Faculty of Pharmacy and Alternative medicines, Bahawalpur 2. University Claude Bernard Lyon 1, France 3. Foundation for Young Researchers, Pakistan. Corresponding Author Talha Jamshaid Email: [email protected] Contact# 00923328694049 Abstract

Micrometer magnetic hybrid particles are of great interest in biomedical field, and various morphologies have been prepared via encapsulation processes. Regarding submicron, only few processes have been investigated and the most recent one leading to highly magnetic submicron magnetic hybrid particles is based on oil in water magnetic emulsion (MES) transformation. The encapsulation of magnetic iron oxide nanoparticles forming oil in water MES was investigated using different styrene/cross-linker divinylbenzene volume ratio in the presence of potassium per-sulfate initiator. The encapsulation performed is basically conducted by using well-defined oil in water MES as a seed in radical emulsion polymerization. Magnetic particles are largely used in various applications and particularly in in- vitrobiomedical diagnostic and bio-nanotechnology. In fact, they have been employed for extraction of various biomolecules even from crude samples and as solid support in numerous samples' preparation for in-vitro diagnosis. Nowadays, they are also successfully being exploited as a carrier of biomolecules in microsystems, microfluidics, lab-on-a-chip and for detection in specific biosensors. Before any use or any preparation of magnetic hybrid particles, various factors should be considered in order to perfectly target the suitable applications. For instance, in case of nucleic acid, the particles shouldn't induce any inhibition of biological amplification techniques. For microfluidic, these particles should be colloidal stable in order to avoid any jump in the microfluidic canals. Regarding biosensor, these particles need to be chemically well designed generally to enhance specific detection or specific signal. Superparmagnetic Particles and their Importances Usama Jamshaid1,2, Dure Nayab3, Rabia Mushtaq3, Naveed Akhtar3, Qazi Adnan Jamil3,Jafar Hussain Sherazi1, Talha Jamshaid2,3,4 1. University of Strasbourg, Strasbourg, France 2. Foundation for Young Researchers, Pakistan 3. Islamia University Bahawalpur, Faculty of Pharmacy and Alternative medicines, Bahawalpur. 4. University Claud Bernard Lyon 1, Lyon, France. Corresponding Author Talha Jamshaid Email: [email protected] Contact# 00923328694049 Abstract Biological applications with super-paramagnetic nanostructures particularly functionalized iron-oxide based nanoparticles (IONPs) have been researched.Nanomaterials, containing iron have gain great interest

51 due to their magnetic behavior which makes its specific role in targeted drug delivery, water treatment and other areas of nano-medicine. Since last decades, iron oxide based magnetic nanoparticles considered for magnetic hyperthermia goals, cell sorting and as contrast agents for magnetic resonance imaging. Iron oxides and in particular magnetite (Fe3O4) and its oxidized form maghemite (γ-Fe2O3) have attracted much interest due to their biocompatibility, low toxicity, and cost-effectiveness. Because of their unique physicochemical properties, IONPs extends applications in labelling and sorting of cells, cell transfection, tissue-specific drug/gene delivery systems and positron emission tomography (PET). Nanoparticle have unique superparamagnetism property which have been playing remarkable role in fast separation and particularly for in- vitro biomedical diagnostic domain.

Assessment of Knowledge, Attitude and Practice among Diabetic Population A Cross-Sectional Study Wajiha Ahmad1, Wajiha Razzaq1, Kanza Arshad1, Madiha Razzaq1, Somia Kanwal1, Wajiha Rasheed1 1. The Islamia University of Bahawalpur, Faculty of Pharmacy and Alternative Medicine, Punjab Pakistan. Corresponding Author Wajiha Ahmad Email:[email protected]

Abstract Objective of study is to assess present knowledge, attitudes and practices of diabetic patients toward the management of diabetes.400 DM patients were participated in this survey based cross-sectional study. Patient’s knowledge, attitude and practices were assessed through semi structured questionnaire. Majority of the participants i.e. 377 (94.2%) have poor knowledge about disease types. The only 131 (32.8%) patients were having knowledge about random blood sugar level. Most of the participants (N=363, 90.7%) reported that oral hypoglycemic agents and/or insulin necessary for management of diabetes but they were unable to differentiate their use during either type of diabetes. Among the total of patients 377 (94.8%) agreed that controlled and planned diet should be followed to control diabetes. Only 185 (46.2%) agreed that upon control of diabetes, the medicines can be stopped immediately while other’s response was neutral and disagree and p-value is 0.002. The majority of the participants (N=339, 84.8%) agreed that diabetic education programs are necessary for disease management. Regardless of having sufficient knowledge about disease, patient’s practice was poor as 265 (66.3%) patients were going for follow-up regularly to physician, 228 (57.0%) reported that they exercise regularly. 297 (74.3%) follows a controlled and planned diet while others not.The study showed low levels of diabetes awareness but positive attitudes towards the importance of DM care and satisfactory diabetes practices in Pakistan. Programs to increase patient’s awareness about DM are essential for all diabetics in Pakistan in order to improve their management toward disease.

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Assessment of Health-Related Quality of Life Quality of Life among Elderly Population of Bahawalpur, Pakistan Aqsa Tahir*1, Aleema Iftikhar1, Wajiha Rasheed1, Somia Kanwal1 1. Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur, PunjabPakistan Corresponding Author Aqsa Tahir Email:[email protected]

Abstract

The present investigation aimed at the assessment of health related Quality of life in elderly population and the evaluation of positive and negative indicators that influence the HRQoL significantly. This was descriptive, cross-sectional and analytical study. HRQoL was assessed by using WHOQoL-BREF. The data was collected from 384 respondents of Bahawalpur area with age more than 50 years. The data was analyzed by Pearson's correlation coefficient to determine the level of significance between different domains of WHOQoL-BREF. Paired t-test was used to compare difference between mean scores of different domains. In all 384 individuals, 201 of the participants were males while 183 were females. All of the participants were married and majority of them were living in their homes with their families. The highest and lowest mean score of WHOQoL-BREF domains was found for physical health domain (56.23) for bodily pain and in general and for psychological health domain (58.37). The respondents significantly showed better condition on mental component than its physical component. Respondent’s economic status and living conditions were significant determinants of poorer physical health-related quality of life. The analysis suggested that the elderly people's economic status and living condition was the most significant predictor of their HRQoL. It is concluded that Quality of life of elderly people is somewhat satisfactory in Bahawalpur, Pakistan. QoL of male respondents is better than female respondents. To improve the quality of life of elderly more attention should be paid to all aspects of life including their health and economic status.

Vaccination Coverage of Children in the Slum Areas of Bahawalpur and Its Periphery Kanza Arshad1, Wajiha Razzaq1, Madiha Razzaq1 1. Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur, Punjab Pakistan Corresponding Author Kanza Arshad Email:[email protected]

Abstract Immunization is a type of intervention that can prevent the occurrence of a number of severe diseases such as tuberculosis, poliomyelitis, measles, meningitis, hepatitis B, pneumonia, diphtheria, pertusis and tetanus. Immunization is a basic tool to ensure the health of child. Main objective of the study was to estimate the vaccination rate in children of slums areas of Bahawalpur. Non-experimental, cross-sectional design was used to explore the vaccination status among the children living in slum areas of Bahawalpur and its periphery. Study population was comprised of 400 children. A semi-structured questionnaire was used as a data collection tool. The questionnaire was consisting of total 28 questions including 6 demographic questions and 22 other questions, which were used to analyze the vaccination coverage among the children of slums areas. The questionnaire was filled by collecting data from the vaccination cards of the children of the slum areas of the Bahawalpur and its periphery. Children of less than 23

53 month age were included in the study. Any children living outside the slum area was not included. Descriptive statistics was applied to summarize the data. About 91.2 % children were vaccinated while 8.8% children were non-vaccinated in the slum areas of Bahawalpur and its periphery. Out of 91.2% children, 72.2% children were fully immunized while 24 % were partially immunized. About 50.8% children have vaccination cards while 49.2% don’t have vaccination card. About 92% parents in slum areas were non-educated and only 8 percent parents were having some sort of education. Results of the study showed that vaccination coverage in the slum areas of Bahawalpur and its periphery was greater in female children than male children. The study concluded that majority of children in slum area of Bahawalpur were completely vaccinated. We observed that there were no educated people in the slum areas of Bahawalpur however a positive attitude of parents was observed about vaccination. Evaluating the Use of Central Nervous System Stimulants among Medical and Non-medical Students Madiha Razzaq1, Kanza Arshad1, Wajiha Razzaq1, Danial Umer1, Fariha Hassan1, Uzma Baig1, Tehmina Akram1 1. The Islamia University Bahawalpur, Faculty of Pharmacy and Alternative Medicine, Punjab Pakistan Corresponding Author Madiha Razzaq Email:[email protected]

Abstract Central Nervous System (CNS) stimulants are psychoactive drugs that induce temporary improvements in either mental or physical functions or both. But their potential for abuse and addiction became vulnerable. The illegitimate use of prescription stimulants by medical and non-medical students has been well documented over the past few years worldwide. Thus this study has been performed to evaluate the use of CNS stimulants among the undergraduate students of medical or non-medical field. A semi-structured questionnaire was prepared for survey based cross-sectional study. A sample of 440 students of 4th and final year was selected conveniently from four institutes, two medical colleges and two universities of Southern Punjab, Pakistan. The questionnaires were distributed equally in both medical and non-medical students. It was evaluated that medical students (n=178, 80.9%) have more knowledge about CNS stimulants then non-medical students(n=102, 46.4%).So there is significant difference in knowledge about prescription CNS stimulants but insignificant difference is present in several features like withdrawal symptoms associated with the use of the Prescription CNS stimulant in medical and non- medical students. This study revealed that (n=25, 11.4%) and (n=33, 15%) of the medical and non- medical students respectively stated to be the diagnosed ADHD patients. Total 77.7% and 70.5% medical and non-medical students respectively use non-prescription CNS stimulants (Nicotine, Caffeine, Cocaine, Energy drinks, alcoholic beverages and shisha smoking) for various purposes i.e. to improve attention, mend up the confidence and to lose weight. Medical students (n=75, 34.1%) stated to suffer with fatigue as withdrawal symptom more than non-medical students (n=41, 18.6%) while sleep disturbance issue was most commonly endure by the non-medical students. Illicit use by oral route of administration for prescription CNS Stimulantsis more among medical students than non-medical students; whereas least adopted route of administration is snorting and intranasal among both these groups of students. It is concluded thatthere is significant difference between medical and non-medical students with respect to knowledge about the appropriate use and risk association, problem encounter in concentrating things and current status of the user and the reason behind their use is less awareness, increased educational burden and lack of parental guidance.

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Assessment of Health Related Quality of Life among Hepatitis Patients in Bahawalpur, Punjab Pakistan: A Cross Sectional Study Somia Kanwal1, Aqsa Tahir1, Wajiha Rasheed1, Muhammad Ahsan1, Arshia Abbass1 1.The Islamia University of Bahawalpur, Faculty of Pharmacy & Alternative Medicine, Punjab Pakistan Corresponding Author Somia Kanwal Email:[email protected]

Abstract The objective of this study was to assess the health related quality of life of hepatitis patients and to determine the factors associated with HRQoL significantly. This was a descriptive, cross-sectional and analytical study. HRQoL was assessed by using EQ-5D-3L. 200 patientsfrom Bahawalpur Victoria hospital affected with hepatitis were assessed. Descriptive statistics were performed to describe demographic and disease related characteristics of the patients. HRQoL was scored using values obtained from the United States general population survey. EQ-5D scale scores and VAS were compared with Mann–Whitney and Kruskal-Wallis test. The mean age of the respondents was 37 years and most of the respondent were male about 121 (60.5%). About one hundred and two (51%) respondents were illiterate. A total of 46 health states were reported by the respondents. A poor HRQoL was reported in this study as the mean EQ-5D descriptive score and EQ-VAS score reported were 0.46 and 32.92 respectively.103 (51.5%) of the respondents reported extreme anxiety and depression in the fifth domain. Almost all the study variables were found to be significantly associated with EQ5D index score including age, Education, Occupation, Family income and the respondent receiving treatment right now;however VAS score was significantly linked with education, economic status and current treatment. The current study shows that HRQoL of hepatitis patients in Bahawalpur is poor.The one of the main reason for poor HRQoL score is found to be economic conditions in the developing countries. These findings suggest that increasing age, poor economic conditions,low education level and current treatment can lead to poor HRQoL. By applying these outcomes in clinical practice, HRQoL can be improved. Raising education status and reducing cost of treatment can improve the disease control and management of hepatitis. Key words: Health related quality of life (HRQoL), hepatitis, EQ-5D-3L, Visual analogue scale (VAS).

Assessment of Knowledge, Attitude and Perception of Medical and Pharmacy Students about Antibiotic Use and Its Resistance in Southern Punjab, Pakistan Wajiha Rasheed1, Aqsa Tahir1, Somia Kanwal1,Javaria Munir1, Nimra Farooq1 1. The Islamia University of Bahawalpur, Faculty f Pharmacy and Alternative Medicine, Punjab, Pakistan Corresponding Author Wajiha Rasheed Email:[email protected]

Abstract Antibiotic resistance is a major problem worldwide and equal to failure of treatment and change in antibacterial regimens.Doctors and pharmacy students are inefficiently equipped to make choices on antibiotic selection may cause antibiotics use inappropriately. This study was conducted toassess the knowledge, attitude and perception of medical and pharmacy students about antibiotic use and its resistance with the aim of helping to develop educational intervention for them.This was a cross-sectional study conducted on final year medical and pharmacy

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students from three medical colleges and two universities of southern Punjab Pakistan, respectively. A validate, semi structured questionnaire written in English was administered to the final year pharmacy (n=180) and medical students (n=250).Total 430 students (Pharmacy students=180, Medical students=250) participated in this study and response rate was 100%. The level of knowledge of both medical and pharmacy students was moderate. While 42.8% (n=77) of pharmacy students and 43% (n=107) of medical students perceived that lack of restrictions about antibiotic usage lead to antibiotic resistance.Students have perception to get more education on antibiotic resistance. Additional data are needed to determine the optimal format of the education and content to provide future practitioners with the information needed to use antibiotics judiciously. Keywords: Knowledge, Attitude, Perception, Educational intervention and Antibiotic resistance.

Knowledge, Attitude and Practices ofHealth Care Workers Regarding Polio Vaccination and Cold Chain System Wajiha Razzaq1, Wajiha Rasheed1, Madiha Razzaq1, Somia Kanwal1, Kanza Arshad1, Wajiha Ahmad1, Aqsa Tahir1 1. The Islamia University of Bahawalpur, Faculty of Pharmacy and Alternative Medicine, Punjab, Pakistan Corresponding Author Wajiha Razzaq Email:[email protected]

Abstract Worldwide 84% of children have been secured against polio and measles but in Pakistan a large number of children are still suffering from polio.Pakistan is still one of three countries that is not polio free.The expanded programme on immunization in Pakistan was initiated according to instructions of world health organization in 1978. In the present situation the main objective of expanded programme on immunization is to protect all the children in the range of 0-23 months against 8 diseases which can be prevented by vaccines, these diseases include Diphtheria, Tetanus, Tuberculosis, Pertussis, Measles, Polio, Haemophilus influenzae type b and Hepatitis B. HCW knowledge, attitude and practices are prime factors in successful implementation of immunization programme. This cross-sectional study was performed to access the knowledge, attitude and practices of HCW regarding polio vaccination and cold chain system in Bahawalpur, Pakistan. Data collection methods include questionnaire and checklist. 10 health care centers 1 hospital and 170 respondents were selected.90.6% of respondents provided correct answer that Polio virus is transmitted through infected food with feces and 97.1% respondent answered correctly that OPV drop should be given to new born children. Poor knowledge of health care workers regarding the temperature maintenance and route of OPV was observed. Poor attitude and practices of health care workers regarding polio vaccination and cold chain system were observed. 88.2 % of the respondents were unaware of the angle at which dropper should be kept while delivering polio drops. There were plenty of lacks in knowledge, attitude and practices of health care workers. Regular training and supervision of HCW and cold chain system is very necessary for the purpose of achieving the true immunization success. Key words: - HCW = Health care worker, OPV = Oral polio vaccine

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Cochlear Implants for Hearing Loss: Systemic Review Sadia Rajput1, Naveed Akhtar3, Irfan Bashir1, 2,Imtiaz Majeed1, Waqas Akram1 1. Faculty of Pharmacy, University Of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan 3. Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur, Punjab Pakistan Corresponding Author Sadia Rajput Email:[email protected] Contact# +92-42-35880007 Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Hearing impairment or inability to hear is sensory defect in human being for which modern cochlear implants are used. In 1961 William House and John Doyle implanted first cochlear implant.Cochlear implants (CI) work by converting environmental sound into electrical impulses and passes by cochlear implant electrode array that is to be placed in very close proximity to cochlear nerve. CI is surgically implanted in the inner ear that stimulates the hearing nerve in profoundly deaf individuals to receive sound. Currentstudy aims to highlight the pros and cons associated with CI. Major complications includes improper electrode placement, flap necrosis and rare facial nerve problems whereas infection, incision, facial nerve stimulation and dizziness are minor complications. Cochlear implants provides more positive results when received in younger age than in older patients. Men are sensitive to post-operative complications whereas meningitis and abnormal electrode insertion is common with women. Speech intelligibility abilities and developed speech perception in significant in children who receives cochlear implants before 10 years of age.

Stress Hyperglycemia among Burnt Patients: An Overview Sadia Rajput1, Naveed Akhtar3, Irfan Bashir1, 2,Imtiaz Majeed1, Waqas Akram1 1. Faculty of Pharmacy, University Of Central Punjab, Lahore, Pakistan 2. Foundation for Young Researchers, Lahore, Pakistan 3. Faculty of Pharmacy & Alternative Medicine, The Islamia University of Bahawalpur, Punjab Pakistan

Corresponding Author Sadia Rajput Email:[email protected] Contact# +92-42-35880007 Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan

Abstract Burns however target skin, single organ. But almost all body system is likely to be affected. Burn patients above 40% total body surface area (TBSA) followed by hyper-metabolic changes that lasts for at least 9-12 months post-injury are at risk of Stress induced hyperglycemia.Blood glucose level above 140mg/dl, a situation called Stress Hyperglycemia (SH) where in Systemic

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metabolic changes with subsequent increased gluconeogensis, glucogenolysis and resistance to insulin results in decrease glucose uptake and reduced clearance in burned patients. Current review discusses the pathophyisology of burns and stress hyperglycemia. It highlights the various risk factors specifically ICU interventions such as mechanical ventilation, renal replacement therapy, prolonged immobility, therapeutic hypothermia and vasoactive infusions of epinephrine, norepinephrine and dopamine that influence the development of SH. Some medications such as glucocorticoids parentral nutrition also increases the risk of SH. However, immediate attention to metabolic changes and treatment with Fluid resuscitation, Intensive insulin therapy and Recombinant human growth hormone (rhGH) in severely burned patients is beneficial. Growth hormone therapy provides evidence of limiting peripheral protein wasting with similar mechanism to that of insulin.

Mechanochemical Synthesis, characterization and Cytotoxicity Assay of Cadmium Chloride with L-Cysteine Rabia Ali 1, Dr. Muhammad Zahid Qureshi 2, Sana Jameel 1, Sarah Ahmad 1 1. Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan. 2. Government College University, Lahore, Pakistan. Presenting Author: Rabia Ali E-mail: [email protected] Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan Abstract The objective of this research was firstly to study the complexation of toxic cadmium with the cysteine to check the chemical and physicochemical alterations of substances resulting due to the applied mechanical force and secondly to study its effect on cytotoxicity level. Among all non- essential heavy metals, Cadmium (Cd) is significantly gaining most of the attention because of its probable toxicity in various organs of the body. Apart from the toxic effects of Cd, it also imparts carcinogenic and categorized by the International Agency for Research on Cancer (IARC) and the National Toxicology Program (NTP) as a human carcinogen. Cysteine acts as a chelatory for the removal of cadmium by forming complex through thiol group of cysteine. Metallothioneins (MTs) are small intracellular (6-10kDa) , cysteine rich proteins widely distributed in plants, bacteria, vertebrates and non vertebrates. One molecule of MT can bind to 7 atoms of Cd with high affinity The complexation in this work was done through Mechanochemical synthesis, which includes the grinding cadmium chloride with cysteine together in mole ratio of 1:2. The characterization including FTIR ,powder XRD and MTT assay for cytotoxicity was done. It was concluded that the complex was formed and resulted in complexation between metal salt and ligand. Moreover, the complex also showed decrease in cytotxicity of cadmium after complexation with cysteine and an increase in cell viability.

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Orodispersible films of an antipsychotic drug: development and physicochemical characterization

Aneela Manzoor 1, Muhammad Naeem Aamir 1*, Akhtar Rasul 1,Khizar Abbas 2

1 Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Pakistan 2The Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan

*Corresponding Author Muhammad Naeem Aamir [email protected] +923214527428

Abstract Purpose: To develop orodispersible film (ODF) of Paroxetine to deliver maximum amount of the drug in shortest duration of time. Method: ODFs were prepared by using hydroxypropyl methylcellulose (HPMC E5), polyvinyl alcohol (PVA) and different superdisintegrants at a specific proportion and subjected to characterization for folding endurance, weight variations, thickness, disintegration time, drug release pattern and drug content. The surface morphology of ODF was examined by means of scanning electron microscope. Physical compatibility between the drug and excipients was guaranteed in the ODF by Fourier transform infrared spectroscopy. Results: After characterization, result data indicated that all films prepared were transparent, smooth and elegant in appearance; showed good folding endurance; were uniform in thickness, weight and drug content. The surface pH of all ODF was found to be neutral and they disintegrate within few seconds. FTIR spectroscopy supported compatible among all excipients and they can be used together in formulation. Conclusions: It was concluded that stable paroxetine orodispersible films can be made by solvent casting technique with ultrafast dissolution rate.

Keywords: Paroxetine Orodispersible films, solvent casting method, superdisintegrants, Hydroxypropyl methylcellulose, Poly vinyl alcohol, Polyethylene glycol 400.

Understanding and elimination of curing effect of Eudragit® NE 30D coated pellets Dr. Muhammad Irfan Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Pakistan

Abstract The aim of this work was to investigate curing effect of Eudragit® NE 30D coatings and to suggest appropriate strategies to eliminate it. Non-pareil sugar cores were selected as starter cores for 10% w/w layering of propranolol HCl as a model drug using 5% w/w HPMC as binder. The drug-layered-sugar cores were coated with Eudragit® NE 30Din a lab scale fluidized bed coater to obtain 10%, 15% and 20% w/w coating levels. In order to evaluate curing effect, the coated pellets were cured at 60 °C and 60 °C-75% RH for 24 h. In vitro drug release, water

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uptake-weight loss, swelling and macroscopic pictures of the uncured and cured pellets during and after drug release were performed to characterize the coated pellets. A significant decrease in drug release clearly indicated the presence of strong curing effect with Eudragit® NE 30D coated pellets. This could be due to more water uptake, less weight loss and higher swelling of cured Eudragit® NE 30D coated pellets in comparison to uncured ones which might be caused by further gradual coalescence of flexible polymeric particles during storage at elevated temperature and humidity. The observed curing effect was successfully eliminated by reducing flexibility of Eudragit® NE 30Dcoatings by incorporating various anti-tacking agents in appropriate concentrations. Importantly, the coated pellets with no curing effect were also storage stable at 40 °C and 40 °C-75% RH up to 3 months.

In silico exploration of binding selectivity of transcriptional inhibitors in complex with cyclin dependent kinases Tahir Ali Chohan and Farzana Chaudhary 1Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, 54000, Pakistan *Email: [email protected], [email protected]

Cyclin dependent kinase 2 (CDK2), is a member of highly conserved ser/thr protein kinase family that play crucial role in regulating multiple events of cell division cycle. Over- expression of CDK2 causes the abnormal regulation of cell-cycle which is directly associated with hyper-proliferation in cancer cells making it a key therapeutic target for cancer therapy. Several CDK2 inhibitors have entered in clinical trials for cancer treatment, but they were terminated during phase II and/or phase III trials due to unwanted pharmacological effects and low specificity resulting in undesirable off-target interactions. Hence, it is still a challenging task to improve selectivity among CDKs. Recently, ShudongWang et al. have identified a series of pyrimidine-core based derivatives as CDK2 and CDK7 selective inhibitors. In this work, the mechanism that enables the ligand to selectively inhibit the CDK2 or CDK7 was investigated by EasyMIF, molecular docking simulations, MESP, molecular dynamics (MD) simulations, and free-energy calculations. We found that Lys89 is a key residue that recognizes inhibitors more effectively with CDK2 through good binding free energies rather than CDK7 (Val100). Analysis of binding free energies reveal that the favorable formation of these complexes is driven by van der Waals contributions and non- polar contributions to solvation energy.

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