Migraine is a complicated genetically influenced disorder characterized by episodes of moderate-to-severe headache. It has a prevalence rate of 10% per year worldwide and accounts for 7% of all neurological disorders worldwide. This prevalence is 6% among males and 18% among females. Despite the high prevalence of the illness, it is misdiagnosed and mistreated by healthcare professionals. Therefore, this study aimed to compare physicians' and pharmacists' knowledge, attitudes, and practices regarding migraine management. This descriptive cross-sectional study was performed in major public healthcare facilities and well-established community pharmacy chains in Lahore. A purposive sampling technique was used to recruit participants. Data were collected using a self-administered questionnaire and analyzed by calculating descriptive statistics and a chi-square test. The results showed that 61.67% of physicians were males and 60.00% of pharmacists were females with five years or less of working experience. Most healthcare professionals were well aware of the episode duration, definition of chronic migraine, and its types (physicians = 70.00%, 72.78%, 78.33%; pharmacists = 75.71%, 67.14%, 71.43%, respectively) and provided patients with information regarding migraine triggers, drugs causing migraine, side effects of drugs, and guidance to prevent side effects. Moreover, most healthcare providers considered prevention and acute treatments as a part of a broader approach to managing chronic migraine and considered prescribing preventive medicines at lower doses to minimize potential side effects. The knowledge of physicians and pharmacists was significantly different regarding migraine-associated symptoms, preference for nonpharmacological interventions to alleviate symptoms of chronic migraine, and consideration of prevention and acute treatments as part of the broader approaches to managing chronic migraine (p < 0.05). The study concluded that the physicians' and pharmacists' knowledge, attitudes, and practices were good. However, healthcare professionals' knowledge significantly differs regarding migraine-associated symptoms, preference for nonpharmacological interventions to alleviate symptoms of chronic migraine, and consideration of prevention and acute treatments as part of the broader approaches to managing chronic migraine.
Anxiety and depression are common worldwide and often occur together. Anxiety can alter appetite, causing women to consume more food than usual, leading to changes in eating behavior and obesity. This comparative cross-sectional study compared the severity of depression, anxiety, stress, and eating disorders among working and nonworking women visiting community pharmacies. Data were collected through face-to-face interviews with 244 working women and 267 nonworking women. The data were analyzed using descriptive statistics, and a chi-square test was conducted to evaluate differences in the severity of depression, anxiety, stress, and eating disorders between the two groups of participants. Most participants were literate; approximately half of the working (50.82%) and nonworking women (55.06%) had a normal body mass index. There were significant differences between the working and nonworking women in terms of their education and physical activity levels (p < 0.05). Both groups were identified as being at risk of developing bulimia, but their ability to control eating habits differed significantly (p = 0.008). Most participants reported never using laxatives, diet pills, or diuretics to control their weight. Moreover, they reported that they had never received treatment for eating disorders or experienced thoughts of suicide. The study found no significant difference in depression (p = 0.085) and anxiety levels (p = 0.207) between working and nonworking women. However, a significant difference was found in stress levels between working and nonworking women (p = 0.001). Our study highlights a significant prevalence of psychological issues among working and nonworking women in Pakistan, impacting their eating habits and contributing to developing eating disorders and obesity. Interestingly, working women display higher physical activity levels, while nonworking women demonstrate better oral control to prevent eating disorders. To improve women's mental and physical well-being, we recommend prioritizing mental health interventions for all women, promoting healthy eating habits, supporting physical activity, and investigating underlying factors influencing psychological well-being.
Malaria is an infectious disease caused by parasites of the Plasmodium genus. It is one of the major causes of morbidity and mortality worldwide. The World Health Organization (WHO) has recommended artemisinin combination therapy (ACT) to manage malaria among children and adults. However, chloroquine as monotherapy and ACT are commonly prescribed in treating malaria in Pakistan's healthcare delivery system. Therefore, this study assessed the prescribing trends for treating malaria patients in public and private healthcare facilities. Moreover, the study also determined the number of drugs prescribed per prescription by physicians and consultants. This descriptive study was conducted for six months in Lahore's major public and private healthcare facilities. A purposive sampling technique was employed to review 300 malaria patients' prescriptions accessed from the hospital records. Descriptive statistics and the chi-square test were used to achieve the study's objectives. The study showed that most malaria prescriptions were from both public (64.67%) and private healthcare facilities (42.67%) and comprised a dual-drug regimen involving antimalarials, antibiotics, antipyretics, or their combinations. There was a significant difference (p = 0.002) in the prescription trend between public and private healthcare facilities regarding the number of drugs prescribed for treating malaria. Moreover, prescriptions from private healthcare facilities mainly contained antimalarial drugs (58.59%) and antibiotics (17.60%), while most prescriptions from public healthcare facilities contained antipyretics and other drugs (60.67%) (p = 0.001). Most of the consultants prescribed two (66.67%) or three drugs (33.33%), while the prescribing trends of physicians ranged between one and four, which was also statistically significantly different (p = 0.001). In addition, most prescriptions from public healthcare facilities were rationally prescribed (68%). On the other hand, most prescriptions from private healthcare facilities were rational (54%) and semirational (42%). The rationality of prescriptions by public and private healthcare facilities was also significantly different (p = 0.001). Public healthcare facilities were found to exhibit more rational prescribing trends for managing malaria compared to private healthcare facilities, with a focus on prescribing an optimal number of drugs per prescription and a lower usage of antimalarial and antibiotic medications.
Respiratory tract infections (RTIs), caused by microorganisms such as bacteria and viruses, are a leading cause of morbidity and mortality in children worldwide. Antibiotic resistance is a serious concern, and proper prescribing practices are necessary to avoid life-threatening situations. Thus, this study aims to conduct a gender-based analysis and compare antibiotic prescribing patterns for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore. This comparative cross-sectional study was conducted at Children’s Hospital in Lahore, Pakistan, for three months and enrolled 250 pediatric patients who met the inclusion criteria, including 155 males and 95 females. Data were collected through face-to-face interviews and reviewing hospital records. The results of the study showed that the average number of drugs per prescription was 3.06 ± 1.29 (male) and 3.12 ± 1.5 (female), while the average number of antibiotics per prescription was 2.25 ± 0.60 (male) and 2.17 ± 0.58 (female). The most prevalent medical conditions were bronchopneumonia (53.55% males and 58.95% females), followed by respiratory distress (20.00% males) and pneumonia (16.13% males and 16.84% females). The most commonly prescribed drugs were J01DD04: Ceftriaxone (78.71% males and 71.58% females), J01CR02: Amoxicillin/Clavulanate (59.35% males and 56.84% females), and J01GB06: Amikacin (41.29% males and 45.26% females). A low percentage of prescriptions had major drug‒drug interactions (8.39% males and 10.53% females), while most prescriptions had no drug‒drug interactions (81.94% males and 84.21% females). There was no significant difference between male and female patients for caregiver, indications for antibiotic prescriptions, the class of active agent prescribed, and drug interactions. Our study findings indicate that most male and female patients admitted to the hospital with lower respiratory tract infections were prescribed antibiotics alongside analgesics and antipyretics. Furthermore, our analysis revealed minimal drug interactions among the prescribed medications. Importantly, we observed a similar antibiotic prescribing trend among male and female pediatric patients, highlighting the consistency in treatment approaches.
Macrolides are a group of antibiotics produced by Streptomyces bacteria commonly used to treat bacterial infections, including gum infections, gingivitis, and stomach and intestinal ulcers. Roxithromycin is a macrolide antibiotic that effectively targets bacterial cells and inhibits their growth, promoting symptom relief and recovery. Despite this, there is limited research on roxithromycin pharmacokinetics and dosing regimens, particularly in healthy female volunteers from the local population. Thus, this study aimed to investigate roxithromycin's pharmacokinetic parameters and dose regimen in ten healthy female volunteers aged 18 to 30 years. Participants received an oral dose of 300 milligrams of roxithromycin, and blood samples were collected at various intervals for 48 hours. Pharmacokinetic parameters were assessed using two open compartmental models and high-performance liquid chromatography (HPLC). The results showed that the Cmax of roxithromycin was 10.13 ± 0.43 µg/mL, attained at a time to reach tmax of 2.42 ± 0.34 hours. Moreover, the drug exhibited a volume of distribution of 1.38 ± 0.55 L/kg, an elimination half-life of 34.95 ± 22.51 hours, and a total body clearance of 0.04 ± 0.01 L/hr/kg. In accordance with these results, the calculated dosage regimen for 24-hour intervals was 975 milligrams as a priming dose and 372 milligrams as a maintenance dose. In conclusion, this study found that the elimination half-life (t1/2 β) of roxithromycin was higher than literature values, leading to less clearance and ultimately increased Cmax, tmax, and area under the curve (AUC) values of the orally administered drug, indicating the need for dose adjustment in patients.