COVID-19 And Pakistan – Why Does The Count Matter?
Globally, the confirmed cases of Coronavirus disease 2019 (COVID-19) reported to the World Health Organisation (WHO) have surpassed eight million in 188 countries with an inclusion of more than four hundred thousand deaths (WHO, 2020). According to the WHO’s distribution, region of America predominates with more than four million confirmed cases with Europe sitting next on the table. Despite their advanced health care systems and powerful economies, the highest death toll so far was reported by the United States of America (USA) followed by Brazil and United Kingdom (UK). Considering the devastating impact of COVID-19 on first world nations, it was reasonable to expect the worst in developing countries like Pakistan. The reasons being the densely populated landscape with an estimated 25% living below the national poverty line, a fragile healthcare infrastructure and an already strained economy.
With the emergence of the first COVID-19 confirmed case late February this year, Pakistan has reached a total of 2039 confirmed cases including 26 deaths by March, 16,817 confirmed cases including 385 deaths by April, 72,460 confirmed cases including 1,543 deaths by May and 181,088 confirmed cases including 3,590 deaths as of June 22, 2020 (NIH, 2020). Further to the provincial breakdown, Sindh recorded the highest number of confirmed cases (38%) whereas maximum deaths (40%) are reported by Punjab to date. Overall, COVID-19 seemed to affect men more than women and people aged less than 50 years. However, the majority of deaths were observed in people over 60 years of age. Despite the sudden surge seen in the number of positive cases in Pakistan, the rate at which the infection spreads and reported deaths is nowhere close to the figures recorded in the developed countries. Whether this is really a true reflection of the COVID-19 situation on the ground is something yet to be fully established.
Mass testing is one of the most important tools in fighting pandemics. Without testing, it is too difficult to identify, isolate and treat the infected individuals presenting non-specific symptoms or those who are silent carriers. Not only this, it makes contact tracing literally impossible, thus increasing the risks of local transmission. Most importantly, in the absence of such valuable information, relevant authorities would remain blindfolded in their strategies due to very limited understanding of the pandemic itself. In turn, this would have a huge impact on the decision making processes and the implementation of different interventions such as physical distancing, complete or smart lockdown to slow down the spread of the disease. There is no set number to indicate adequate testing but the WHO has repeatedly emphasised on aggressive testing. Based on their recommendations, more than 10% of given tests if come back positive depicts lower testing capacity that fail to identify all the infected cases in the given communities.
With an estimated population of 220 million, Pakistan has conducted 1,102,162 tests to date corresponding to 4,993 tests per million population. The country has a current capacity of 35,000 tests per day with almost 30,000 tests conducted daily; mainly down to an increase in overall testing capacity from two to more than hundred designated COVID-19 laboratories across the country. In the order of highest to lowest deaths reported, the testing data of some countries are stated in Table.1 (Worldometer, 2020).
Evaluation of Indigenous Plant Extracts for Acetylcholinesterase Enzyme Inhibition
Acetylcholinesterase (AChE) is the enzyme, which holds significant therapeutic potential against indications with cognitive decline. Keeping this in view, the present study was designed to identify the extract leads from indigenous plants.
The ethanolic extracts of seven indigenous plants (Berberis vulgaris, Beta vulgaris, Brassica rapa, Borago officinalis, Cinnamomum cassia, Physalis alkekengi and Valeriana officinalis) were prepared and tested for their AChE enzyme inhibitory potential, using Ellman’s assay.
Our data showed that among the seven tested extracts, two of them (Berberis vulgaris and Cinnamomum cassia) demonstrated more than 50% inhibition at the tested dose of 1 mg/ml.
Hence, these plant extracts may serve as promising druggable leads for herbal formulations indicated for cognitive decline.
Acetylcholinesterase; Enzyme Inhibition; Ethanolic Plant Extracts
- Zainab Abbasi
- Wajid Zaman
- Huma Aslam Bhatti
- H.E.J. Research Institute of Chemistry, International Center for Chemical & Biological Sciences, University of Karachi, Karachi-75270, Pakistan
- Ghulam Abbas
- Department of Pharmacology, Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan
Rationality of Use of Alprazolam within the Population of Karachi
Objective: To evaluate the prescribing and usage trends of Alprazolam within the population of Karachi, Pakistan to access the potential of abuse and misuse.
Methods: It was a prospective observational study conducted over a period of 3 months in various health care settings. Data was collected on a tool based on “Medication Appropriateness Index”.
Results: The study was conducted on 124 participants of which 74 were male and 47 were female. 68.2% of the participants used alprazolam as an anxiolytic while the second most common indication was that of panic disorders for which15.5% participants were prescribed. 50.7% participants were taking the prescribed dose of 1mg however variations were observed. In side effects profile the largest group of 59% of participants experienced drowsiness followed by 14.2% of participants feeling confused. 74.4% participants reported that they were not taking any other medication concurrently. 43.9% participants took alprazolam for the 14 day period while the rest were self medicating. 80.6% reported to take it as a sleeping aid. 75% of participants did not opt for any other medication in case the preferred brand was unavailable.
Conclusion: Although the prescribing trend is in accordance to the guidelines however the problem of self medication for prolong periods in varying doses exist which is an indication of a probable existence of abuse and misuse within our population.
Keywords: Alprazolam; misuse; abuse
- Sidra Tanwir
- Najeeb Khatian
- Arif Sabah
- Sarah Haroon
- Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan
Perception, Attitude and Satisfaction Level of Online Education System during COVID-19 among the Pharmacy Students of Karachi, Pakistan
Objective: The aim of this study is to assess the perception, attitude and satisfaction of online (Virtual) education system during COVID-19 among the Pharmacy students of Karachi, Pakistan.
Methods: This cross-sectional study was carried out on pharmacy students in June 2020 through an online-based questionnaire survey. The questionnaire was distributed to over 350 students via social media (WhatsApp, Facebook, etc.) out of which 207 students have participated in the study. Data was collected on an excel sheet for statistical analysis. The Statistical Package for the Social Sciences (SPSS-20) software was used for this purpose.
Results: Out of 207 students, 154 were females and 53 were males. 115 (55.55%) students used laptops for taking online lecture whereas 86 (41.51%) students using mobile phones. 87(42.03%) students like the online mode of education whereas 120 (57.97) students dislike.
Conclusion: The findings of this study revealed a very low satisfaction level and disliking behavior of pharmacy students towards online education learning because of various problems. Among these problems Wi-Fi connectivity and electricity issues are the major problems that produce the resistance in satisfaction level of the students.
Keywords: Online Education, Pharmacy, Students, Wi-Fi connectivity and Electricity.
- Hammad Ahmed
- Department of Pharmacology, Faculty of Pharmacy, Ziauddin University, Karachi 75600, Pakistan
Prospective Study Comparing With Different Brands of Glimepride Regarding its Quality Attributes
Objective: There are a number of brands of of glimepride tablets available. There is a quality variation between the brands. The change in the quality may affect the efficacy of the medicine. The mainseek of this study is to scrutinize the physicochemical uniformity of six brands ofglimepiride (anti-hyperglycemic) tablets collected from retail pharmacies atKarachi,Pakistan.
Method: The physicochemical properties of glimepride tabletmay vary on the quality of six different brands of glimepiride tablets evaluated.During the present study, weight variation (WV), thickness and diameter (TD),hardness (H), friability (F), disintegration (DT), dissolution (DS) and percent drug content (DC) of the drug was evaluated for the tablets of six brands of glimepride.
Result: It has been noticed that nearly all the brands complied with the official compendia.Weight variation, diameter, thickness hardness testand friability of the six different brands werewithin the specification of British Pharmacopeia and United States Pharmacopeia.It has been found that one brandGP 006 had within limit higher weight content, hardness, and disintegration among all brands. It has been further noted that GP 006 had nearly passing limits in dissolution test. The percentage of drug content has been 99.3% to 101.4%.
Conclusion: It has been concluded from the present study that all the brands marketed at Karachi, Pakistan met the criteria of official pharmacopeia and regulatory body (DRAP). The in-vitro studies of dissolution provided the information regarding the solubility of glimepride within desired period of time.
Keywords: Prospective study; quantitative estimation; physico-chemical test; glimepride tablets; comparative analysis
- Saad Altaf
- Ferozsons Laboratories Limited, P. O. Ferozsons, Amangarh-Nowshera, Pakistan
- Sidrah Hassan
- Maria Ashfaq
- Adeel Arsalan
- Faculty of Pharmacy, Ziauddin University, 4/B, Shahrah-e-Ghalib, Clifton, Karachi, Pakistan
Impact of lifestyle in the prevention and management of COVID-19
The current review deals with the preventive strategies keeping in mind the lack of direct treatment for COVID-19 by drugs or vaccines. The review focuses on strategies to strengthen immunity so that the body fights off the pathogen itself. Factors like sleep, diet and exercise related to lifestyle medicine are discussed in detail with respect to their impact on the immune system.
- Sarah Khan
- Department of Psychology, University of Karachi, Karachi, Pakistan
- Rafeeq Alam Khan
- Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan