To measure awareness about adverse drug reaction (ADRs) reporting among doctors, pharmacists and nurses and to determine reasons of ADRs under-reporting in Pakistan. In present study, a self-administered questionnaire was used to measure the awareness level about ADRs reporting among health care professionals (HCPs) of Pakistan. This was a cross sectional study. Out of the respondents 51 % were physicians, 29.7 % pharmacists and 19.3 % were nurses. 65.5 % of HCP population observed ADRs, out of which only 57.4 % reported these in their respective hospitals. About 77.3 % of population understood the importance of reporting ADRs while 67.3 % of population agrees that pharmacists are chief personnel for the development of system. 71.8 % of HCPs agrees that ADRs are not reported because Community pharmacy lacks legally qualified pharmacists. Only 14.3 % of HCPs population knows that there is any ADR reporting organization in Pakistan. The study recommends the need of such reporting system and more than half of the studied population agreed that pharmacists are required in developing such system.

The objective of the study was to compare the two antidepressant drugs citalopram and escitalopram on the basis of efficacy in depressed patients of Hepatitis C patients receiving interferons. In this double blind randomized trial, the hepatitis C patients visited National institute of liver and Gastro intestinal diseases (NILGID), Dow University Hospital, were screened for depression before starting treatment with interferons. The Institutional review board approval was obtained and its letter reference no.is: IRB-682/DUHS/Approval/2016/169. Patients with previous history of depression were excluded from the study. The patients who started with Interferon therapy were assessed for depression on baseline and then on each visit. Those who developed depression were randomly assigned to receive either citalopram or escitalopram. Treatment groups were assessed with depression scale each time they visit the clinic. Two antidepressants were compared for their efficacy at an interval of 4 weeks, 8weeks and then 12 weeks. In the current study 80 patients were randomized to receive either citalopram or escitalopram. The study outcome was better in patients treated with escitalopram. The mean change in depression score from baseline to the end of the study was greater in escitalopram group i.e. 10.41 as compared to citalopram group i.e. 14.17. The difference in depression score was also calculated as 4.28 and. 3.76 (p < 0.001) for both the drugs at week 8 and week 12 respectively, which was statistically significant. Difference in depression score were also calculated for gender 0.576 (p = 0.497) and age 0.950 (p = 0.265), which were found to be non-significant, statistically. The results demonstrated superiority of escitalopram over citalopram, the drug is twice as potent as the racemic mixture. Additionally the drug is well tolerated and exhibited better effects. Escitalopram proved to be a safer alternative to citalopram.

Liver’s contribution to innate immunity is eminent. However, uncontrolled inflammatory conditions predispose the liver to immune-mediated injury. Nigella sativa L. is traditionally implicated in infectious, inflammatory, metabolic and hepatorenal complications. This study aimed to evaluate the protective role of N. sativa seed extract (NSE) against concanavalin A (ConA)-induced acute immunological liver injury in mice. In vitro, NSE was subjected to quantitative phytochemical characterization and 1,1-diphenyl-2-picryhydrazyl (DPPH) analysis. In vivo, male Balb/c mice were pretreated with NSE (100, 200 and 400 mg/kg/day, p.o.) and pioglitazone (5 mg/kg/day, p.o.) for seven consecutive days. A single dose of ConA (12 mg/kg, i.v.) was injected and samples were collected for biochemical, histopathological and qRT-PCR analyses after 8 h of ConA injection. In vitro analysis showed considerable quantities of polyphenols and significant DPPH scavenging ability of NSE. In mice, ConA resulted in a significant (p<0.05) increase in liver injury markers (ALT, AST, ALP and TBil) and hepatic oxidative stress (SOD, CAT and MDA). Also, a substantial elevation of pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) in liver tissues was noticed. Furthermore, ConA markedly downregulated PPARγ and upregulated JAK2 and STAT3 expressions. In addition, considerably decreased expressions of Bcl-2 and increased Bax and Caspase-9 were observed. NSE demonstrated hepatoprotective effect in a dose-dependent manner through attenuating liver injury markers, oxidative stress parameters, pro-inflammatory cytokines levels as well as liver inflammation and hepatocyte apoptosis via modulating PPARγ/JAK2/STAT3 and Bcl-2/Bax/Caspase-9 pathways. Conclusively, the antioxidative, anti-inflammatory and anti-apoptotic actions of NSE could protect against acute immunological liver injury.

Anthracycline antibiotics are very effective chemotherapeutic agents. Doxorubicin has broad spectrum of activity against solid tumors and hematologic malignant tumors. The development of nephrotoxicity and cardiomyopathy has greatly limited the use as a highly potent and efficacious anti-neoplastic agent. Adriamycin induced injury appears to be a multifactorial, but free radical generation is one of the most important denominators to most of the proposed mechanisms. The present study aimed to determine the toxic effects of doxorubicin on wistar albino rats. Toxicity study of doxorubicin was observed on LD50 dose 20 mg/kg, respectively. Single Intra-peritoneal injection of doxorubicin was given to male wistar rats which were divided into 3 groups. Group I served as control, Group II treated with doxorubicin 20mg/kg, Group III treated with α-Tocopherol 380 IU/day. The body weights, morphological behavior changes, static movement and oxidant enzymes tests were checked. Single Intra-peritoneal injection of doxorubicin induced significant (p ≤ 0.01-0.001) pathological changes in the health, including general weakness, morphological changes associated with bleeding, change in anti-oxidant enzyme levels and inflammation of the intestine. It was found that after the intraperitoneal administration of doxorubicin the levels of glutathione peroxidase was significantly reduced along the protein oxidation. It is concluded that after the administration of α-Tocopherol the serious effects produced by doxorubicin were minimized and protective effects was seen in rats.

Objective: This study aimed to evaluate the comparative assessment of Garlina and Murraya koenigii L. in hyperlipidemic rats.Material and Methods: In vivo antihyperlipidemic potential of different MURK (Murraya koenigii L.) extracts and Garlina was conducted on Wistar rats induced with high-cholesterol diet. All test samples were given at p.o. dosage of 50 mg/ kg and animals were observed for 60-days. Animal Food-intake and body weight along with lipid markers in liver and aorta were investigated. In addition to this, serum lipid biomarkers along with atherogenic index was also determined. The results compared with Atorvastatin treated group. Data is expressed as mean ± standard error mean (S.E.M) using ANOVA to determine significance. Results: MURK extracts significantly decreased body weight and food intake, in contrast to the Garlina and Atorvastatin groups. MURK-HEX (hexane) extract displayed the significant reduction of 3.83 ± 2.3 g in body weight. Similarly, MURK-hexane and MURK-EA (ethylacetate) also demonstrated the highest rate of reduction in food consumption, i.e., 65.62 ± 0.5 g and 64.61 ± 0.7 g respectively. Tissue levels of cholesterol and triacylglycerol (TAG) were measured in the liver and aorta. MURK-EA treated rats had the lowest liver cholesterol levels (130 mg/dl), while the group that received MURK-MeOH (methanol) had the lowest aortic cholesterol levels (120 mg/dl). Additionally, lower TAG levels in liver and aorta of MURK-MeOH treated group were observed, measuring 129 mg/dl and 139 mg/dl respectively. MURK-MeOH group also showed the lowest serum lipid markers, i.e., TAG, LDL, and cholesterol at 136, 144, and 48 mg/dl respectively. Further, the inverse relationship between atherogenicity index of plasma (AIP) and percent protection of treatment regime indicated that all treatment groups successfully control hyperlipidemia.Conclusion: Garlina and MURK extracts possess significant lipid lowering potential. Garlina enhanced the HDL serum levels and in turn, showed lowest AIP comparable to that of standard drug Atorvastatin.