How can I buy cocaine online in Peshawar

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How can I buy cocaine online in Peshawar

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The University of Agriculture, Peshawar

How can I buy cocaine online in Peshawar

Official websites use. Share sensitive information only on official, secure websites. Objectives: To find out prescription patterns of general practitioners in Peshawar. Methods: Cross-sectional survey of drug prescriptions was done at six major hospitals and pharmacies of Peshawar between April and May A total of prescriptions that included drugs, were analyzed to assess completeness, average number of drugs, prescription frequency of various drug classes, and number of brands prescribed. Results: No prescription contained all essential components of a prescription. Legibility was poor in Dosage, duration of use, signature of physician and directions for taking drugs were not written in On average each prescription included 3. Most frequently prescribed drug classes included analgesics We found , , and different brands of anti-infective agents, gastrointestinal drugs, analgesics and multivitamins being prescribed. Conclusion: We observed a high number of average drugs per prescription mostly using brand names, and over-prescription of analgesics, antimicrobials, multivitamins and anti-ulcer drugs. Quality of written prescriptions was poor in terms of completeness. Any drug prescription should contain, in legible form, elements required for appropriate dispensing of drugs, to ensure continuity of care and for legal purposes. Rational prescription means that patients receive appropriate medicine in proper dosage, at the lowest cost. Polypharmacy and over-prescription of antimicrobials, analgesics, and vitamins are common in South Asia. This cross-sectional study was conducted in Peshawar, Khyber Pakhtunkhwa, having a population of over three million. Prescriptions generated at six major locations in the city over a period of one month April to May were assessed. Location A, B and C are large public sector hospitals serving mostly middle and lower socioeconomic class. Location A receives to outpatients, Location B receives outpatients and Location C receives outpatients daily personal communication, Muhammad Irfan, 5 th March Location D harbors numerous private physician clinics. These clinics receive patients from all socioeconomic classes and charge high fees. Location E and Location F are both private non-profit hospitals located in central Peshawar. Each of these receives over outpatients daily personal communication, Usman Raza, April Data collection was done by a team of five medical students from clinical years under faculty supervision. Prescriptions were obtained for viewing, from patients purchasing drugs at pharmacies of the five hospitals, after obtaining informed consent. For private clinics Location D , 25 pharmacies serving these clinics were approached. A structured proforma was filled by observing the prescriptions and names of drugs in each prescription. Legibility of prescriptions was also recorded. For this study, a General Practitioner was defined as allopathic practitioner holding MBBS degree, practicing as a medical specialist or a general physician. Prescriptions of other specialists, and those for in-patients and emergency cases were excluded. Poor legibility was defined as difficulty in reading names of one or more drugs in a prescription by the data collection team in the first attempt. Data were entered into an online database based on MySQL and double checked. Database was imported into Microsoft Excel for analysis. Averages or proportions were calculated for variables and presented as graphs or tables. Of the prescriptions, eight were discarded due to incompleteness, yielding a final sample of prescriptions. A total of prescriptions written by general practitioners that included drugs were analyzed. Only The average number of drugs per prescription was 3. The maximum number of drugs recorded in a prescription was Elements considered essential for the medical and legal completeness and usefulness of a written prescription 4 were assessed in our study, as depicted in Table-II. For these results, 10 incomplete records were not considered yielding a sample size of Range refers to highest and lowest values among the six locations sampled. As depicted in Fig. Among individual drugs, most commonly prescribed were various brands of Multivitamins , 8. A large variety of brands was found among prescriptions especially for anti-infective agents, gastrointestinal drugs, analgesics, multivitamins and psychotherapeutics with , , , and 71 different brands being prescribed in these classes respectively. The World Health Organization has recommended an ideal average upper limit of 2. Other countries show similar figures ranging from 2. The overall quality of written prescriptions was poor, since no prescription contained all essential components of prescription. Poor hand writing of practitioners can lead to fatal instances of inadvertent drug substitutions. The absence of a diagnosis or indication makes it difficult to assess rationality of a prescription, and may lead to repeat testing and treatment, increasing financial burden on the patient. Only a fifth of prescriptions in our study contained a diagnosis or indication, which is lower than figures reported from India. Inconsiderate antimicrobial prescription may contribute to the emergence of antimicrobial resistance. Compared to our figure of Frequency of analgesic prescription in our study is the highest reported among studies from other countries Compared to multivitamin prescription of our study Use of generic drug names is recommended worldwide, but was very low in our study. We observed very large number of brands of various drug classes being prescribed, which may be linked to the competitive market of pharmaceuticals and weak regulatory systems, which have not been able to cap the number of brands being produced. The practices reported in our study may lead to higher costs, poor quality of care, emerging antimicrobial resistance and unnecessary health risks due to adverse reactions and drug interactions. Our study excludes specialist consultants, non-registered practitioners and in-patients, and the results represent a part of the full spectrum of drug prescriptions in the region. Further, owing to the limited data collection period, it does not account for seasonal variations. Our study found a relatively high number of drugs per prescription, with a high proportion of brand name prescriptions. We found high frequencies of analgesic, antimicrobial, multivitamin and gastrointestinal drug prescription. In terms of quality, none contained all essential components of a prescription. Legibility was poor and essential elements missing in many prescriptions. Results indicate the need to study factors associated with these practices and promote evidence-based prescription. We thank Mansoor Nasir who developed the online database system for simultaneous data entry by the team members. We are also thankful to Qandeel Kamal, Nadia Khan and Ranaz Begum for their contributions in data collection and data entry. Competing interests: The author s declare that they have no conflict of interests. UAR conceived and design the study, supervised data collection, supported other authors in drafting of the manuscript, performed statistical analysis and interpretation of results. TK participated in the design of the study, led data collection and data entry, and prepared the initial draft of the manuscript. MA participated in data collection, data entry and preparation of draft manuscript. UMI reviewed the draft manuscript and made revisions to presentation of results, interpretation of data, discussion. All authors read and approved the final manuscript. As a library, NLM provides access to scientific literature. Pak J Med Sci. Find articles by Usman Ahmad Raza. Tayyeba Khursheed 2 Dr. Find articles by Tayyeba Khursheed. Muhammad Irfan 3 Dr. Find articles by Muhammad Irfan. Maryam Abbas 4 Dr. Find articles by Maryam Abbas. Uma Maheswari Irfan 5 Dr. Find articles by Uma Maheswari Irfan. Usman Ahmad Raza, E-mail: usmanar gmail. Received Jan 21; Accepted Mar 3. PMC Copyright notice. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Directions for taking drugs not written.

How can I buy cocaine online in Peshawar