Clinical Pharmacology Papers & Publications

The global burden of metabolic disorders, including obesity and type 2 diabetes, necessitates innovative therapeutic strategies. SLU-PP-332, a synthetic agonist of estrogen-related receptor α (ERRα), has emerged as a promising exercise mimetic, demonstrating preclinical efficacy in enhancing mitochondrial biogenesis, insulin sensitivity, and energy expenditure. This brief review synthesizes current knowledge on SLU-PP-332 and related ERRα agonists, highlighting their molecular mechanisms, preclinical outcomes, translational challenges, and ethical considerations. ERRα activation by SLU-PP-332 upregulates peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), driving fatty acid oxidation and mimicking exercise-induced metabolic adaptations. However, pan-ERR activity raises concerns about off-target effects such as cardiac hypertrophy and hepatotoxicity. Despite robust preclinical data, clinical translation remains hindered by the absence of human trials and undefined long-term safety. Future research must prioritize isoform-selective agonist design, rigorous clinical validation, and equitable access frameworks.

Mostafa Eissa

The World Health Organization (WHO) has recently made recommendations for treating all Human Immunodeficency Virus (HIV/AIDS) patients irrespective of their immune status. This issue poses challenges to lower-middle-income countries like Nigeria due to resource limitations. This study performed a budget impact analysis (BIA) of different strategies for the initiation of antiretroviral therapy (ART) among individuals living with HIV/AIDS in Nigeria. A dynamic cohort budget impact model was used to compare two initiation arms (CD4 < 350> 500 cells/ml), with CD4 > 500 cells/ml representing the 2015 WHO guidelines for initiation of ART. Outcomes were hospitalization costs, new infection transmission, and overall budget impact. Key inputs included HIV prevalence in Nigeria, ART access and costs, hospitalization rates and costs, ART uptake trends, and transmission rates. Sensitivity analysis empolyed Monte Carlo simulations to assess the impact of selected parameters. At the end of year five, applying the 2015 WHO guidelines reduced new HIV transmissions by 87.0%, preventing 77,000 infections. Hospitalization cost reductions saved $1.12 million. Overall budget impacts were $718 million for immediate initiation versus $903 million for deferred initiation, yielding $184 million in savings. Monte Carlo simulations showed reduced transmission as the main driver of savings. Prioritizing early treatment initiation espoused by the 2015 WHO guidelines maximize resource efficiency, reduces long-term healthcare costs, and accelerate progress toward epidemic control targets. The findings strongly support the adoption and sustained implementation of the 2015 WHO guidelines for immediate ART initiation. It has public health and economic benefits.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Systemic onset juvenile idiopathic arthritis (SoJIA) is a rare inflammatory disorder. It is the severest form of juvenile idiopathic arthritis, and complications occur most commonly in this type. Non-responsiveness to standard therapy with corticosteroids and disease-modifying antirheumatic drugs is not uncommon. Interleukin-1 beta (Il-1β) has been shown to be a main contributor to the pathogenesis of SoJIA. Anakinra, a recombinant Il-1β receptor antagonist, was shown to be effective in small cohorts of therapy-resistant adult and pediatric still's patients. This study aimed to evaluate the real-world efficacy, steroid-sparing effect, and safety profile of anakinra in patients with SoJIA at a tertiary care center in Libya. A retrospective case series was conducted on patients with SoJIA treated with anakinra at the Tripoli Children's Hospital between 2010 and 2017. Data on demographic characteristics, disease activity, corticosteroid dosage, concomitant medications, and adverse events were collected at baseline and at 1-, 3-, 6-, and 12-month post-treatment. 13 patients were treated with anakinra with a mean age of 9.4±4.6 years at anakinra initiation and a female-to-male ratio of 2: 1. All patients were on corticosteroids and 92.3% on methotrexate at treatment initiation. The proportion of patients achieving inactive disease (Jadas 10=0) increased over time. A marked steroid-sparing effect was observed: the number of patients requiring high-dose steroids (>0.5 mg/kg/day) decreased from 100% at baseline to 7.6% at 12 months, and 53.8% successfully discontinued corticosteroids entirely. All patients experienced injection site reaction, and macrophage activation syndrome occurred in 15.4% as a side effect after treatment initiation. But no severe infections or fatalities occurred. Reasons for discontinuation included remission (46.1%), drug unavailability (23.0%), inefficacy (15.3%), and side effects (15.3%). Anakinra demonstrated significant efficacy in inducing rapid disease control and reducing corticosteroid dependence in patients with refractory SoJIA, with a manageable safety profile

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Objective: Pyrazolopyrimidines are heterocyclic molecules containing nitrogen as the main composition, and hence, they exhibit pharmacological efficacy. They are analogs of purines so that possessing wide applications in the field of medicinal chemistry. The main objective of this study is to synthesize different derivatives of pyrazole-pyrimidine classes by adopting simple methodology as well as by employing green chemistry. The purpose of the synthesis of these molecules is to study the antitumor activity against Ehrlich ascites carcinoma (EAC) cell lines. Methods: After literature studies, it makes us to involve in the research of synthetic organic chemistry, especially to synthesize new compounds of pyrazolopyrimidines. We are reported solvent-free synthesis of pyrazolo [3,4-d]-pyrimidine-thiones through ethyl acetoacetate, hydrazine hydrate, thiourea, and different benzaldehydes. An ionic liquid 2-methyl-imidazolium-oxalate catalyzed the reactions under ultrasonication bath. Both conventional and ultrasonic methods were employed and comparison studies have been made. It was found that ultrasonic method completed the reaction quicker than the conventional method. All the synthesized compounds were confirmed their structures by 1 HNMR, Fourier transform infrared, 13C-NMR, and elemental analysis spectra. The compounds were tested for in vitro anticancer activity against EAC cell lines. Most compounds revealed significant anticancer activity relative to doxorubicin as a positive control with inhibitory concentration (IC50) values. Results: Ultrasonication method is a simple method under which all the reactions were completed at faster time (<7 min) compared to the convention method. Among eight molecules, 8a and 8d completed the reactions at a faster rate. We reported IC50 values of all the molecules, in which 8e and 8g were exhibited excellent potency against EAC cell lines at different concentrations .

Dr Ganesh N Yallappa

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

Ayurvedic formulations are of three types, Herbal, Mineral and Herbo-Mineral. Of which, Herbomineral is prepared either by Khalweeya or by Bhasmeekarana procedures. The quality of Bhasma depends on the number of putas given. Rasa Bhasma is one such kind of a Herbo-mineral preparation which can be obtained by Puta procedure as described in texts of Rasa Shastra. Though there are different procedures mentioned for preparation of Rasa Bhasma, maarana done with Gorvara puta seems to be an apt way to obtain the final product. Puta is the generalised way of heat application used during the pharmaceutical procedures of Rasa dravyas, where the purified organic Metal/Mineral is converted completely into powder form which can be absorbed easily into the body without causing any ill effects. Different types of Puta have been explained for bhasmeekarana of different metals and minerals. Among them, certain putas have been mentioned where Mandaagni plays a crucial role in Maarana (Incineration). These Mandaagniputas are in use of preparing certain Bhasmas like ShilajitBhasma, HaratalaBhasma, GouripashanaBhasma, and PaaradaBhasma. As these drugs are having relatively low boiling and melting points when compared to other dravyas, and are easy to evaporate when exposed to high temperatures, they need a standardized quantum of heat by which they can be transformed into Bhasma. Gorvara puta is one such kind where agni plays a major role in the preparation of Bhasma. So, the present study A Comprehensive Study of Gorvara Puta in Preparation of Rasa Bhasmahas has been under taken.

Suri abhiram

Rasa aushadhis are known for their uniqueness in curing the diseases with a very low dosage. These formulations are divided into two types based on their mode of preparation i.e., Single drug and Compound drug formulations. Based on their origin, the drugs are divided into three types, Herbal, Mineral and Animal. Any of these two or three together is combined to make a compound formulation. Apart from these, the other major factor which is needed for a formulation is the Rasa Panchaka of a Drug. Many of the formulations are being prepared based on their availability, keeping their Rasa Panchaka and Samprapti vighatana in mind. These formulations are designed in such a way that two or more drugs will be having one common quality, or Opposite Qualities or an Antidote of a particular Vishadravya, which can help in curing the disease. So an attempt is made to Review Tribhuvanakeerti Rasa with its Probable mode of action.

Suri abhiram

A medication error is any preventable event that may cause or lead to inappropriate use of drugs or patient harm if it is not under the control of the health care professional. Despite the fact that healthcare professionals take the responsibility very seriously, it has been estimated that 250 000 Americans die annually due to medication errors. Although, estimates show that one in ten patients worldwide is affected by medication errors while receiving hospital care, the harm can be caused by a range of incidents or adverse events. The exact incidence of medication errors in the neonatal intensive care unit (NICU) is unknown. In neonates especially premature infants, the immaturity of developing body systems affects the absorption, distribution, metabolism and excretion of drugs and therefore an exponential risk for medication errors is present. The risk of medication errors in children are much greater than adults.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypertension is a public health issue that significantly increases the risk of health problems and decreases health quality of life of the patients. Angiotensin converting enzyme inhibitors are used to control hypertension by preventing production of angiotensin II in turn decrease blood pressure, thus it may enhance the quality of life. This study aims to assess the effect of angiotensin converting enzyme inhibitors on the quality of life of patients with hypertensive aging 40 years or older in Benghazi city in comparison with other classes of hypertension medications. A case control observational study was conducted, adopting the structured face-to-face interviewing survey technique. Over 150 patients who visited Benghazi medical center during the study period (November, 2019 to March, 2020), to follow up their chronic disease. The investigators used a pre-validated, pre-piloted questionnaire that has been adopted from SF 36 and modified according to the updated literature review; responses to each question were coded and analyzed. The results display that antihypertensive medications were found to be significantly related to the limitation on the physical activity domain and found that medications decrease the limitation on the activity with about 20% of the patients who taking angiotensin receptor blockers (20%) and 30% of the patients taking angiotensin converting enzyme inhibitors, 40% of the patients had no limitations on bending kneeling and stooping. Moreover, on the limitations on walking more than one kilometre, the results were about 15% of the patients taking angiotensin receptor blockers and 30% of the patients taking angiotensin converting enzyme inhibitors had a slightly or no limitation on walking more than a kilometre. Thus, the findings indicate that antihypertensive medications have a positive effect on quality of life of the patient in limitation on activity domain but no conclusive difference was found between angiotensin converting enzyme inhibitors and angiotensin receptor blockers medications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

This study's objective was to determine the distribution of allele frequencies of CYP2C9 and CYP2C19 gene polymorphisms among the Papuan population, known as the second-largest ethnic group in Indonesia. According to recent research, there is a decrease in CYP2C9 and CYP2C19 produced by humans globally, including in Indonesia. These gene polymorphisms aid in the transmission of various endogenous and exogenous drugs in the human body. Material and Methods: A sum of 99 subjects, comprising 73 male and 26 female subjects aged 20-30 years, were used for this research. PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis using AvaII, NsiI, and SfaNI enzymes tested for the genotypes CYP2C9 and CYP2C19 administered. The distribution of genotypes was calculated in the population (P<0.05) using the Hardy-Weinberg equilibrium. The Faculty of Medicine Gadjah Mada University's Medical and Health Research Ethics Committee (MHREC) accepted this research with written consent. The results revealed that in Papua subjects, CYP2C9*2 (rs1799853) and CYP2C19*17 (rs12248560) alleles were absent while in 17 percent of the population CYP2C9*3 (rs1057910) allele frequency was. In conclusion, CYP2C9*3 has the highest polymorphism rate in Indonesia, with the absence of CYP2C9*2 and CYP2C19*17. Therefore, genetic drift can occur within this ethnic group.

Syahrul Tuba

Self-medication with antibiotics is becoming a trend that threats the health systems worldwide through developing bacterial resistance which is associated with high health care costs and increased rate of morbidity and mortality. The main objective of this study is to assess antibiotic self-medication practice among Libyan university pharmacy students. This is a cross-sectional study conducted among pharmacy students at Sabratha University in the western region of Libya. A validated questionnaire was used to collect relevant data which were statistically analyzed. A total of 170 undergraduate Pharmacy students participated in the study during spring 2021. About 80% of the participants reported the use of antibiotics without consulting a physician. The major reason for using antibiotics was to get a quick relief of emergency conditions which was reported by 35% of the students. About 25% of the students used antibiotics to relieve their pains and aches. The most commonly used antibiotic was amoxicillin (55%). Most antibiotics were obtained over the counter from community pharmacies (85%). Half of the participants were not sure if they can advise patients to use antibiotics without a prescription, although 60% of them believed that it was good practice. In conclusion, prevalence of antibiotic self-medication among university pharmacy undergraduate students is high. Thus, serious interventions are required to ensure safe and effective use of antibiotics among the population in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Streptococcus bovis/gallolyticus was considered as lower grade pathogen involved in endocarditis. Recent accumulating evidence has suggested that Streptococcus bovis/gallolyticus plays an important role in the initiation and development of colorectal cancer. This study was aimed to address the association between Streptococcus bovis/gallolyticus and colorectal cancer among Libyan patients, to determine the dominant biotype of Streptococcus bovis/gallolyticus associated with colorectal cancer patients and to evaluate the antibiotic susceptibly patterns of isolated strains. The study involved 20 colorectal cancer patients, 20 patients with large adenomas polyp and 20 people with healthy colonic mucosa as a control group. All the candidates were subjected to colonoscopy and histopathological examinations and conformation. The suspected and normal cases were then diagnosed according to the protocol used by the medicine specialist and grouped in accord with the study aim. All biopsies were handled and treated to isolate the suspected positive colonies of Streptococcus bovis/gallolyticus. Of the 20 colorectal cancer patients, seven patients (35%) were found to be Streptococcus bovis/gallolyticus carriers, (95% CI 1.22 - 1.72, p < 0.05). Nine patients (45%) were diagnosed colorectal cancer positive at age above 60 years old, eight patients (40%) at age 40 - 60 years old and three patients (15%) at age bellow 40 years old. Also, nine out of 20 patients (45%) with large adenomas polyp were found to be Streptococcus bovis/gallolyticus carriers, (95% CI 2.16 - 2.71, p < 0.05). Of the 20 healthy people with colonic mucosa, Streptococcus bovis/gallolyticus never been isolated. Streptococcus. bovis biotype II/I and Streptococcus. equinis were both susceptible to the above mentioned antibiotic classes, although Streptococcus bovis biotype I was highly resistance to most clinically used antibiotics. However, there was strong relationship between Streptococcus bovis/gallolyticus and colorectal cancer or large polyp formation. However, it is not well understood whether the bacterium has a pathogenic role in the initiation and progression of neoplasia or just an epiphenomenon of colorectal neoplasms.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Tuberculosis is communicable disease which is common and often deadly infectious disease caused by mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem in the world. The aim of this study is to assess prevalence and associated risk factors of pulmonary tuberculosis. Treatment and development of multidrug-resistant tuberculosis were also considered. Drugs for Pulmonary tuberculosis confirmed cases used in calculating tuberculosis prevalence in Libya which is obtained from archive department of Abu Seta Hospital. Data obtained from 427 files during 2019 determine the incidence and epidemiology of tuberculosis in Libya. For a total of 427 confirmed cases of pulmonary tuberculosis, about 75.0% of the cases were male and most of the patients (55.0%) were within the age group of 20 - 40 years old. Of the study patients, 114 patients (26.7%) were viral infected and most of the viral infected cases were in the age group of 20 - 40 years and the majority of this age group patients (n = 41, 53.2%) were infected with HIV/HCV, while the least percentage in this group age were infected with HIV/HBsAg (01.3%). Among 427 cases, 73 cases (17.1%) were comorbid with other chronic diseases. Of the 73 cases, 54 cases (74.0%) were diabetes mellitus whereas only 1.4% of them had bronchial asthma, Parkinsonism and renal failure. The drug therapy of active tuberculosis disease needs combination chemotherapy to escape the selection of naturally occurring drug-resistant mutants. Amongst current anti tuberculosis drugs, the rifamycins hold the highest potential for shortening treatment and improving effects. Prevalence of smear positive tuberculosis and bacteriologically confirmed that a high rate of tuberculosis among unemployed population. This study reported that the highest incidence rate is found in people who are smokers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences