FREQUENCY OF STEROID CONTAMINATION IN DRUGS PRESCRIBED BY QUACKS IN RAWALPINDI

Steroid Contamination in Drugs

Abstract

Objective: To determine the frequency of contamination of steroids in drugs prescribed by quacks, being used by patients in Rawalpindi.
Study Design: Cross- sectional study.
Place and duration of study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology Rawalpindi, from June 2010 to March 2011.
Patients and Methods: One hundred and seventy eight drugs distributed by quacks in Rawalpindi were collected from the patients. Quackery formulations (QF) were analyzed by thin layer chromatography on fluorescent Aluminum silica plates by using mobile phase of methylene chloride: ether: methanol: water (77:15:8:1.2) and relative flow of spots were noted. Samples positive for steroids were confirmed by high performance liquid chromatography.
Results: Out of In total of 178 samples, 125 (70.2%) were received by patients from unregistered hakeems, 29 (16.3%) unregistered homeopaths and 24 (13%) directly from nonmedical shopkeepers, prescribed for in joint pains 84 (47%), generalized weakness 43 (24%), dermatitis 28 (16%), gastrointestinal diseases 12 (7%) and respiratory diseases 11 (6%). Out of 178 samples, 38 (21%) QF were contaminated with steroids found in 18 (48%) tablets, 10 (26%) powders, 5 (13%) creams, 3 (8%) capsules and 2 (5%) syrups. Out of 38 Steroid contaminated QFs 20 (53%) countrained dexamethasone, 12 (32%) prednisolone, 4 (10%) hydrocortisone and 2 (5%) betamethasone.
Conclusion: In modern era, patients are still using drugs prescribed by quacks and 21% of QF in Rawalpindi is contaminated with steroids. The steroids comprise mainly of dexamethasone and prednisolone in adulterated tablets and powders prescribed by hakeems.