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COVID-19, an enveloped, positive-sense single-stranded RNA virus, is spreading quickly and growing exponentially world-wide [1]. As of March 27, 2020, in the US, there are 103,321 individuals who have contracted it and 1,246 have died [2]. Despite the US’s knowledge of the virus since the end of 2019, lack of sufficient preparation is beginning to prove devastating for the American people. One reason for COVID-19’s vigor may be that RNA viruses with spikes on their envelopes have been presumed to have likely outbreak potential due to their high mutation and recombination rate [1]. Coronaviruses can be divided into four types: α, β, γ, and δ, depending on the serotype and genotype. COVID-19 is a β-coronavirus, which causes infections in humans. The most prevalent symptoms of coronavirus include fever, dry cough, lethargy, and muscle pain. The less common symptoms are sore throat, rhinorrhea, hemoptysis, diarrhea, and chills. About 25% of confirmed cases can lead to complications, such as Acute Respiratory Distress Syndrome (ARDS), sepsis, and septic shock. Such complications are seen more often in the elderly population with comorbidities [3].

Objective: While treating anaemia in end stage renal disease (ESRD) patients, recombinant human erythropoietin (EpO) is the therapy of choice. However, it is rarely used in developing countries because of the financial constrains to the healthcare as well as the patient. Keeping the point of view in mind, the objective of this research was to identify the use of Epo, its frequency, and dosage in the patients of ESRD receiving continuous haemodialysis in Quetta city, Pakistan. Methods: This was a retrospective, single cantered study. The selected population was subject with ESRD and on dialysis with prolonged anaemia. All recipients of dialysis in the past one year were targeted for the study. Data of the patients regarding anaemia and the use of erythropoietin was collected through a data collection sheet. Evaluation of the bio-chemical parameters of ESRD patients on haemodialysis was also be taken into consideration. Demographics of the selected patients were recorded carefully for the evaluation and analysis. SPSS 20.0 was used for data analysis and based on the objectives; both descriptive and inferential statistics were used for data elaboration. Results: A total of 97 ESRD patients that fulfilled the inclusion criteria were enrolled. Out of the 97, (52.6%) had age of more than 47 years and the cohort was dominated by males (63, 64.9%). Seventy two patients were on EPo use with majority on dose of 10000 IU with once a week frequency. The Man Whitney U test was used to compare erythropoietin use / non use and biochemical parameters. Haemoglobin percentage was significantly associated with erythropoietin use (p<0.05). The mean rank interpretation revealed erythropoietin users significantly associated with improved haemoglobin percentage. The Kruskal Wallis test was used to compare erythropoietin usage frequency and biochemical parameters. Haemoglobin percentage was again significantly associated with erythropoietin use frequency. The Bonferroni correction revealed erythropoietin frequency of twice a week was significantly associated with improved haemoglobin percentage. Conclusion: Although the use of EPO among ESRD was reasonable, few patients were not prescribed EPo for anaemia associated with ESRD. We do understand that availability and affordability can be a major reason here; policy makers should make sure about the use of EPo because of its evidence-based advantages over other procedures. Keywords: Frequency, erythropoietin, end stage renal disease, Quetta

Background: Use of generic medicines significantly reduces the cost of medicines to both governments and patients. The adoption of generic drugs in medical practices is a complex phenomenon and many determinants can affect it. Physicians and general practitioners play a key role in controlling this phenomenon and their decision in prescribing generic drugs is likely to be affected by many factors. Understanding general practitioners’ perception of the quality and efficacy of generic medicines may help identify potential barriers to greater generic medication use. Objective: To assess the perception, attitude and practice of general practitioners towards prescribing generic medicines in the emergency room of public hospitals in Khartoum, Sudan. Methods: A hospital-based descriptive cross-sectional study was implemented. All of the Emergency rooms in public hospitals of Khartoum Sudan were assessed. The data was collected through a standardized questionnaire (Annex). The data were analysed through the Statistical Package for Social Sciences (SPSS) version 21.0 (IBM SPSS Inc., Chicago, IL) was used. Results: The predominant gender was females who account for 53% per cent of the sample, while males were 47%. According to the distribution of general practitioners understanding, 72% had a good understanding of generic medicines while 28% had a poor understanding of generic medicine. According to the distribution of general practitioners perception, 64% of had, good perceptions towards generic medicines while 36% had poor perceptions towards generic medicine. According to the distribution of general practitioners attitude, 68% had a good attitude towards prescribing generic medicines while 32% had poor perceptions of generic medicine. Conclusion: Good understanding, perceptions and attitudes among general practitioners towards prescribing generic medicines in the emergency room of public hospitals was observed in Khartoum, Sudan. Majority of the GPs think that generic medicines locally manufactured in Sudan are not following Good Manufacturing Practices (GMP) guidelines as multinationals.