September 1981, Volume 31, Issue 9

Original Article

Abuse of Steroidal Drugs by Homoeopaths and Hakims

Nafis M. Din  ( National Institute of Health, Islamabad. )
Changez Khan  ( National Institute of Health, Islamabad. )
M.I. Burney  ( National Institute of Health, Islamabad. )

Abstract

Reports of remarkable recovery by using Unani and Homoeopathic medicines in chronic diseases like rheumatoid Arthritis, sinusitis, Chronic pharyngitis, bronchial asthma and kidney stone have often been reported. Twenty Nine samples of Unani and homoeopathic medicines were investi­gated by Chemical and Thin Layer Chromatographic methods for the presence of
steroids. The results show that 80% of samples tested contained cortisone, hydrocortisone, Dexamethasone and Prednisolone (JPMA 31:204,1981).

Introduction

The indiscriminate use of steroids is causing a great concern. Apart from qualified doctors, who have specifically been trained to use these potent drugs, Hakims and Homoeopaths are also been using them without the knowledge of their adverse effects.
The striking therapeutic response to the drugs prescribed by practitioners of traditional medicine in diseases like rheumatoid Arthritis prompted us to conduct this study.

Material and Methods

Twenty nine unspecified Unani and Homoeopathic preparations were received from different sources. The samples were screened for the presence of glucocorticoid like Cortisone, Hydrocortisone, Prednisolone and Dexamethasone using colour test, Spectrophotometery (Johsons and Thoruton, 1966) and modified thin layer Chromatography (Esthal, 1969).
Silica Gel 20 x 20 cm plates, 0.25 mm layer thickness were activated at 110°C for one hour. The plates were kept in desicator for activiation.
The unknown samples were solubilised by checking the solubility in different organic and inorganic solvents. Samples and reference standards were applied to the Chromatoplate, dried and developed in Chloroform saturated chambers. The time of operation in each case was 40 minutes. After development the plates were air dried and observed under U.V. 366 mm. The Chromato-plates were sprayed with 5% phosphoric acid solution in Ehanol (Treatment-I) and heated at 110°C for 10 minutes and read in day light and U.V. light. After treatment I the Chromatoplates were sprayed with 10% Phos-phomolybdic acid in Acetone (Treatment-II) and heated at 118°C for 5 minutes and observed in day light and U.V. light.

Results

Eighty percent of samples were found to contain glucocorticoids. One sample contained Dexamethasone and prednisolone, 10 contained Dexamethasone, 5 Hydrocortisone, 6 Prednisolone, and 1 sample contained cortisone.

Discussion

Public health problems that have been associated with drugs abuse are common in Pakistan. During investigation, it was found that Hakims and Homoeopths use life saving drugs like steroids (Dexamethasone, Hydrocortisone, Prednisolone and Cortisone) frequently for ailments like asthma, rheumatoid arthitis, kidney pain, Sinusitis and Pharygnitis, without having any knowledge of their therapeutic and toxic effects.
In allopathic system, prednisolone is used in leukaemias, lymphomas and inflammatory condi­tions for its potent effects. Whereas Dexamethasone and Betamethasone are used where high doses are required to suppress the inflammatory reaction and other disease processess. Indiscriminate and prolonged use and abrupt withdrawl of steroidal preparations is likely to result in severe constitutional symptoms, hypotension and vascular collapse. The interactions of these drugs with homoeopathic, Unani and Ayurvedic preparations is also not known. In the absence of any drug monitoring system in the country the minor and, lethal effects of steroids and other drugs of known allopathic systems cannot be evaluated. It is therefore essential that the use of these preparations by those who are not trained in the scientific system should be prohibited by law.

Acknowledgements

The authors are grateful to Dr. Zaheer Ahmed Jan, Chairman, Quality Control of Drugs, Ministry of Health and Social Welfare, Government of Pakistan and Mr. Faiyaz Ahmad Lari, Chief, Biological Production Division, National Institute of Health, Islamabad for extending help and guidance druing the course of this study.

References

1. Johnson, C.A. Thornton Jones, A.D. Drug Identification. London, Pharmaceutical Press, 1966, p. 30-2, 94.
2. Martindalea W. Extra pharmacopoea. 27th ed. London, Pharmaceutical press, 1977, p. 389.
3. Salerni, O.R. Natural and synthetic organic medicinal compounds. St. Louis, Mosby, 1976, p. 150.
4. Turner, P. and Richens, A. Clinical pharmacology, 3rd ed. Edinburgh, Churchill-Livingstone, 1978, p. 186.
5. Neher R. Thin Layer Chromatography, 2nd, Ed. E. Sthal, George Allen & Unwin Ltd., London, 1969, p. 317 322.
6. Softer, L.J. and Dorfman, R.I. The human adrenal gland. Philadelphia, Lea & Febiager, 1961,

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: