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Journal of Pharmacy & Bioallied Sciences Apr 2024The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have...
INTRODUCTION
The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia.
MATERIALS AND METHODS
This cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic.
RESULTS
A total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days.
CONCLUSIONS
This study helps in understanding healthcare practitioners' patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics.
PubMed: 38882843
DOI: 10.4103/jpbs.jpbs_506_23 -
Patient Preference and Adherence 2024The Saudi Community pharmacy sector has been changing towards patient-centred care rather than depending solely on dispensing medications. Accordingly, pharmacies can...
BACKGROUND
The Saudi Community pharmacy sector has been changing towards patient-centred care rather than depending solely on dispensing medications. Accordingly, pharmacies can now provide many services that they previously could not offer. The aims of this study were to identify all pharmacy services provided in a community setting and to assess public awareness and utilization of and satisfaction with these services.
METHODS
This was a cross-sectional study in which the authors first purposively visited community pharmacies to identify the services offered. Pharmacists were asked about pharmacy services currently provided to community. Fieldnotes were used to document pharmacists' responses. After identifying pharmacy services, a questionnaire was desgined and reviewed by experts in the field, piloted and approved by the Ethics Committee at King Faisal University, then disseminated via Google Forms. The satisfaction level with pharmacy services was assessed using a five-point Likert scale. Data were collected from 24 January 2023 to 2 March 2023.
RESULTS
Eighteen community pharmacies offering 17 different services were visited across Alahsa Governorate. The number of participants who completed the questionnaire was 350. Of those (232 [66.3%]) were female, and the majority of the sample (80.5%) were younger than 40 years old. The majority of the participants were unaware of pharmacy services. Out of 17 services, six received a score of 50% or higher regarding participant awareness. The most utilized services were the medication dispensing service "Wasfaty" (250 [71.4%]), medication counselling provided by pharmacists (232 [66.3%]) and minor ailment service (231 [66%]). The overall satisfaction score for pharmacy services was 87.2%.
CONCLUSION
The majority of the participants were unaware of the full range of available pharmacy services. There is a potential for community pharmacists to fill the capacity gap in the healthcare system since, overall, the participants rated the pharmacies' clinical services as satisfactory. Commissioners of pharmacy services may consider extending the scope of community pharmacies to include services that best utilize the expertise of clinical pharmacists.
PubMed: 38882642
DOI: 10.2147/PPA.S460978 -
Scientific Reports Jun 2024Neuronal activity is accompanied by a net outflow of potassium ions (K) from the intra- to the extracellular space. While extracellular [K] changes during neuronal...
Neuronal activity is accompanied by a net outflow of potassium ions (K) from the intra- to the extracellular space. While extracellular [K] changes during neuronal activity are well characterized, intracellular dynamics have been less well investigated due to lack of respective probes. In the current study we characterized the FRET-based K biosensor lc-LysM GEPII 1.0 for its capacity to measure intracellular [K] changes in primary cultured neurons and in mouse cortical neurons in vivo. We found that lc-LysM GEPII 1.0 can resolve neuronal [K] decreases in vitro during seizure-like and intense optogenetically evoked activity. [K] changes during single action potentials could not be recorded. We confirmed these findings in vivo by expressing lc-LysM GEPII 1.0 in mouse cortical neurons and performing 2-photon fluorescence lifetime imaging. We observed an increase in the fluorescence lifetime of lc-LysM GEPII 1.0 during periinfarct depolarizations, which indicates a decrease in intracellular neuronal [K]. Our findings suggest that lc-LysM GEPII 1.0 can be used to measure large changes in [K] in neurons in vitro and in vivo but requires optimization to resolve smaller changes as observed during single action potentials.
Topics: Animals; Potassium; Neurons; Mice; Biosensing Techniques; Action Potentials; Cells, Cultured; Fluorescence Resonance Energy Transfer; Optogenetics
PubMed: 38877089
DOI: 10.1038/s41598-024-62993-1 -
PloS One 2024Medication review (MR) services are evidenced-based practices in which a systematic assessment of a patient's medication is conducted, primarily aiming to optimize drug...
Integrating design thinking and implementation science principles in delivering a medication review service in the community pharmacy setting-An implementation testing study.
BACKGROUND
Medication review (MR) services are evidenced-based practices in which a systematic assessment of a patient's medication is conducted, primarily aiming to optimize drug therapy and minimize adverse drug events through pharmacist interventions. Although studies show that MR services are effective, the implementation of MR services in Malaysia has been challenging due to several barriers. An MR services blueprint was developed to be adapted to the Malaysian community pharmacy setting as part of tailoring strategies.
OBJECTIVE
Through utilizing the design thinking triple diamond model and implementation science principles, a powerful guide for healthcare researchers and stakeholders to assist with effective service implementation, this study aimed to evaluate the implementation testing and observe the effectiveness of the developed MR service blueprint.
METHOD
The study utilizes an effectiveness-implementation Type 3 hybrid implementation science framework conducted from May 2021 to April 2022. Employing a qualitative ethnographic approach, researchers observed pharmacy study sites during the implementation of MR services. Both qualitative and quantitative data were collected across exploration, preparation, testing, and operational phases. Implementation outcomes evaluated include phases, reach, fidelity, acceptability, as well as implementation barriers and strategies. MR intervention outcomes included service characteristics and the number and type of drug-related problems and interventions offered.
RESULTS
17 community pharmacists were invited to pilot the MR service blueprint for six months in their setting. Of this, 78.5% (n = 11) of the pharmacies reached the testing phase, and 36% (n = 4) reached the implementation phase. Fifty-four patients were in the study, giving an implementation reach of 70%. The majority of surveyed patients expressed satisfaction with the service. The total DRP identified was 133, and 64 interventions were provided by the pharmacists. Facilitation strategies such as "Engage stakeholders by creating ownership of the change" and "Equip stakeholders with training" are needed to overcome the barriers.
CONCLUSION
This study marked the beginning of successful MR service implementation at Malaysian community pharmacies. Future studies with multi-level partnered strategies are required to reach full implementation and sustainability.
Topics: Humans; Community Pharmacy Services; Implementation Science; Malaysia; Pharmacists; Male; Female; Adult; Middle Aged; Pharmacies
PubMed: 38870126
DOI: 10.1371/journal.pone.0304291 -
PCN Reports : Psychiatry and Clinical... Dec 2023This study aimed to examine the effects of real-time online clinical practice using real-time virtual reality (VR) compared with 2D PC screening on reducing stigma...
AIM
This study aimed to examine the effects of real-time online clinical practice using real-time virtual reality (VR) compared with 2D PC screening on reducing stigma toward dementia, and to investigate the feasibility of online clinical practice using VR.
METHODS
A single-center, open-label, randomized controlled trial was conducted. Occupational therapy students were randomized to view occupational therapy evaluation screens for dementia patients using a VR headset or 2D monitor. The Attitudes Toward Dementia Scale (ADS), the Dementia Knowledge Scale (DKS), and Images of the Elderly with Dementia (IED) were assessed before and after the intervention. The level of clinical practice satisfaction and the System Usability Scale (SUS) were also assessed.
RESULTS
The number of subjects in the intervention and control groups was 10 and 9, respectively. In ADS scores and IED, the main effect was shown in both groups and did not show interactions. In DKS scores, the main effect and interaction were not shown. The VR headset tended to be more usable than the 2D monitor in terms of usability. Satisfaction ratings indicated the characteristics of a realistic clinical experience through real-time VR viewing.
CONCLUSION
Real-time VR and 2D online clinical practice could reduce the stigma toward dementia, but there were no significant differences between the types. The real-time VR experience was more similar to actual clinical practice than a 2D PC screening due to the sense of immersion, but issues in blinding and lack of audio and video quality were found.
PubMed: 38868728
DOI: 10.1002/pcn5.160 -
Research in Social & Administrative... Jun 2024Early identification and treatment of mental illnesses is imperative for optimal patient outcomes. Pharmacists may play an important role in mental healthcare through... (Review)
Review
BACKGROUND
Early identification and treatment of mental illnesses is imperative for optimal patient outcomes. Pharmacists may play an important role in mental healthcare through the provision of screening services for mental illnesses.
OBJECTIVE
(s): To systematically review the impact of pharmacist-led mental illness screening on clinical or patient-reported outcomes and identify and report any follow-up or referral systems used in pharmacist-led screening interventions for mental illnesses.
METHODS
A systematic review was conducted by searching MEDLINE, CINAHL, Embase and APA PsycInfo via EBSCOhost from inception to 9 March 2023 to identify studies involving pharmacist-led screening interventions for mental illnesses. Data was collected on the mental illness in question, setting and population characteristics, screening tools used, clinical or patient-reported outcomes, and follow-up and referral systems reported.
RESULTS
Twenty six studies were identified that related to screening for mental illnesses, such as depressive disorders and substance use disorders. There were a variety of study designs, including uncontrolled studies (n = 23), pre-post studies (n = 2) and randomised controlled trials (n = 1). Screening was conducted in different settings, with most studies conducted in community pharmacies (n = 21/26, 87.8 %) and focusing on depression screening (n = 12/26, 46.1 %). A range of follow-up and referral methods to other healthcare professionals were reported, including verbal (n = 3/26, 11.5 %), both written and verbal (n = 3/26, 11.5 %), communications via electronic health record (n = 2/26, 7.7 %) and written (n = 1/26, 3.8 %).
CONCLUSIONS
Pharmacists provide screening for a variety of mental illnesses in different settings. Various referral methods and follow-up pathways may be utilised for post-screening patient care. However, current evidence is insufficient to establish improvements in early detection, treatment, or outcomes. Further large, well-designed studies are required to support the role of pharmacists in mental illness screening, provide evidence on the impact of pharmacist-led mental illness screening services and inform the most effective follow up and referral methods.
PubMed: 38866605
DOI: 10.1016/j.sapharm.2024.06.001 -
Upsala Journal of Medical Sciences 2024To compare statin utilization and ischemic heart disease (IHD) mortality trends in Lithuania and Sweden and to assess correlations between the total utilization of...
AIMS
To compare statin utilization and ischemic heart disease (IHD) mortality trends in Lithuania and Sweden and to assess correlations between the total utilization of statins and IHD mortality.
METHODS
An ecological study assessing time trends in statin utilization (DDDs per 1000 inhabitants per day; DDD/TID) and IHD mortality in Lithuania and Sweden between 2000 and 2020. Statin utilization data in Lithuania were wholesale trade data, and Swedish data were drugs dispensed at pharmacies. IHD mortality data were extracted from national databases as rates per 100 000 inhabitants. Associations between statin utilization and IHD mortality in Lithuania and Sweden were examined using Spearman's rank and Pearson's correlation coefficients, respectively.
RESULTS
Statin utilization increased from 16.8 to 135.8 DDD/TID in Sweden and from 0.2 to 61.8 DDD/TID in Lithuania between 2000 and 2020. Medium intensity was the most common statin dosage in Lithuania, while Sweden used more high intensity than moderate-intensity statins from 2017. IHD mortality in Lithuania remained high between 2000 and 2020 (from 359.1 to 508.8 deaths per 100 000 population), while it decreased markedly in Sweden (from 226.87 to 88.7 deaths per 100 000 population). IHD mortality and statin utilization were inversely correlated in Sweden (r = -0.993, < 0.001), while a positive correlation was found in Lithuania (rs = 0.871, < 0.001).
CONCLUSION
Despite the growing statin utilization in both countries, Lithuania recorded a slight increase in IHD mortality rates unlike the situation in Sweden. This indicates room for improvement in the management of modifiable cardiovascular risk factors in Lithuania including how statins are prescribed and used in clinical practice.
Topics: Lithuania; Sweden; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Myocardial Ischemia; Male; Female; Middle Aged; Aged; Drug Utilization
PubMed: 38863727
DOI: 10.48101/ujms.v129.10412 -
JAC-antimicrobial Resistance Jun 2024The irrational use of antibiotics in humans and livestock has contributed to the emergence of antimicrobial resistance (AMR). This study investigated the commonly sold...
BACKGROUND
The irrational use of antibiotics in humans and livestock has contributed to the emergence of antimicrobial resistance (AMR). This study investigated the commonly sold and dispensed antibiotics for prophylaxis in broiler chickens in pharmacy and agro-veterinary shop personnel in the Lusaka District of Zambia.
METHODS
This cross-sectional study was conducted from August 2023 to October 2023 among 200 veterinary medicine dispensers in the Lusaka District of Zambia using a simulated farmer or mystery shopper approach. Data analysis was performed using IBM Statistical Package for Social Sciences version 23.0.
RESULTS
Out of the 200 medicine outlets investigated, 23 (11.5%) were agro-veterinary shops, while 177 (88.5%) were community pharmacies. A total of 165 community pharmacies and agro-veterinary shops provided veterinary services in the Lusaka District and sold medicines without prescription giving a 100% non-prescription sale. Of the 178 medicines dispensed for prophylaxis, 88.5% were antibiotics, while 13.5% were vitamins. The most dispensed antibiotic drug for prophylaxis in broiler chickens was oxytetracycline (30.34%), amoxicillin (17.98%) and gentamicin/doxycycline (10.67%).
CONCLUSIONS
This study revealed a high sale and dispensing of antibiotics for prophylaxis in broiler chickens of which oxytetracycline, amoxicillin and gentamicin/doxycycline were commonly dispensed. There is a need for increased regulatory enforcement of selling antibiotics without a prescription as this may predispose poultry to the development of AMR and possible transmission of superbugs to humans and the environment. Educational interventions should be provided to community pharmacy and agro-veterinary personnel on adhering to antimicrobial stewardship practices when dispensing poultry antibiotics.
PubMed: 38863561
DOI: 10.1093/jacamr/dlae094 -
Presentation of B-cell lymphoma in childhood and adolescence: a systematic review and meta-analysis.BMC Cancer Jun 2024The diagnosis of B-cell lymphoma, one of the commonest cancers seen in childhood and adolescence, is challenging. There is a crucial need to identify and delineate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The diagnosis of B-cell lymphoma, one of the commonest cancers seen in childhood and adolescence, is challenging. There is a crucial need to identify and delineate the prevalence of associated symptoms in order to improve early diagnosis.
AIMS
To identify clinical presentations associated with childhood and adolescent B-cell lymphomas and estimate symptom prevalence.
METHODS
A systematic review of observational studies and meta-analysis of proportions was carried out. Medline and EMBASE were systematically searched, with no language restrictions, from inception to 1st August 2022. Observational studies with at least 10 participants, exploring clinical presentations of any childhood and adolescent lymphoma, were selected. Proportions from each study were inputted to determine the weighted average (pooled) proportion, through random-effects meta-analysis.
RESULTS
Studies reported on symptoms, signs and presentation sites at diagnosis of 12,207 children and adolescents up to the age of 20. Hodgkin's lymphoma most frequently presented with adenopathy in the head-and-neck region (79% [95% CI 58%-91%]), whilst non-Hodgkin's lymphoma presented abdominally (55% [95% CI 43%-68%]). Symptoms associated with lymphoma included cervical lymphadenopathy (48% [95% CI 20%-77%]), peripheral lymphadenopathy (51% [95% CI 37%-66%]), B-symptoms (40% [95% CI 34%-44%]), fever (43% [95% CI 34%-54%]), abdominal mass (46% [95% CI 29%-64%]), weight loss (53% [95% CI 39%-66%]), head-and-neck mass (21% [95% CI 6%-47%]), organomegaly (29% [95% CI 23%-37%]), night sweats (19% [95% CI 10%-32%]), abdominal pain (28% [95% CI 15%-47%]), bone pain (17% [95% CI 10%-28%]) and abnormal neurology (11% [95% CI 3%-28%]).
CONCLUSION
This systematic review and meta-analysis of proportions provides insight into the heterogeneous clinical presentations of B-cell lymphoma in childhood and adolescence and provides estimates of symptom prevalence. This information is likely to increase public and clinical awareness of lymphoma presentations and aid earlier diagnosis. This review further highlights the lack of studies exploring childhood and adolescent lymphoma presentations in primary care, where patients are likely to present at the earliest stages of their disease.
Topics: Humans; Adolescent; Child; Lymphoma, B-Cell; Lymphadenopathy; Observational Studies as Topic; Child, Preschool; Hodgkin Disease; Prevalence
PubMed: 38862882
DOI: 10.1186/s12885-024-12372-w -
Frontiers in Pharmacology 2024Both (SF) and (AM) are known for their anti-inflammatory, antifibrotic, and anticancer activities. However, the efficacy, multi-target mechanisms, and therapeutic...
BACKGROUND
Both (SF) and (AM) are known for their anti-inflammatory, antifibrotic, and anticancer activities. However, the efficacy, multi-target mechanisms, and therapeutic substances of SF-AM herb pair on the progression of hepatitis-cirrhosis-hepatocellular carcinoma hepatocellular carcinoma (HCC) remain unclear.
PURPOSE
To investigate the efficacy, mechanisms, and potential therapeutic substances of SF-AM herb pair in the progression of hepatitis-cirrhosis-HCC.
METHODS
Firstly, diethylnitrosamine was used to establish the hepatitis-cirrhosis-HCC model. HE staining and non-targeted metabolomics were used to evaluate the efficacy of SF-AM herb pair. Subsequently, the absorbed components of SF-AM herb pair in the plasma of rats were determined through HPLC-Q-TOF-MS/MS analysis. Flow cytometry, Western blot, and qRT-PCR were then employed to assess CD4 and CD8 T lymphocytes, PI3K/Akt signaling pathway-related proteins, and their corresponding mRNAs. Simultaneously, the efficacy and mechanism of SF-AM herb pair on HCC were confirmed by experiments. Finally, Pearson correlation analysis was performed between pharmacodynamic indicators and components to identify the potential therapeutic substances of SF-AM herb pair.
RESULTS
SF-AM herb pair can alleviate the pathological damage and reverse metabolic abnormalities in hepatitis, cirrhosis, and HCC rats, particularly during the hepatitis and cirrhosis stages. Pharmacological researches have demonstrated that SF-AM herb pair can increase the proportion of CD8 T lymphocytes, inhibit the expression of PI3K, Akt, p-Akt, NF-κB p65, NF-κB pp65, and Bcl-2, as well as increase the expression of IκBα, Bax, and cleaved caspase-3. These findings suggest that SF-AM herb pair has the ability to enhance immunity, anti-inflammation and promote apoptosis. Cell experiments have shown that SF-AM herb pair can inhibit the proliferation of HepG2 cell and regulate the PI3K/Akt signaling pathway. Moreover, 23 absorbed prototypical components and 53 metabolites of SF-AM herb pair were identified at different stages of HCC rats. Pearson correlation analysis revealed that matrine, cytisine, wogonoside, and isoastragaloside are potential therapeutic substances in SF-AM herb pair for the prevention and treatment of hepatitis, cirrhosis, and HCC.
CONCLUSION
In summary, this study revealed the efficacy, mechanisms, and potential therapeutic substances of SF-AM herb pair in the hepatitis-cirrhosis-HCC axis and provided a reference for its clinical application.
PubMed: 38860166
DOI: 10.3389/fphar.2024.1284752