Search results for: access to drugs

Authors: Chieh-Nan Chen, Ji-Yu Lin, I-Ming Chu

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Polypeptide thermosensitive hydrogel is an excellent candidate as a smart device to deliver drugs and cells due to its remarkable biocompatibility, low gelation concentration, and respond to temperature stimuli, it can be easily injected as a polymer solution into the patient’s body where it undergoes gelation due to an elevation in temperature. Poly (ethylene glycol) monomethyl ether-poly (ethyl-l-glutamate) (mPEG-PELG) contains a hydrophobic side chain –C2H5 which is useful in encapsulating and stabilizing hydrophobic drugs. In this study, we plan to focus on the hydrophobic anti-carcinogenic and anti-inflammatory drug curcumin, which due its insolubility in water, requires a proper carrier for delivery into the body. Our main concept is to use mPEG-PELG to stabilize curcumin, inject the curcumin-loaded hydrogel into the tumor site, and allow the enzymatically-sensitive hydrogel to be degraded by bodily fluids and release the drug. The polymers of interest have been successfully synthesized and characterized by 1H-NMR, FT-IR, SEM, and CMC. Curcumin loading content and drug release were assayed using HPLC. Preliminary results show that these materials have potential as a delivery vehicle for poorly soluble drugs.

Keywords: curcumin, drug release, hydrogel, polypeptide material

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Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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Authors: Chapman Eze Nnadozie

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Relational databases constitute a very vital tool for the effective management and administration of both personal and organizational data. Data access ranges from a single user database management software to a more complex distributed server system. This paper intends to appraise the use a programming language extension like structured query language (SQL) to establish links to a relational database (Microsoft Access 2013) using Visual C++ 9 programming language environment. The methodology used involves the creation of tables to form a database using Microsoft Access 2013, which is Object Linking and Embedding (OLE) database compliant. The SQL command is used to query the tables in the database for easy extraction of expected records inside the visual C++ environment. The findings of this paper reveal that records can easily be accessed and manipulated to filter exactly what the user wants, such as retrieval of records with specified criteria, updating of records, and deletion of part or the whole records in a table.

Keywords: data access, database, database management system, OLE, programming language, records, relational database, software, SQL, table

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Authors: Ana Caroline Ibrahim Lino, Denise Bomtempo Birche de Carvalho

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The background of this research is the international process of control and monitoring of illicit psychoactive substances that has commenced in the early 20th century. This process was intensified with the UN Single Convention on Narcotic Drugs of 1961 and had its culmination in the 1970s with the "War on drugs", a doctrine undertaken by the United States of America. Since then, the phenomenon of drug prohibition has been pushing debates around alternatives of public policies to confront their consequences at a global level and in the specific context of Latin America. Previous research has answered the following key questions: a) With what characteristics and models has the international illicit drug control system consolidated in Latin America with the creation of the Organization of American States (OAS) and the Inter-American Drug Abuse Control Commission (CICAD)? b) What drug policies and programs were determined as guidelines for the member states by the OAS and CICAD? The present paper mainly addresses the analysis of the drug strategies developed by the OAS/CICAD for the Americas from 2004 to 2016. The primary sources have been extracted from the OAS/CICAD documents and reports, listed on the Internet sites of these organizations. Secondary sources refer to bibliographic research on the subject with the following descriptors: illicit drugs, public policies, international organizations, OAS, CICAD, and reducing the demand and supply of illicit drugs. The "content analysis" technique was used to organize the collected material and to choose the axes of analysis. The results show that the policies, strategies, and action plans for Latin America had been focused on anti-drug actions since the creation of the Commission until 2010. The discourses and policies to reduce drug demand and supply were of great importance for solving the problem. However, the real focus was on eliminating the substances by controlling the production, marketing, and distribution of illicit drugs. Little attention was given to the users and their families. The research is of great relevance to the Social Work. The guidelines and parameters of the Social Worker's profession are in line with the need for social, ethical, and political strengthening of any dimension that guarantees the rights of users of psychoactive substances. In addition, it contributed to the understanding of the political, economic, social, and cultural factors that structure the prohibitionism, whose matrix anchors the deprivation of rights and violence.

Keywords: illicit drug policies, international organizations, latin America, prohibitionism, reduce the demand and supply of illicit drugs

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Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

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In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

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Authors: A: Asmawi, L. S. Affendey, N. I. Udzir, R. Mahmod

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The topic of enhancing security in XML databases is important as it includes protecting sensitive data and providing a secure environment to users. In order to improve security and provide dynamic access control for XML databases, we presented XLog file to calculate user trust values by recording users’ bad transaction, errors and query severities. Severity-aware trust-based access control for XML databases manages the access policy depending on users' trust values and prevents unauthorized processes, malicious transactions and insider threats. Privileges are automatically modified and adjusted over time depending on user behaviour and query severity. Logging in database is an important process and is used for recovery and security purposes. In this paper, the Xlog file is presented as a dynamic and temporary log file for XML databases to enhance the level of security.

Keywords: XML database, trust-based access control, severity-aware, trust values, log file

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Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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Authors: Shrawan Baghel, Helen Cathcart, Biall J. O'Reilly

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Amorphous drug formulations have great potential to enhance solubility and thus bioavailability of BCS class II drugs. However, the higher free energy and molecular mobility of the amorphous form lowers the activation energy barrier for crystallization and thermodynamically drives it towards the crystalline state which makes them unstable. Accurate determination of the crystallization tendency/kinetics is the key to the successful design and development of such systems. In this study, dipyridamole (DPM) and cinnarizine (CNZ) has been selected as model compounds. Thermodynamic fragility (m_T) is measured from the heat capacity change at the glass transition temperature (Tg) whereas dynamic fragility (m_D) is evaluated using methods based on extrapolation of configurational entropy to zero 〖(m〗_(D_CE )), and heating rate dependence of Tg 〖(m〗_(D_Tg)). The mean relaxation time of amorphous drugs was calculated from Vogel-Tammann-Fulcher (VTF) equation. Furthermore, the correlation between fragility and glass forming ability (GFA) of model drugs has been established and the relevance of these parameters to crystallization of amorphous drugs is also assessed. Moreover, the crystallization kinetics of model drugs under isothermal conditions has been studied using Johnson-Mehl-Avrami (JMA) approach to determine the Avrami constant ‘n’ which provides an insight into the mechanism of crystallization. To further probe into the crystallization mechanism, the non-isothermal crystallization kinetics of model systems was also analysed by statistically fitting the crystallization data to 15 different kinetic models and the relevance of model-free kinetic approach has been established. In addition, the crystallization mechanism for DPM and CNZ at each extent of transformation has been predicted. The calculated fragility, glass forming ability (GFA) and crystallization kinetics is found to be in good correlation with the stability prediction of amorphous solid dispersions. Thus, this research work involves a multidisciplinary approach to establish fragility, GFA and crystallization kinetics as stability predictors for amorphous drug formulations.

Keywords: amorphous, fragility, glass forming ability, molecular mobility, mean relaxation time, crystallization kinetics, stability

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Authors: Sachin Saxena, Manju Srivastava

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The present study describes a stable, highly sensitive and selective analytical sensor. Fe-BTC was synthesized at room temperature using the noble Iron-trimesate system. The high surface area of as synthesized Fe-BTC proved MOFs as ideal modifiers for glassy carbon electrode. The characterization techniques such as TGA, XRD, FT-IR, BET (BET surface area= 1125 m2/gm) analysis explained the electrocatalytic behaviour of Fe-BTC towards these two drugs. The material formed is cost effective and exhibit higher catalytic behaviour towards analyte systems. The synergism between synthesized Fe-BTC and electroanalytical techniques helped in developing a highly sensitive analytical method for studying the redox fate of ARP and RZ, respectively. Cyclic voltammetry of ferricyanide system proved Fe-BTC/GCE with an increase in 132% enhancement in peak current value as compared to that of GCE. The response characteristics of cyclic voltammetry (CV) and square wave voltammetry (SWV) revealed that the ARP and RZ could be effectively accumulated at Fe-BTC/GCE. On the basis of the electrochemical measurements, electrode dynamics parameters have been evaluated. Present study opens up new field of applications of MOFs modified GCE for drug sensing.

Keywords: MOFs, anti-psychotic, electrochemical sensor, anti-migraine drugs

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Authors: Babatunde Olumide Olawale, Oyebode Olumide Oyediran

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The security safe is a place or building where classified document and precious items are kept. To prevent unauthorised persons from gaining access to this safe a lot of technologies had been used. But frequent reports of an unauthorised person gaining access into security safes with the aim of removing document and items from the safes are pointers to the fact that there is still security gap in the recent technologies used as access control for the security safe. In this paper we try to solve this problem by developing a multimodal biometric system for physical access control into a security safe using face and voice recognition. The safe is accessed by the combination of face and speech pattern recognition and also in that sequential order. User authentication is achieved through the use of camera/sensor unit and a microphone unit both attached to the door of the safe. The user face was captured by the camera/sensor while the speech was captured by the use of the microphone unit. The Scale Invariance Feature Transform (SIFT) algorithm was used to train images to form templates for the face recognition system while the Mel-Frequency Cepitral Coefficients (MFCC) algorithm was used to train the speech recognition system to recognise authorise user’s speech. Both algorithms were hosted in two separate web based servers and for automatic analysis of our work; our developed system was simulated in a MATLAB environment. The results obtained shows that the developed system was able to give access to authorise users while declining unauthorised person access to the security safe.

Keywords: access control, multimodal biometrics, pattern recognition, security safe

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Authors: Nabil Ahmed Kamal Badawy, Ali Falah Alhajraf, Mawaheb Falah Alsamdan

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Objectives: To estimate the prevalence of self-medication with over-the-counter pain relievers (acetaminophen, ibuprofen, and aspirin) among Kuwaiti citizens above the age of 16 years old and describe their patterns of use, perceived awareness of, and concerns about the drugs’ potential side effects. Design: A descriptive cross-sectional questionnaire-based survey. Setting: Samples were selected from the six Kuwaiti governorates. Subjects: The data were collected over a four-month period in 2012, from 850 subjects who identified as Kuwaiti citizens. These subjects were recruited using stratified random sampling. Results: Overall, a 67% response rate was obtained. In total, 68% (573) of the respondents reported the use of over-the-counter pain relievers. Women, middle-aged or single individuals, and those who had completed higher education used these drugs more than any other subgroup (p<0.05). We found evidence of inappropriate use of these drugs, with 15% (88) of the consumers using them almost daily. Further, 19% (111) of the consumers exceeded the recommended dosage at least once. Not only were 81% of the consumers unaware of the potential side effects, but also more than 61% were not concerned about them. Women were more knowledgeable than men regarding the maximum dose (p=0.036, OR 1.49, CI 1.03–2.17). Consumers with higher levels of education did not show distinct knowledge regarding the maximum allowed dose of the drugs (p=0.252, OR 1.71, CI 0.68-4.25). Conclusion: The results showed a high prevalence of self-medication with over-the-counter pain relievers among Kuwaiti citizens. The subjects showed marked unawareness and a lack of concern regarding the potential complications resulting from the inappropriate use of these analgesics. This demonstrates the need for educational interventions directed toward both patients and health care workers.

Keywords: awareness of side effects, concern, patterns of use, prevalence

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Authors: Mansilla, Juan Camilo

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According to many studies, public space in the cities of Global South is constantly morcellated and captured by a multiplicity of actors in a permanent struggle for power. This imposed public space restricts the access to services and political actions to many inhabitants. The author has conducted several focus group sessions using video in a reflective mode with low-income communities in Medellín, Colombia in order to study how people in this city are shift from a physical public space to a hybrid public space shaped by internet. Beyond the fragmented city and the violent urban context manifested by participants, these activities have highlighted how the access to the city is currently going through a dialectic movement between the physical and the digital space. The purpose of this article is to make explicit the link between this hybrid public space and the boundaries of exclusion in the city. Urban marginality is closely related with the idea of access and space. Low-income communities in Medellín assume the digital realm like a “not controlled space” of resistance, where alternative ways of expression like hip hop movement, graffiti, dance, video and virtual communities produce effective changes in the physical realm.

Keywords: access to the city, hybrid public space, low-income communities, Medellín, urban marginality

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Authors: M. Shahadat Hossain

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People experiencing economic disadvantages have limited access to justice system. Employment status is a key indicator of economic disadvantage. There is a link between employment status and vulnerability to legal problems. This paper addresses the obstacles unemployed people experience to secure justice in Australia. This paper further explores exiting services for economically disadvantaged people to secure justice where these unemployment people can get access. It reveals that unemployed people are vulnerable to multifaced crime and violence. Due to high cost of legal services, these unemployed people are unable to afford legal services to access justice. They are often found higher levels of nonactions in terms of access to justice also due to lack of their initiatives. This paper further reveals that legal aid commissions are state and territory statutory agencies in Australia which provide free legal information, advice, duty lawyers, and legal representation services. Community legal centres are independent, non-profit government organizations with a focus of early advice, problem solving, and working with other agencies to address connected, financial, and health problems. Moreover, the private profession helps people who cannot afford to pay for a lawyer in several ways. But there are problems of shortage of funding for these legal services and making available to economically disadvantaged people. However, this paper argues that people experiencing long-term unemployment face barriers to secure justice due to their economic disadvantages. It further argues that services available for them to access to justice is inadequate.

Keywords: economic disadvantages, unemployment, access to justice, Australia

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Authors: Lisdey Espinoza Pedraza

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Organised crime in Mexico evolves faster that our capacity to understand and explain it. Organised gangs have become successful entrepreneurs in many ways ad they have somehow mimicked the working ways of the authorities and in many cases, they have successfully infiltrated the governmental spheres. This business model is only possible under a clear scheme of rampant impunity. Impunity, however, is not exclusive to the PRI. Nor the PRI, PAN, or PRD can claim the monopoly of corruption, but what is worse is that none can claim full honesty in their acts either. The current security crisis in Mexico shows a crisis in the Mexican political party system. Corruption today is not only a problem of dishonesty and the correct use of public resources. It is the principal threat to Mexican democracy, governance, and national security.

Keywords: security, war on drugs, drug trafficking, Mexico, Latin America, United States

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Authors: Alieh Farshbaf

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Introduction: Current anti-retroviral drugs have some restrictions for treatment of HIV-1 infection. The efficacy of retroviral drugs is not same in different infected patients and the virus rebound from latent reservoirs after stopping them. Recently, the engineering of stem cells and gene therapy provide new approaches to eliminate some drug problems by induction of resistance to HIV-1. Literature review: Up to now, AIDS-restriction genes (ARGs) were suitable candidate for gene and cell therapies, such as cc-chemokine receptor-5 (CCR5). In this manner, CCR5 provide effective cure in Berlin and Boston patients by inducing of HIV-1 resistance with allogeneic stem cell transplantation. It is showed that Zinc Finger Nuclease (ZFN) could induce HIV-1 resistance in stem cells of infected patients by homologous recombination or non-end joining mechanism and eliminate virus loading after returning the modified cells. Then, gene modification by HIV restriction factors, as TRIM5, introduced another gene candidate for HIV by interfering in infection process. These gene modifications/editing provided by stem cell futures that improve treatment in refractory disease such as HIV-1. Conclusion: Although stem cell transplantation has some complications, but in compare to retro-viral drugs demonstrated effective cure by elimination of virus loading. On the other hand, gene therapy is cost-effective for an infected patient than retroviral drugs payment in a person life-long. The results of umbilical cord blood stem cell transplantation showed that gene and cell therapy will be applied easier than previous treatment of AIDS with high efficacy.

Keywords: stem cell, AIDS, gene modification, cell engineering

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Authors: M. Dahiru, O. I. Enabulele

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The research wish to investigate the occurrence of multidrug- resistant Acinetobacter, in carrot and estimate the role of carrot in its transmission, in a rapidly growing urban population. Thus, 50 carrot samples were collected from Jakara wastewater irrigation farms and analyzed on MacConkey agar and screened by Microbact 24E (Oxoid) and susceptibility of isolates tested against 10 commonly used antibiotics. Acinetobacter baumannii and A. lwoffii were isolated in 22.00% and 16% of samples respectively. Resistance to ceporex and penicillin of 36.36% and 27.27% in A. baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and co-trimoxazole, were observed. However, for A. lwoffii apart from 37.50% resistance to ceporex, it was also resistant to all other drugs tested. There was a similarity in the resistant shown by A. baumannii and A. lwoffii to fluoroquinolones drugs and β- lactame drugs families in addition to between sulfonamide and animoglycoside demonstrated by A. lwoffii. Interestingly, when resistant similarities to different antibiotics were compared for A. baumannii and A. lwoffii as a whole, significant correlation was observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%) respectively, and high multi drug resistance (MDR) of 27.27% and 62.50% by A. baumannii and A. lwoffii respectively and overall MDR of 42.11% in all isolates. The occurrence of multidrug-resistance pathogen in carrot is a serious challenge to public health care, especially in a rapidly growing urban population where subsistence agriculture contributes greatly to urban livelihood and source of vegetables.

Keywords: urban agriculture, public health, fluoroquinolone, sulfonamide, multidrug-resistance

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Authors: T. Hojageldiyev, Y. Bolmammedov, S. Gurbanaliyev

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It is known that drugs used in the treatment of tuberculosis show toxic effect to organism especially to liver besides its therapeutic effect. Because of ineffectiveness of drugs used in the treatment regimen of tuberculosis against multidrug resistance (MDR) and extensively drug-resistance (XDR) tuberculosis requires the development of new treatment methods and new, novel drugs. Considering the usage of Artemisia absinthium in traditional medicine in treatment of wounds which suggests its antibacterial activity it seems that, also it may have significant antimycobacterial activity. The objective of present study was to evaluate antibacterial activity of ethanolic extract of A. absinthium against M. tuberculosis. In this study, the effect of ethanolic extract of A. absinthium was tested against tuberculosis and pharmaco-toxicological properties evaluated on laboratory animals. The 20%, 40%, 70% and 96% ethanolic extracts of A. absinthium prepared then its bacteriostatic and bactericidal activities were evaluated by validated methods. Data were analyzed by GraphPad Prism 7.0 at the level P < 0.05. Results showed that ethanolic extracts of A. absinthium show no toxicological properties with having high LD50. All concentrations of extract show high bacteriostatic activity on M. tuberculosis. 96% ethanolic extract has highest bactericidal effect among other concentrations. By conducting further studies, as a result of our study, antimycobacterial drug can be prepared from A. absinthium.

Keywords: Artemisia absinthium, antimycobacterial, ethanolic extract, Mycobacteria tuberculosis

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Authors: Moshmi Sangavarapu

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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.

Keywords: healthcare access, market access, diversity barriers, patient journey

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Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

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Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

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Authors: Asmaa Mandour, Ramzia El-Bagary, Asmaa El-Zaher, Ehab Elkady

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Background: An UHPLC (ultra high performance liquid chromatography) method for the simultaneous determination of norfloxacin (NOR), metronidazole (MET) and tinidazole (TNZ) using monolithic column is presented. Purpose: The method is considered an environmentally friendly method with relatively low organic composition of the mobile phase. Methods: The chromatographic separation was performed using Phenomenex® Onyex Monolithic C18 (50mmx 20mm) column. An elution program of mobile phase consisted of 0.5% aqueous phosphoric acid : methanol (85:15, v/v). Where elution of all drugs was completed within 3.5 min with 1µL injection volume. The UHPLC method was applied for the stability indication of NOR in the presence of its acid degradation product ND. Results: Retention times were 0.69, 1.19 and 3.23 min for MET, TNZ and NOR, respectively. While ND retention time was 1.06 min. Linearity, accuracy, and precision were acceptable over the concentration range of 5-50µg mL-1for all drugs. Conclusions: The method is simple, sensitive and suitable for the routine quality control and dosage form assay of the three drugs and can also be used for the stability indication of NOR in the presence of its acid degradation product.

Keywords: antibacterial, monolithic cilumn, simultaneous determination, UHPLC

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Authors: Kaleb Shiferaw, Berhanu Geberemedhin, Dereje Legesse

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Access to credit is often viewed as a key to transform semi-subsistence smallholders into market oriented producers. However, only a few studies have examined factors that affect farmers’ decision to allocate credit on farm activities in general and livestock production in particular. A trivariate probit model with double selection is employed to identify factors that affect farmers’ decision to allocate credit on livestock production using data collected from smallholder farmers in Ethiopia. After controlling for two sample selection bias – taking credit for the production season and decision to allocate credit on farm activities – land ownership and access to a livestock centered extension service are found to have a significant (p<0.001) effect on farmers decision to use credit for livestock production. The result showed farmers with large land holding, and access to a livestock centered extension services are more likely to utilize credit for livestock production. However since the effect of land ownership squared is negative the effect of land ownership for those who own a large plot of land lessens. The study highlights the fact that improving access to credit does not automatically translate into more productive households. Improving farmers’ access to credit should be followed by a focused extension services.

Keywords: livestock production, credit access, credit allocation, household decision, double sample selection

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Authors: Luphumlo Ncanywa, Paul Watts

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Malaria is a disease that kills approximately one million people annually. Children and pregnant women in sub-Saharan Africa lost their lives due to malaria. Malaria continues to be one of the major causes of death, especially in poor countries in Africa. Decrease the burden of malaria and save lives is very essential. There is a major concern about malaria parasites being able to develop resistance towards antimalarial drugs. People are still dying due to lack of medicine affordability in less well-off countries in the world. If more people could receive treatment by reducing the cost of drugs, the number of deaths in Africa could be massively reduced. There is a shortage of pharmaceutical manufacturing capability within many of the countries in Africa. However one has to question how Africa would actually manufacture drugs, active pharmaceutical ingredients or medicines developed within these research programs. It is quite likely that such manufacturing would be outsourced overseas, hence increasing the cost of production and potentially limiting the full benefit of the original research. As a result the last few years has seen major interest in developing more effective and cheaper technology for manufacturing generic pharmaceutical products. Micro-reactor technology (MRT) is an emerging technique that enables those working in research and development to rapidly screen reactions utilizing continuous flow, leading to the identification of reaction conditions that are suitable for usage at a production level. This emerging technique will be used to develop antimalarial drugs. It is this system flexibility that has the potential to reduce both the time was taken and risk associated with transferring reaction methodology from research to production. Using an approach referred to as scale-out or numbering up, a reaction is first optimized within the laboratory using a single micro-reactor, and in order to increase production volume, the number of reactors employed is simply increased. The overall aim of this research project is to develop and optimize synthetic process of antimalarial drugs in the continuous processing. This will provide a step change in pharmaceutical manufacturing technology that will increase the availability and affordability of antimalarial drugs on a worldwide scale, with a particular emphasis on Africa in the first instance. The research will determine the best chemistry and technology to define the lowest cost manufacturing route to pharmaceutical products. We are currently developing a method to synthesize Lumefantrine in continuous flow using batch process as bench mark. Lumefantrine is a dichlorobenzylidine derivative effective for the treatment of various types of malaria. Lumefantrine is an antimalarial drug used with artemether for the treatment of uncomplicated malaria. The results obtained when synthesizing Lumefantrine in a batch process are transferred into a continuous flow process in order to develop an even better and reproducible process. Therefore, development of an appropriate synthetic route for Lumefantrine is significant in pharmaceutical industry. Consequently, if better (and cheaper) manufacturing routes to antimalarial drugs could be developed and implemented where needed, it is far more likely to enable antimalarial drugs to be available to those in need.

Keywords: antimalarial, flow, lumefantrine, synthesis

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Authors: Takashi Kaminagayoshi, Shigeyuki Haruyama

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To improve the manufacturing efficiency of biologics, such as antibody drugs, a quality engineering framework was designed. Within this framework, critical steps and parameters in the manufacturing process were studied. Identification of these critical steps and critical parameters allows a deeper understanding of manufacturing capabilities, and suggests to process development department process control standards based on actual manufacturing capabilities as part of a PDCA (plan-do-check-act) cycle. This cycle can be applied to each manufacturing process so that it can be standardized, reducing the time needed to establish each new process.

Keywords: antibody drugs, biologics, manufacturing efficiency, PDCA cycle, quality engineering

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Authors: Hakim Benoumelghar

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The launch in 1999 of the open access Initiative (OAI) and the protocol for sharing metadata, OAI-PMH, in parallel with the provision of deposit platforms, open-source software, such as DSpace in 2002, which allow libraries to develop digital repositories and play a leading role in the open access movement, and by building institutional open archives alongside the theme. This study focuses on Algerian universities and their projects and platforms for digital repositories of theses and scientific papers and the possibilities of access to the university community to develop research and access to archives of scientific digital content offered by the scientific community. This contribution attempts to compare Algerian and foreign institutional deposits in developed countries in order to have development and perspectives to facilitate scientific research and give more possibilities to the scientific community in documentary matters.

Keywords: digital repository, repository software, university, algeria

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Authors: Said Abdul Ahad Ahadi, Elyas Baray, Nitin Rakesh, Sudeep Varshney

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Wi-Fi is a widely used internet source that is used to provide internet access in many areas such as Stores, Cafes, University campuses, Restaurants and so on. This technology brought more facilities in communication and networking. On the other hand, due to the transmission of data over the air, which makes the network vulnerable, so it becomes prone to various threats such as Evil Twin and etc. The Evil Twin is a kind of adversary which impersonates a legitimate access point (LAP) as it can happen by spoofing the name (SSID) and MAC address (BSSID) of a legitimate access point (LAP). And this attack can cause many threats such as MITM, Service Interruption, Access point service blocking. Various Evil Twin Attack Detection Techniques are proposed, but they require additional hardware, or they require protocol modification. In this paper, we proposed a new technique based on Access Point’s two fingerprints, Received Signal Strength Indicator (RSSI) and Hop Count, that is hard to copy by an adversary. And we implemented the technique in a system called “ETDetector,” which can detect and prevent the attack.

Keywords: evil twin, LAP, SSID, Wi-Fi security, signal variation, ETAD, kali linux, scapy, python

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Authors: Moetazza M. Al-Shafei, Hala Abdel Karim, Eitedal M. Daoud, Hassan Zaki Hassuna

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Epilepsy is a common neurological disorder affecting all age groups. It is one of the world's most prevalent non-communicable diseases. Increased evidence suggesting that long term usage of anti-epileptic drugs can have adverse effects on bone mineralization and bone molding .Aiming to study these effects and to give guide lines to support bone health through early intervention. From Neurology Out-Patient Clinic kaser Elaini University Hospital, 60 Patients were enrolled, 40 patients on antiepileptic drugs for at least two years and 20 controls matched with age and sex, epileptic but before starting treatment both chosen under specific criteria. Patients were divided into four groups, three groups with monotherapy treated with either Phynetoin, Valporic acid or Carbamazipine and fourth group treated with both Valporic acid and Carbamazipine. Estimation of serum Carboxy-Terminal Telopeptide of Type I- Collagen(ICTP) bone resorption marker, serum 25(OH )vit D3, calcium ,magnesium and phosphorus were done .Results showed that all patients on AED had significant low levels of 25(OH) vit D3 (p<0.001) ,with significant elevation of ICTP (P<0.05) versus controls. In group treated with Phynotoin highly significant elevation of (ICTP) marker and decrease of both serum 25(OH) vit D3 (P<0, 0001) and serum calcium(P<0.05)versus control. Double drug group showed significant decrease of serum 25(OH) vit D3 (P<0.0001) and decrease in Phosphorus (P<0.05) versus controls. Serum magnesium showed no significant differences between studied groups. We concluded that Anti- epileptic drugs appears to be an aggravating factor on bone mineralization ,so therapeutically it can be worth wile to supplement calcium and vitamin D even before initiation of antiepileptic therapy. ICTP marker can be used to evaluate change in bone resorption before and during AED therapy.

Keywords: antiepileptic drugs, bone minerals, carboxy teminal telopeptidetype-1-collagen bone resorption marker, vitamin D

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Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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Authors: V. Surena, B. Nazemisalman, F. Noghrehkar

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Introduction: Gingival overgrowth (GO) is a common side effect involving users of antiepileptic, immunosuppressive and calcium channel blocker drugs. Cyclosporine and phenytoin are amongst the most widely used drugs associated with GO. Gingival fibroblasts seem to have a significant role in the production of certain enzymes after administration of the drugs contributing to GO. Previous studies have shown a higher prevalence of GO in children and adolescents. The aim of this study was to compare normal human gingival fibroblasts with those exposed to Cyclosporine or phenytoin in measuring the production levels of certain enzymes that could have a possible role in GO. Methods: samples were obtained from the gingival biopsies of seven adult and seven children and were cultured into plates. With the growth of fibroblast cells, they were treated with or without either Cyclosporine or phenytoin. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to determine the expressed levels of R-EGF, cathepsin B,L, Lysyl oxidase, COL1, TGF β1, MMP-1,2, and TIMP1. Results: according to RT-PCR analyses, the expressed levels of R-EGF, cathepsin B, L, Lysyl oxidase, COL1, TGF β1, MMP-1, 2 and TIMP1 were affected by Cyclosporine and phenytoin. TGF-β1, TIMP, Cathepsin B and EGF showed comparable values in the adult and pediatric groups. Conclusions: Different expressed levels of enzymes after treatment of the gingival fibroblasts of adults and pediatrics with phenytoin or Cyclosporine could be the reason for the higher severity of GO in children. More studies need to be performed on the pathogenesis of GO at different age groups.

Keywords: cyclosporine, fibroblasts, phenytoin, gingivae

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Authors: Jay Ananth

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The drug discovery process currently requires numerous years of clinical testing as well as money just for a single drug to earn FDA approval. For drugs that even make it this far in the process, there is a very slim chance of receiving FDA approval, resulting in detrimental hurdles to drug accessibility. To minimize these inefficiencies, numerous studies have implemented computational methods, although few computational investigations have focused on a crucial feature of drugs: lipophilicity. Lipophilicity is a physical attribute of a compound that measures its solubility in lipids and is a determinant of drug efficacy. This project leverages Artificial Intelligence to predict the impact of a drug’s lipophilicity on its performance by accounting for factors such as binding affinity and toxicity. The model predicted lipophilicity and binding affinity in the validation set with very high R² scores of 0.921 and 0.788, respectively, while also being applicable to a variety of target receptors. The results expressed a strong positive correlation between lipophilicity and both binding affinity and toxicity. The model helps in both drug development and discovery, providing every pharmaceutical company with recommended lipophilicity levels for drug candidates as well as a rapid assessment of early-stage drugs prior to any testing, eliminating significant amounts of time and resources currently restricting drug accessibility.

Keywords: drug discovery, lipophilicity, ligand-receptor interactions, machine learning, drug development

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Authors: Abhishek Pandey

Abstract:

Capping and lamination are the most common tablet defects with poorly compressible drugs the common example of that Ibuprofen and Acetaminophen. Generally both these drugs are compressed by wet granulation method which is very time consuming process Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis Acetaminophen used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression technique and their evaluation. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimize formulation nine different formulations were generated among them batch F5, F6, F7 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of evaluation parameters.

Keywords: capping, lamination, tablet defects, direct compression

Procedia PDF Downloads 438