Search results for: generic medicines
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 548

Search results for: generic medicines

488 Ethnobotanical Medicines for Treating Snakebites among the Indigenous Maya Populations of Belize

Authors: Kerry Hull, Mark Wright

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This paper brings light to ethnobotanical medicines used by the Maya of Belize to treat snake bites. The varying ecological zones of Belize boast over fifty species of snakes, nine of which are poisonous and dangerous to humans. Two distinct Maya groups occupy neighboring regions of Belize, the Q’eqchi’ and the Mopan. With Western medical care often far from their villages, what traditional methods are used to treat poisonous snake bites? Based primarily on data gathered with native consultants during the authors’ fieldwork with both groups, this paper details the ethnobotanical resources used by the Q’eqchi’ and Mopan traditional healers. The Q’eqchi’ and Mopan most commonly rely on traditional ‘bush doctors’ (ilmaj in Mopan), both male and female, and specialized ‘snake doctors’ to heal bites from venomous snakes. First, this paper presents each plant employed by healers for bites for the nine poisonous snakes in Belize along with the specific botanical recipes and methods of application for each remedy. Individual chemical and therapeutic qualities of some of those plants are investigated in an effort to explain their possible medicinal value for different toxins or the symptoms caused by those toxins. In addition, this paper explores mythological associations with certain snakes that inform local understanding regarding which plants are considered efficacious in each case, arguing that numerous oral traditions (recorded by the authors) help to link botanical medicines to episodes within their mythic traditions. Finally, the use of plants to counteract snakebites brought about through sorcery is discussed inasmuch as some snakes are seen as ‘helpers’ of sorcerers. Snake bites given under these circumstances can only be cured by those who know both the proper corresponding plant(s) and ritual prayer(s). This paper provides detailed documentation of traditional ethnomedicines and practices from the dying art of traditional Maya healers and argues for multi-faceted diagnostic techniques to determine toxin severity, the presence or absence of sorcery, and the appropriate botanical remedy.

Keywords: ethnobotany, Maya, medicine, snake bites

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487 Developing Effective Strategies to Reduce Hiv, Aids and Sexually Transmitted Infections, Nakuru, Kenya

Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi

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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.

Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach

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486 Enhancing the Use of Traditional, Complementary and Alternative Medicines into Global Cancer Treatment and Research

Authors: Alejandro Salicrup, Riacrdo Gelhman, Geetha Gopalakrishna

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The main aim of this session is to have a panel to discuss specific steps for the integration of traditional, complementary and alternative medicine (TCAM) with conventional oncology for enhancing treatment practices at the global level, specifically in low-and-middle-income-countries (LMICs). Concrete current and required programs for strengthening Integrative Oncology research in LMICs will also be discussed. Case Studies from Latin America, Asia, Europe and Africa will discuss and highlight 1) What is working regarding treatment practices in integrative oncology in their countries/regions providing concrete examples 2) What is not working on this integration for cancer treatment in their countries/regions with concrete examples and 3) What are the challenges and opportunities for research related to integrative oncology treatment. Discussion will include potential next steps and potential mechanisms to enhance global integrative oncology research aimed to enhance the use of TCAM therapies and strengthening cancer treatment in LMICs.

Keywords: global cancer treatment, integrative oncology research, low and middle income countries, traditional, complementary and alternative medicines

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485 Generic Competences, the Great Forgotten: Teamwork in the Undergraduate Degree in Translation and Interpretation

Authors: María-Dolores Olvera-Lobo, Bryan John Robinson, Juncal Gutierrez-Artacho

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Graduates are equipped with a wide range of generic competencies which complement solid curricular competencies and facilitate their access to the labour market in diverse fields and careers. However, some generic competencies such as instrumental, personal and systemic competencies related to teamwork and interpersonal communication skills, decision-making and organization skills are seldom taught explicitly and even less often assessed. In this context, translator training has embraced a broad range of competencies specified in the undergraduate program currently taught at universities and opens up the learning experience to cover areas often ignored due to the difficulties inherent in both teaching and assessment. In practice, translator training combines two well-established approaches to teaching/learning: project-based learning and genuinely cooperative – or merely collaborative – learning. Our professional approach to translator training is a model focused on and adapted to the teleworking context of professional translation and presented through the medium of blended e-learning. Teamwork-related competencies are extremely relevant, and they require explicit and implicit teaching so that graduates can be confident about their capacity to make their way in professional contexts. In order to highlight the importance of teamwork and intra-team relationships beyond the classroom, we aim to raise awareness of teamwork processes so as to empower translation students in managing their interaction and ensure that they gain valuable pre-professional experience. With these objectives, at the University of Granada (Spain) we have developed a range of classroom activities and assessment tools. The results of their application are summarized in this study.

Keywords: blended learning, collaborative teamwork, cross-curricular competencies, higher education, intra-team relationships, students’ perceptions, translator training

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484 Nagabhasma Preparation and Its Effect on Kidneys: A Histopathological Study

Authors: Lydia Andrade, Kumar M. R. Bhat

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Heavy metals, especially lead, is considered to be a multi-organ toxicant. However, such heavy metals, are used in the preparation of traditional medicines. Nagabhasma is one of the traditional medicines. Lead is the metal used in its preparation. Lead is converted into a health beneficial, organometallic compound, when subjected to various traditional methods of purification. Therefore, this study is designed to evaluate the effect of such processed lead in various stages of traditionally prepared Nagabhasma on the histological structure of kidneys. Using the human equivalent doses of Nagabhasma, various stages of its preparation were fed orally for 30 days and 60 days (short term and long term). The treated and untreated rats were then sacrificed for the collection of kidneys. The kidneys were processed for histopathological study. The results show severe changes in the histological structure of kidneys. The animals treated with lead acetate showed changes in the epithelial cells lining the bowman’s capsule. The proximal and distal convoluted tubules were dilated leading to atrophy of their epithelial cells. The amount of inflammatory infiltrates was more in this group. A few groups also showed pockets of inter-tubular hemorrhage. These changes, however, were minimized as the stages progressed form stages 1 to 4 of Nagabhasma preparation. Therefore, it is necessary to stringently monitor the processing of lead acetate during the preparation of Nagabhasma.

Keywords: heavy metals, kidneys, lead acetate, Nagabhasma

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483 Students' ExperiEnce Enhancement Through Simulaton. A Process Flow in Logistics and Transportation Field

Authors: Nizamuddin Zainuddin, Adam Mohd Saifudin, Ahmad Yusni Bahaudin, Mohd Hanizan Zalazilah, Roslan Jamaluddin

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Students’ enhanced experience through simulation is a crucial factor that brings reality to the classroom. The enhanced experience is all about developing, enriching and applications of a generic process flow in the field of logistics and transportations. As educational technology has improved, the effective use of simulations has greatly increased to the point where simulations should be considered a valuable, mainstream pedagogical tool. Additionally, in this era of ongoing (some say never-ending) assessment, simulations offer a rich resource for objective measurement and comparisons. Simulation is not just another in the long line of passing fads (or short-term opportunities) in educational technology. It is rather a real key to helping our students understand the world. It is a way for students to acquire experience about how things and systems in the world behave and react, without actually touching them. In short, it is about interactive pretending. Simulation is all about representing the real world which includes grasping the complex issues and solving intricate problems. Therefore, it is crucial before stimulate the real process of inbound and outbound logistics and transportation a generic process flow shall be developed. The paper will be focusing on the validization of the process flow by looking at the inputs gains from the sample. The sampling of the study focuses on multi-national and local manufacturing companies, third party companies (3PL) and government agency, which are selected in Peninsular Malaysia. A simulation flow chart was proposed in the study that will be the generic flow in logistics and transportation. A qualitative approach was mainly conducted to gather data in the study. It was found out from the study that the systems used in the process of outbound and inbound are System Application Products (SAP) and Material Requirement Planning (MRP). Furthermore there were some companies using Enterprises Resources Planning (ERP) and Electronic Data Interchange (EDI) as part of the Suppliers Own Inventories (SOI) networking as a result of globalized business between one countries to another. Computerized documentations and transactions were all mandatory requirement by the Royal Custom and Excise Department. The generic process flow will be the basis of developing a simulation program that shall be used in the classroom with the objective of further enhanced the students’ learning experience. Thus it will contributes to the body of knowledge on the enrichment of the student’s employability and also shall be one of the way to train new workers in the logistics and transportation filed.

Keywords: enhancement, simulation, process flow, logistics, transportation

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482 Endemic Medicinal Plants in Eritrea: Scientific Name, Botanical Description and Geographical Location

Authors: Liya Abraham

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Medicinal plants are globally valuable sources of herbal products, either as lifesaving or life maintaining medicines. Studies reveal that more than 25% of modern drugs in the world are derived from plants. The Horn of Africa as a world hotspot; it has more than 1500 endemic plants. Eritrea, a country located in the Horn of Africa, is blessed with medicinal flora and fauna and marine and terrestrial biodiversity. Previous studies of flora of Ethiopia and Eritrea, incomplete species lists, indicate figures ranging between 6000 and 7000 species, with levels of endemism between 12–20%. In the past two decades, there has been growing interest in natural remedy herbal medicines owing to, but not limited to; resistance to antimicrobials, intolerance of side effects of modern drugs, and rise in chronic diseases like diabetes, hypertension, cancer, etc. Hence, owing to the rising demand for nature based health solutions, deforestation, construction purposes, grazing, and agricultural expansion; several medicinal plants in general and the endemic ones, in particular, are in the verge of extinction. Therefore, conservation strategies of endangered and endemic medicinal plants, especially those located in hot spot regions, must be promoted at global level. Thus, the author aims to share certain information regarding the endemic medicinal plants in Eritrea with the international scientific world.

Keywords: endemic, eritrea, horn of Africa, medicinal plants, species

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481 Adverse Drug Reactions Monitoring in the Northern Region of Zambia

Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

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480 Evaluation of Golden Beam Data for the Commissioning of 6 and 18 MV Photons Beams in Varian Linear Accelerator

Authors: Shoukat Ali, Abdul Qadir Jandga, Amjad Hussain

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Objective: The main purpose of this study is to compare the Percent Depth dose (PDD) and In-plane and cross-plane profiles of Varian Golden beam data to the measured data of 6 and 18 MV photons for the commissioning of Eclipse treatment planning system. Introduction: Commissioning of treatment planning system requires an extensive acquisition of beam data for the clinical use of linear accelerators. Accurate dose delivery require to enter the PDDs, Profiles and dose rate tables for open and wedges fields into treatment planning system, enabling to calculate the MUs and dose distribution. Varian offers a generic set of beam data as a reference data, however not recommend for clinical use. In this study, we compared the generic beam data with the measured beam data to evaluate the reliability of generic beam data to be used for the clinical purpose. Methods and Material: PDDs and Profiles of Open and Wedge fields for different field sizes and at different depths measured as per Varian’s algorithm commissioning guideline. The measurement performed with PTW 3D-scanning water phantom with semi-flex ion chamber and MEPHYSTO software. The online available Varian Golden Beam Data compared with the measured data to evaluate the accuracy of the golden beam data to be used for the commissioning of Eclipse treatment planning system. Results: The deviation between measured vs. golden beam data was in the range of 2% max. In PDDs, the deviation increases more in the deeper depths than the shallower depths. Similarly, profiles have the same trend of increasing deviation at large field sizes and increasing depths. Conclusion: Study shows that the percentage deviation between measured and golden beam data is within the acceptable tolerance and therefore can be used for the commissioning process; however, verification of small subset of acquired data with the golden beam data should be mandatory before clinical use.

Keywords: percent depth dose, flatness, symmetry, golden beam data

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479 Product Feature Modelling for Integrating Product Design and Assembly Process Planning

Authors: Baha Hasan, Jan Wikander

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This paper describes a part of the integrating work between assembly design and assembly process planning domains (APP). The work is based, in its first stage, on modelling assembly features to support APP. A multi-layer architecture, based on feature-based modelling, is proposed to establish a dynamic and adaptable link between product design using CAD tools and APP. The proposed approach is based on deriving “specific function” features from the “generic” assembly and form features extracted from the CAD tools. A hierarchal structure from “generic” to “specific” and from “high level geometrical entities” to “low level geometrical entities” is proposed in order to integrate geometrical and assembly data extracted from geometrical and assembly modelers to the required processes and resources in APP. The feature concept, feature-based modelling, and feature recognition techniques are reviewed.

Keywords: assembly feature, assembly process planning, feature, feature-based modelling, form feature, ontology

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478 Utilization of Traditional Medicine for Treatment of Selected Illnesses among Crop-Farming Households in Edo State, Nigeria

Authors: Adegoke A. Adeyelu, Adeola T. Adeyelu, S. D. Y. Alfred, O. O. Fasina

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This study examines the use of traditional medicines for the treatment of selected illnesses among crop-farming households in Edo State, Nigeria. A sample size of ninety (90) households were randomly selected for the study. Data were collected with a structured questionnaire alongside focus group discussions (FGD). Result shows that the mean age was 50 years old, the majority (76.7%) of the sampled farmers were below 60 years old. The majority (80.0%) of the farmers were married, about (92.2%) had formal education. It exposes that the majority of the respondents (76.7%) had household size of between 1-10 persons, about 55.6% had spent 11 years and above in crop farming. malaria (8th ), waist pains (7th ), farm injuries ( 6th ), cough (5th), acute headache(4th), skin infection (3rd), typhoid (2nd) and tuberculosis (1st ) were the most and least treated illness. Respondents (80%) had spent N10,000.00 ($27) and less on treatment of illnesses, 8.9% had spent N10,000.00-N20,000.0027 ($27-$55) 4.4% had spent between N20,100-N30,000.00 ($27-$83) while 6.7% had spent more than N30,100.00 ($83) on treatment of illnesses in the last one (1) year prior to the study. Age, years of farming, farm size, household size, level of income, cost of treatment, level of education, social network, and culture are some of the statistically significant factors influencing the utilization of traditional medicine. Farmers should be educated on methods of preventing illnesses, which is far cheaper than the curative.

Keywords: crop farming-households, selected illnesses, traditional medicines, Edo State

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477 Self-Medicating Behavior of Urban Pakistani Population toward Psychotropic Agents and Its Correlates

Authors: M. Umar Hafeez, Furqan Khursheed Hashmi, Nadeem Irfan Bukhari, Shahzad Ali, Muzammil Ali

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The trend of self-medication is increasing due to various factors and is associated with a large number of complications. A cross-sectional study was aimed to investigate self-medication trend in an urban community and its correlates such as level of education, gender and behavior of using psychoactive medicines. A validated questionnaire was used to collect the data from different locations of Lahore, provincial capital of Punjab, Pakistan. The trend of self-medication was noted in reference to difference in educational level and in gender. This study showed that total 110 respondents, all literate,were found to be self-medicating, and their educational status was as 73.13% primary, 63.15% secondary, 61.12% higher secondary and 62.15% university going. In this sample 74.99% were males and 48.00%were females. Twenty nine (26.36%) of the total sample were found to be using psychoactive agents without consulting the physician. The trend of self-medication was 10% higher in individuals having primary level education, whereas there was not much difference of self-medication trend in other levels of education. The main reasons involved in self-medication trend were socio-economic status, medicine accessibility, religious and cultural beliefs, lack of awareness about risks associated with medicine, non-prescription sale of medicines and previous medication experience. The trend of self-medication of psychotropic agents is quite significant.

Keywords: self-medication, educated community, psychotropic drugs, education levels

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476 A Comparative Study of Automotive / Transportation Design Programs and University: Industry Cooperation Models in Higher Education

Authors: Efe Çukur

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This study aims to discuss and compare i) widespread and generic design, particularly industrial design education in relation to the specific needs of the automotive/transportation industry, and ii) an automotive/transportation design education model within and under to provide the conditions of design education and automotive industry, especially in Turkey and T.R.N.C. The automotive industry is the 11th largest in the world ($1.51 trillion). One of the most important departments in this industry, along with sales, marketing and engineering, is the design department. The automotive industry is known as the locomotive industry, but there is a non-automotive design department on the academic side of Turkey. This suggestion; includes the presentation of a program proposal that meets the needs of the industry for Turkey and T.R.N.C., the second largest automobile manufacturing country in Europe. On the education side, industrial design education has become a generic title. Automotive design studios are divided into several subgroups. Even in the higher graduate education, the automotive design departments get their subgroups like exterior design and interior design. Transportation design, which is a subfield of industrial design, is offered as higher education in transportation design departments, particularly in America and Europe. In these departments, the curriculum is shaped to the needs of the sectors. Higher education transportation design programs began in the mid-20th century. Until those high education programs...Until these high education programs, the industry has adapted architectures and engineers for designer workloads. Still today transportation design graduates are not the majority of the design studios. The content of the study is an in-depth comparison of these institutions and how the requirements, demands of the industry are met in this regard and revealed. Some of the institutions are selected from Europe and US. To be analyzed under the headings of staff, courses, syllabus, University-Industry collaboration, and location selection. The study includes short, mid, and long term proposals and a hypothesis for discussion. In short, the study will not only provide a wide comparative scope of information on generic and specialized aspects of design education in different countries but also propose a higher education model for automotive / transportation design with solid data of requirements, methodology, and structure regarding learning outcomes, and especially industry cooperation.

Keywords: design education, automotive - transportation design programs, transportation design, automotive industry in Turkey /T.R.N.C., automotive design education in Turkey /T.R.N.C.

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475 Numerical Investigation of the Effect of Blast Pressure on Discrete Model in Shock Tube

Authors: Aldin Justin Sundararaj, Austin Lord Tennyson, Divya Jose, A. N. Subash

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Blast waves are generated due to the explosions of high energy materials. An explosion yielding a blast wave has the potential to cause severe damage to buildings and its personnel. In order to understand the physics of effects of blast pressure on buildings, studies in the shock tube on generic configurations are carried out at various pressures on discrete models. The strength of shock wave is systematically varied by using different driver gases and diaphragm thickness. The basic material of the diaphragm is Aluminum. To simulate the effect of shock waves on discrete models a shock tube was used. Generic models selected for this study are suitably scaled cylinder, cone and cubical blocks. The experiments were carried out with 2mm diaphragm with burst pressure ranging from 28 to 31 bar. Numerical analysis was carried out over these discrete models. A 3D model of shock-tube with different discrete models inside the tube was used for CFD computation. It was found that cone has dissipated most of the shock pressure compared to cylinder and cubical block. The robustness and the accuracy of the numerical model were validation with the analytical and experimental data.

Keywords: shock wave, blast wave, discrete models, shock tube

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474 Quantitative Assessment of Different Formulations of Antimalarials in Sentinel Sites of India

Authors: Taruna Katyal Arora, Geeta Kumari, Hari Shankar, Neelima Mishra

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Substandard and counterfeit antimalarials is a major problem in malaria endemic areas. The availability of counterfeit/ substandard medicines is not only decreasing the efficacy in patients, but it is also one of the contributing factors for developing antimalarial drug resistance. Owing to this, a pilot study was conducted to survey quality of drugs collected from different malaria endemic areas of India. Artesunate+Sulphadoxine-Pyrimethamine (AS+SP), Artemether-Lumefantrine (AL), Chloroquine (CQ) tablets were randomly picked from public health facilities in selected states of India. The quality of antimalarial drugs from these areas was assessed by using Global Pharma Health Fund Minilab test kit. This includes physical/visual inspection and disintegration test. Thin-layer chromatography (TLC) was carried out for semi-quantitative assessment of active pharmaceutical ingredients. A total of 45 brands, out of which 21 were for CQ, 14 for AL and 10 for AS+SP were tested from Uttar Pradesh (U.P.), Mizoram, Meghalaya and Gujrat states. One out of 45 samples showed variable disintegration and retension factor. The variable disintegration and retention factor which would have been due to substandard quality or other factors including storage. However, HPLC analysis confirms standard active pharmaceutical ingredient, but may be due to humid temperature and moisture in storage may account for the observed result.

Keywords: antimalarial medicines, counterfeit, substandard, TLC

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473 Leveraging Business to Business Collaborations to Optimize Reverse Haul Logistics

Authors: Pallav Singh, Rajesh Yabaji, Rajesh Dhir, Chanakya Hridaya

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Supply Chain Costs for the Indian Industries have been on an exponential trend due to steep inflation on fundamental cost factors – Fuel, Labour, Rents. In this changing context organizations have been focusing on adopting multiple approaches to keep logistics costs under control to protect the profit margins. The lever of ‘Business to Business (B2B) collaboration’ can be used by organizations to garner higher value. Given the context of Indian Logistics Industry the penetration of B2B Collaboration initiatives have been limited. This paper outlines a structured framework for adoption of B2B collaboration through discussion of a successful initiative between ITC’s Leaf Tobacco Business and a leading Indian Media House. Multiple barriers to such a collaborative process exist which need to be addressed through comprehensive structured approaches. This paper outlines a generic framework approach to B2B collaboration for the Indian Logistics Space, outlining the guidelines for arriving at potential opportunities, identification of collaborators, effective tie-up process, design of operations and sustenance factors. The generic methods outlined can be used in any other industry and also builds a foundation for further research on many topics.

Keywords: business to business collaboration, reverse haul logistics, transportation cost optimization, exports logistics

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472 Exploiting Charges on Medicinal Synthetic Aluminum Magnesium Silicate's {Al₄ (SiO₄)₃ + 3Mg₂SiO₄ → 2Al₂Mg₃ (SiO₄)₃} Nanoparticles in Treating Viral Diseases, Tumors, Antimicrobial Resistant Infections

Authors: M. C. O. Ezeibe, F. I. O. Ezeibe

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Reasons viral diseases (including AI, HIV/AIDS, and COVID-19), tumors (including Cancers and Prostrate enlargement), and antimicrobial-resistant infections (AMR) are difficult to cure are features of the pathogens which normal cells do not have or need (biomedical markers) have not been identified; medicines that can counter the markers have not been invented; strategies and mechanisms for their treatments have not been developed. When cells become abnormal, they acquire negative electrical charges, and viruses are either positively charged or negatively charged, while normal cells remain neutral (without electrical charges). So, opposite charges' electrostatic attraction is a treatment mechanism for viral diseases and tumors. Medicines that have positive electrical charges would mop abnormal (infected and tumor) cells and DNA viruses (negatively charged), while negatively charged medicines would mop RNA viruses (positively charged). Molecules of Aluminum-magnesium silicate [AMS: Al₂Mg₃ (SiO₄)₃], an approved medicine and pharmaceutical stabilizing agent, consist of nanoparticles which have both positive electrically charged ends and negative electrically charged ends. The very small size (0.96 nm) of the nanoparticles allows them to reach all cells in every organ. By stabilizing antimicrobials, AMS reduces the rate at which the body metabolizes them so that they remain at high concentrations for extended periods. When drugs remain at high concentrations for longer periods, their efficacies improve. Again, nanoparticles enhance the delivery of medicines to effect targets. Both remaining at high concentrations for longer periods and better delivery to effect targets improve efficacy and make lower doses achieve desired effects so that side effects of medicines are reduced to allow the immunity of patients to be enhanced. Silicates also enhance the immune responses of treated patients. Improving antimicrobial efficacies and enhancing patients` immunity terminate infections so that none remains that could develop resistance. Some countries do not have natural deposits of AMS, but they may have Aluminum silicate (AS: Al₄ (SiO₄)₃) and Magnesium silicate (MS: Mg₂SiO₄), which are also approved medicines. So, AS and MS were used to formulate an AMS-brand, named Medicinal synthetic AMS {Al₄ (SiO₄)₃ + 3Mg₂SiO₄ → 2Al₂Mg₃ (SiO₄)₃}. To overcome the challenge of AMS, AS, and MS being un-absorbable, Dextrose monohydrate is incorporated in MSAMS-formulations for the simple sugar to convey the electrically charged nanoparticles into blood circulation by the principle of active transport so that MSAMS-antimicrobial formulations function systemically. In vitro, MSAMS reduced (P≤0.05) titers of viruses, including Avian influenza virus and HIV. When used to treat virus-infected animals, it cured Newcastle disease and Infectious bursa disease of chickens, Parvovirus disease of dogs, and Peste des petits ruminants disease of sheep and goats. A number of HIV/AIDS patients treated with it have been reported to become HIV-negative (antibody and antigen). COVID-19 patients are also reported to recover and test virus negative when treated with MSAMS. PSA titers of prostate cancer/enlargement patients normalize (≤4) following treatment with MSAMS. MSAMS has also potentiated ampicillin trihydrate, sulfadimidin, cotrimoxazole, piparazine citrate and chloroquine phosphate to achieve ≥ 95 % infection-load reductions (AMR-prevention). At 75 % of doses of ampicillin, cotrimoxazole, and streptomycin, supporting MSAMS-formulations' treatments with antioxidants led to the termination of even already resistant infections.

Keywords: electrical charges, viruses, abnormal cells, aluminum-magnesium silicate

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471 The Roles of Non-Codified Traditional Medicine in a Suburban Village in Kerala, India

Authors: Sachi Matsuoka

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This study aimed at implicating a current community health in South India focusing on a Vaidya, a non-codified traditional doctor, based on long-term field works. As the prevalence of colonic diseases is increasing in all over the world, it is needed to know the potential of non-codified medicines and how they can effectively take in a part in community health. Describing the people’s treatment seeking behaviours in a suburban village which is susceptible to modernization can give us a new insight for studying Indian medicines, that is included not only non-codified but also codified traditional ones, affected by global, national and local communities. Both qualitative and quantitative data were gathered via participatory fieldworks and open-ended interviews to a Vaidya and his 97 patients and 31 individuals who lived in a community near the Vaidya’s station. It was found that the community members seldom consulted the Vaidya while a number of patients outside the village (mainly from urban nearby area) daily visited the Vaidya. Thus, the role of the Vaidya as the community’ s primary health care provider had nearly disappeared. Nonetheless, the Vaidya was deeply respected as one of the community’ s leaders by its members because of the spiritual and financial support he provided to them. The reasons for choosing the Vaidya for the patients from urban area are characterized by several social factors of the patients such as their religious belief, seriousness, occupation and medical history. Meanwhile, not only the Vaidya but also other codified traditional medicines, e.g., Ayurveda, were less popular among the community members. It sounds paradoxical given that the traditional Indian medical system has been becoming popular as an alternative medicine in societies outside of India, such as in Europe. The community members who are less educated and engaged in religious activities in daily life preferred to allopathy, the biomedicine in Indian context. It is thus concluded that roles of non-codified medicine has changed depending on its cultural and social contexts, even though its medical system is not authorized by the government. Nowadays, traditional medical effectiveness is recognized as evidenced by scientific survey and the codified medical doctors treats diseases rather than people. However, this study implicated that people’s treatment seeking behaviors are likely based on the social context in which people live their lives even though evidenced based codified medicine is provided in their community.

Keywords: medical pluralism, non-codified medicine, south india, treatment-seeking behaviours

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470 A Method of Representing Knowledge of Toolkits in a Pervasive Toolroom Maintenance System

Authors: A. Mohamed Mydeen, Pallapa Venkataram

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The learning process needs to be so pervasive to impart the quality in acquiring the knowledge about a subject by making use of the advancement in the field of information and communication systems. However, pervasive learning paradigms designed so far are system automation types and they lack in factual pervasive realm. Providing factual pervasive realm requires subtle ways of teaching and learning with system intelligence. Augmentation of intelligence with pervasive learning necessitates the most efficient way of representing knowledge for the system in order to give the right learning material to the learner. This paper presents a method of representing knowledge for Pervasive Toolroom Maintenance System (PTMS) in which a learner acquires sublime knowledge about the various kinds of tools kept in the toolroom and also helps for effective maintenance of the toolroom. First, we explicate the generic model of knowledge representation for PTMS. Second, we expound the knowledge representation for specific cases of toolkits in PTMS. We have also presented the conceptual view of knowledge representation using ontology for both generic and specific cases. Third, we have devised the relations for pervasive knowledge in PTMS. Finally, events are identified in PTMS which are then linked with pervasive data of toolkits based on relation formulated. The experimental environment and case studies show the accuracy and efficient knowledge representation of toolkits in PTMS.

Keywords: knowledge representation, pervasive computing, agent technology, ECA rules

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469 Building a Dynamic News Category Network for News Sources Recommendations

Authors: Swati Gupta, Shagun Sodhani, Dhaval Patel, Biplab Banerjee

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It is generic that news sources publish news in different broad categories. These categories can either be generic such as Business, Sports, etc. or time-specific such as World Cup 2015 and Nepal Earthquake or both. It is up to the news agencies to build the categories. Extracting news categories automatically from numerous online news sources is expected to be helpful in many applications including news source recommendations and time specific news category extraction. To address this issue, existing systems like DMOZ directory and Yahoo directory are mostly considered though they are mostly human annotated and do not consider the time dynamism of categories of news websites. As a remedy, we propose an approach to automatically extract news category URLs from news websites in this paper. News category URL is a link which points to a category in news websites. We use the news category URL as a prior knowledge to develop a news source recommendation system which contains news sources listed in various categories in order of ranking. In addition, we also propose an approach to rank numerous news sources in different categories using various parameters like Traffic Based Website Importance, Social media Analysis and Category Wise Article Freshness. Experimental results on category URLs captured from GDELT project during April 2016 to December 2016 show the adequacy of the proposed method.

Keywords: news category, category network, news sources, ranking

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468 SAR and B₁ Considerations for Multi-Nuclear RF Body Coils

Authors: Ria Forner

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Introduction: Due to increases in the SNR at 7T and above, it becomes more favourable to make use of X-nuclear imaging. Integrated body coils tuned to 120MHz for 31P, 79MHz for 23Na, and 75 MHz for 13C at 7T were simulated with a human male, female, or child body model to assess strategies of use for metabolic MR imaging in the body. Methods: B1 and SAR efficiencies in the heart, liver, spleen, and kidneys were assessed using numerical simulations over the three frequencies with phase shimming. Results: B1+ efficiency is highly variable over the different organs, particularly for the highest frequency; however, local SAR efficiency remains relatively constant over the frequencies in all subjects. Although the optimal phase settings vary, one generic phase setting can be identified for each frequency at which the penalty in B1+ is at a max of 10%. Discussion: The simulations provide practical strategies for power optimization, B1 management, and maintaining safety. As expected, the B1 field is similar at 75MHz and 79MHz, but reduced at 120MHz. However, the B1 remains relatively constant when normalised by the square root of the peak local SAR. This is in contradiction to generalized SAR considerations of 1H MRI at different field strengths, which is defined by global SAR instead. Conclusion: Although the B1 decreases with frequency, SAR efficiency remains constant throughout the investigated frequency range. It is possible to shim the body coil to obtain a maximum of 10% extra B1+ in a specific organ in a body when compared to a generic setting.

Keywords: birdcage, multi-nuclear, B1 shimming, 7 Tesla MRI, liver, kidneys, heart, spleen

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467 A Case Study on Effectiveness of Hijamah (Wet Cupping) on Numbness of Foot in Diabetic Patient

Authors: Nafdha Thajudeen

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Hijamah therapy is one of the leading alternative & complementary modalities in the World. It is a kind of detoxification, rejuvenation, and blood purification method. It comes under Ilaj bil Tadbeer (Regimental therapy) in the Unani medical system. In diabetes, hands and foot care in people is very important because of slow blood circulation, where blood sometimes is not able to fully penetrate the capillaries. Hijamah therapy works upon the following two principles- Tanqiyae Mawad (Evacuation of morbid humor) and Imalae Mawad (Diversion of humor). The aim of this study was to find out the effectiveness of hijamah therapy on the numbness of legs in a diabetic patient. This case study was carried out in Ayurvedic Research Hospital (Non-Communicable Diseases), Ninthavur, Sri Lanka. A 63 years old female diabetic patient came to the clinic with the complain of numbness in both feet for one year. The treatment history of the patient revealed that she had taken western medicine for her complaints for 7 months. In her first visit, wet cupping was done on local and distal points. The patient said there was a remarkable improvement; internal medicines were given to keep the sugar level in normal with some external applications. Every week, wet cupping was done on the same points, with repeating the same medicines. Foot numbness was fully cured within one month. The finding of this study shows that the complaint of numbness in the diabetic patient was treated with hijamah therapy with internal & external medicine. This case study can be concluded as hijamah therapy is very effective in treating diabetic numbness. This single case study may be the entrance for future clinical studies

Keywords: Hijamah therapy, Ilaj bil thadbeer, diabetes, numbness

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466 Care at the Intersection of Biomedicine and Traditional Chinese Medicine: Narratives of Integration, Negotiation, and Provision

Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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465 Perceptions of Pregnant Women on the Transitional Use of Traditional Medicine in the Transitional District Western Uganda

Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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464 Distribution Routs Redesign through the Vehicle Problem Routing in Havana Distribution Center

Authors: Sonia P. Marrero Duran, Lilian Noya Dominguez, Lisandra Quintana Alvarez, Evert Martinez Perez, Ana Julia Acevedo Urquiaga

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Cuban business and economic policy are in the constant update as well as facing a client ever more knowledgeable and demanding. For that reason become fundamental for companies competitiveness through the optimization of its processes and services. One of the Cuban’s pillars, which has been sustained since the triumph of the Cuban Revolution back in 1959, is the free health service to all those who need it. This service is offered without any charge under the concept of preserving human life, but it implied costly management processes and logistics services to be able to supply the necessary medicines to all the units who provide health services. One of the key actors on the medicine supply chain is the Havana Distribution Center (HDC), which is responsible for the delivery of medicines in the province; as well as the acquisition of medicines from national and international producers and its subsequent transport to health care units and pharmacies in time, and with the required quality. This HDC also carries for all distribution centers in the country. Given the eminent need to create an actor in the supply chain that specializes in the medicines supply, the possibility of centralizing this operation in a logistics service provider is analyzed. Based on this decision, pharmacies operate as clients of the logistic service center whose main function is to centralize all logistics operations associated with the medicine supply chain. The HDC is precisely the logistic service provider in Havana and it is the center of this research. In 2017 the pharmacies had affectations in the availability of medicine due to deficiencies in the distribution routes. This is caused by the fact that they are not based on routing studies, besides the long distribution cycle. The distribution routs are fixed, attend only one type of customer and there respond to a territorial location by the municipality. Taking into consideration the above-mentioned problem, the objective of this research is to optimize the routes system in the Havana Distribution Center. To accomplish this objective, the techniques applied were document analysis, random sampling, statistical inference and tools such as Ishikawa diagram and the computerized software’s: ArcGis, Osmand y MapIfnfo. As a result, were analyzed four distribution alternatives; the actual rout, by customer type, by the municipality and the combination of the two last. It was demonstrated that the territorial location alternative does not take full advantage of the transportation capacities or the distance of the trips, which leads to elevated costs breaking whit the current ways of distribution and the currents characteristics of the clients. The principal finding of the investigation was the optimum option distribution rout is the 4th one that is formed by hospitals and the join of pharmacies, stomatology clinics, polyclinics and maternal and elderly homes. This solution breaks the territorial location by the municipality and permits different distribution cycles in dependence of medicine consumption and transport availability.

Keywords: computerized geographic software, distribution, distribution routs, vehicle problem routing (VPR)

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463 Ethnopharmacological Survey of Medicinal Plants Used in Southwest Algeria to Treat Gastro-Intestinal Ailments

Authors: Karima Sekkoum Abdelkrim Cheriti, Leila Feguigui

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Algeria has a large plant biodiversity accounting more than 4125 species (123 Families) and is endowed with resources of medicinal plants growing on various bioclimatic zones from subhumide to semi-arid and Saharan. On the other hand, the ethnopharmacology investigation remains the principal way to improve, evaluate, and finding bioactive substances derived from medicinal plants. In continuation of our works in Saharan ethpharmacopeae and phytochemistry of Saharan medicinal plants, we focus our attention on the importance of local ethnopharmacology especially to treat gastro-intestinal disorders in the south west of Algeria (El Baydh, Naama and Bechar region) as platform for bioactive substances discovery and further development. Our present investigation deals with an ethnopharmacological study on medicinal plants used for the treatment of gastro-intestinal disorders in the south west of Algeria. The study presents the uses of plants in local traditional herbal medicines, determines the homogeneity of informant traditional knowledge and the preferred medicinal plants used to treat gastro-intestinal disorders. The results indicated that Asteraceae and Lamiaceae are the most locally used families and medicines were prepared in the form of powder or infusion and used orally. Aerial parts were the most frequently used plant part. Thus, the results can be used as platform for bioactive substances discovery and further development especially for the preferred plant species used in the treatment of gastro-intestinal disorders.

Keywords: ethnopharmacology, gastro-intestinal, phytochemical, South Algeria, Sahara, endemic species

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462 Inappropriate Antibiotic Use: An Online Survey in Thailand

Authors: Surarong Chinwong, Namthip Intarakumhang Na Rachasima, Siyaporn Kuikhiew, Dujrudee Chinwong

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Irrational use of medicines is a major problem in public health. Half of all patients take medicines incorrectly. An inappropriate use of antibiotics is one of the common types of irrational medicine use; for example, patients use antibiotic for treatment of common cold or diarrhea. Objectives: This cross-sectional study aimed to investigate the behaviors on antibiotic use, using amoxicillin and norfloxacin as examples, as well as sources of received health information. Methods: An online self-administered questionnaire was used to collect data from participants in Thailand between September and December 2015. Participants were asked about their behaviors on antibiotic use. Data were analyzed using descriptive statistics. Results: Of all 405 participants, most were female (65.3 %), aged 18-30 years (49.4 %), undergraduate or lower (69.7%), and civil servant or state enterprises (31.7 %). We found inappropriate behaviors in use of amoxicillin or norfloxacin: 1) there were 201/400 participants (50.3%) taking amoxicillin right away in case of having a common cold, such as having sore throat, running nose, and cough; 2) there were 170/405 participants (42.0%) using amoxicillin for relieving inflammatory symptoms, e.g. muscle inflammation or osteoarthritis; 3) there were 71/398 participants (17.8%) using amoxicillin as a muscle relaxant; 4) there were 135/398 participants (33.9%) using norfloxacin for treating diarrhea. Sources of health information received by the participants were from the internet (78.5%), the radio and/or television (42.2%), advertising publishing (33.3 %), and word of mouth (30.1%). Conclusion: This study showed improper behaviors in antibiotic use especially amoxicillin and norfloxacin. Health care providers including pharmacists should raise the public awareness on dangers of inappropriate antibiotic use and promote the rational use of antibiotics.

Keywords: antibiotic use, amoxicillin, norfloxacin, rational drug use

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461 Anti-Inflammatory Studies on Chungpye-Tang in Asthmatic Human Lung Tissue

Authors: J. H. Bang, H. J. Baek, K. I. Kim, B. J. Lee, H. J. Jung, H. J. Jang, S. K. Jung

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Asthma is a chronic inflammatory lung disease characterized by airway hyper responsiveness (AHR), airway obstruction and airway wall remodeling responsible for significant morbidity and mortality worldwide. Genetic and environment factors may result in asthma, but there are no the exact causes of asthma. Chungpye-tang (CPT) has been prescribed as a representative aerosol agent for patients with dyspnea, cough and phlegm in the respiratory clinic at Kyung Hee Korean Medicine Hospital. This Korean herbal medicines have the effect of dispelling external pathogen and dampness pattern. CPT is composed of 4 species of herbal medicines. The 4 species of herbal medicines are Ephedrae herba, Pogostemonis(Agatachis) herba, Caryophylli flos and Zingiberis rhizoma crudus. CPT suppresses neutrophil infiltration and the production of pro-inflammatory cytokines in lipopolysaccharide (LPS)-induced acute lung injury (ALI) mouse model. Moreover, the anti-inflammatory effects of CPT on a mouse model of Chronic Obstructive Pulmonary Disease (COPD) was proved. Activation of the NF-κB has been proven that it plays an important role in inflammation via inducing transcription of pro-inflammatory genes. Over-expression of NF-κB has been believed be related to many inflammatory diseases such as arthritis, gastritis, asthma and COPD. So we firstly hypothesize whether CPT has an anti-inflammatory effect on asthmatic human airway epithelial tissue via inhibiting NF-κB pathway. In this study, CPT was extracted with distilled water for 3 hours at 100°C. After process of filtration and evaporation, it was freeze dried. And asthmatic human lung tissues were provided by MatTek Corp. We investigated the precise mechanism of the anti-inflammatory effect of CPT by western blotting analysis. We observed whether the decoction extracts could reduce NF-κB activation, COX-2 protein expression and NF-κB-mediated pro-inflammatory cytokines such as TNF-α, eotaxin, IL-4, IL-9 and IL-13 in asthmatic human lung tissue. As results of this study, there was a trend toward decreased NF-κB expression in asthmatic human airway epithelial tissue. We found that the inhibition effects of CPT on COX-2 expression was not determined. IL-9 and IL-13 secretion was significantly reduced in the asthmatic human lung tissue treated with CPT. Overall, our results indicate that CPT has an anti-inflammatory effect through blocking the signaling pathway of NF-κB, thereby CPT may be a potential remedial agent for allergic asthma.

Keywords: Chungpye-tang, allergic asthma, asthmatic human airway epithelial tissue, nuclear factor kappa B (NF-κB) pathway, COX-2

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460 Pill-Box Dispenser as a Strategy for Therapeutic Management: A Qualitative Evaluation

Authors: Bruno R. Mendes, Francisco J. Caldeira, Rita S. Luís

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Population ageing is directly correlated to an increase in medicine consumption. Beyond the latter and the polymedicated profile of elderly, it is possible to see a need for pharmacotherapeutic monitoring due to cognitive and physical impairment. In this sense, the tracking, organization and administration of medicines become a daily challenge and the pill-box dispenser system a solution. The pill-box dispenser (system) consists in a small compartmentalized container to unit dose organization, which means a container able to correlate the patient’s prescribed dose regimen and the time schedule of intake. In many European countries, this system is part of pharmacist’s role in clinical pharmacy. Despite this simple solution, therapy compliance is only possible if the patient adheres to the system, so it is important to establish a qualitative and quantitative analysis on the perception of the patient on the benefits and risks of the pill-box dispenser as well as the identification of the ideal system. The analysis was conducted through an observational study, based on the application of a standardized questionnaire structured with the numerical scale of Likert (5 levels) and previously validated on the population. The study was performed during a limited period of time and under a randomized sample of 188 participants. The questionnaire consisted of 22 questions: 6 background measures and 16 specific measures. The standards for the final comparative analysis were obtained through the state-of-the-art on the subject. The study carried out using the Likert scale afforded a degree of agreement and discordance between measures (Sample vs. Standard) of 56,25% and 43,75%, respectively. It was concluded that the pill-box dispenser has greater acceptance among a younger population, that was not the initial target of the system. However, this allows us to guarantee a high adherence in the future. Additionally, it was noted that the cost associated with this service is not a limiting factor for its use. The pill-box dispenser system, as currently implemented, demonstrates an important weakness regarding the quality and effectiveness of the medicines, which is not understood by the patient, revealing a significant lack of literacy when it concerns with medicine area. The characteristics of an ideal system remain unchanged, which means that the size, appearance and availability of information in the pill-box continue to be indispensable elements for the compliance with the system. The pill-box dispenser remains unsuitable regarding container size and the type of treatment to which it applies. Despite that, it might be a future standard for clinical pharmacy, allowing a differentiation of the pharmacist role, as well as a wider range of applications to other age groups and treatments.

Keywords: clinical pharmacy, medicines, patient safety, pill-box dispenser

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459 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

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

Procedia PDF Downloads 205