Harnessing lipid metabolism through diacylglycerol kinases: implications for immune modulation and cancer therapy.

Appropriate drug utilization has a huge contribution to global reduction in morbidity and mortality with its consequent medical, social and economic benefits. The aim of this study was to evaluate the rational use of antihypertensive drugs in public healthcare facilities in Kano, Nigeria and to administer intervention where necessary. The study was a cross sectional prospective survey involving 600 patients from six public healthcare facilities (100 from each) selected by multistage sampling technique. Using a modified extraction form, data were collected, compiled, audited and analyzed according to the WHO/INRUD Rational Drugs Use indicators. Educational intervention was administered in the areas that needed intervention and the impact measured. A total of 3,044 individual drugs were prescribed for 1,176 patient’s encounters, giving an average of 2.6, and the range of drugs per encounter varied from 1 to 5. The average number of drugs per prescription does not significantly vary after intervention (p < 0.275). Although there was an increased in the percentages of drugs prescribed by generic after intervention (from 65.6% to 70.6%), it was not statistically significant (p = 0.081). All drugs were prescribed from EML/STGs and prescription by generic was high. Average consultation time significantly increase from 5.95 to 6.09 minutes (p = 0.045). Additionally an insignificant increase in dispensing time (1.10 to 1.27 minutes) after intervention (p = 0.182). Educational intervention improved rational use of antihypertensive drugs. Continuous supervision and educating the healthcare team on rational use of drugs must be encouraged.Keywords: Antihypertensive; Hypertension; Drug utilization; Rational drug use

Introduction: This study was conducted to investigate the effect of long-term drug use due to medical diseases on rational drug use in children, using data obtained from parents. It is a cross-sectional study. Methods: Among the 288 parents who applied to the pediatric outpatient clinics of Muğla Training and Research Hospital between January 1, 2022 and March 31, 2022; 144 people with children aged 0-12 who have a chronic disease and have been using regular medication for at least three months are included in the research group, 144 people who did not have a chronic disease and did not use medication constantly were determined as the control group. In addition to the form containing sociodemographic data and questions to evaluate rational drug use awareness, knowledge, attitudes and behaviors, the "Parental Attitude Scale For Rational Drug Use (PASRDU)" was answered through a face-to-face interview. Data analysis was conducted with SPSS 26 program with a confidence level of 95%. Parental Attitude Scale For Rational Drug Use scores showed normal distribution in both groups. Independent samples t-test was used to compare Parental Attitude Scale For Rational Drug Use scores according to groups, a chi-square test was used to compare the relationship between groups and categorical (grouped) variables, and a two-way ANOVA test was used to compare demographic characteristics and group variables according to Parental Attitude Scale For Rational Drug Use scores. Results: Of the parents participating in the study, 67.71% were mothers and 32.29% were fathers. The average age was 34.88±6.44 years in the research group and 33.57±6.57 years in the control group. The rates of having chronically ill individuals at home and individuals constantly using medication at home are higher in the research group and are statistically significant. While the presence of leftover or spare medication at home was be similar in the research and control groups, the rate of using these medications when necessary was 45.8% in the research group and 56.3% in the control group. While 43.1% of those in the research group did not give over-the-counter medicine to their children, this rate was 16% in the control group. The control group uses over-the-counter vitamins twice as much as the research group. The most commonly used over-the-counter medication in the entire population is antipyretics with a rate of 44.79%. The scores of the research group in Parental Attitude Scale For Rational Drug Use and its subscales are higher than the control group and are statistically significant. The place of residence for the longest time, educational level, having too much medication at home, and using non-prescription medication statistically affect the scores. In addition, the duration of the disease of the children in the research group significantly affected the Parental Attitude Scale For Rational Drug Use total score and the Accurate and Conscious Use subscale, and the disease group significantly affected the Effective and Safe Use subscale score. Conclusion: According to our research, long-term use of medication in children due to medical illness affects rational drug use. Accurate and current information is required in the preparation and use of drugs used in children due to the change in dosage and pharmaceutical form depending on age. In addition, herbal products and food supplements are also used during childhood. Therefore, the knowledge, attitudes and behaviors of healthcare professionals and parents affect children’s health. As studies on rational drug use in different regions in our country increase, more detailed and separate planning can be made for drugs used in childhood while preparing education and policies for rational drug use.

This study was designed to investing the drug prescribing pattern which is the important point in the rational or irrational use of drugs among patients dispensing their prescriptions from the private pharmacies in Maysan governorate, Iraq for a period of 1 month. The data collected from prescriptions were calculated and analyzed according to the WHO prescribing guidelines. The data showed that the mean of drugs included in single prescription was 3.4, and 12% of prescribed drugs were written as generic names; moreover, the percentage of antibiotics, corticosteroids and anxiolytics were 33.3%, 11.4% and 23.8% respectively. Those results indicate the irrational use of drugs when compared with the world health organization standard values of prescribing indicators, in addition to the bad prescribing pattern regardless of the degree of specialization of the physician, where 52% of those prescriptions (analyzed in the present study) written by specialized physicians. In conclusion, actual intervention and follow up, training on rational use of drugs and intervention strategies for prescribers is required to improve the rational use of drugs.&#x0D; Key words: prescription pattern, polypharmacy, rational drug use&#x0D;

Author response: Comprehensive characterization of tumor microenvironment in colorectal cancer via molecular analysis

Mammalian Diacylglycerol Kinases, a Family of Lipid Kinases with Signaling Functions

Being a chronic metabolic disorder, Diabetes mellitus (DM) affecting six percent of the world population. The WHO defines diabetes mellitus as “A metabolic disorder of multiple aetiology characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in the insulin secretion, insulin action, or both”. Oral antidiabetic drugs (OADs) are the first line treatment for type 2 diabetes mellitus in management of the disease. Rational use of oral antidiabetic drugs (OADs) and insulin are used for the prevention of diabetes mellitus complications. Prescription of rational use of the drugs is a complex issue to achieve the goal that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and at the lowest cost to them and their community. Rational use of the drugs in populations can be effectively studied with drug utilization reviews. The aim is to study the drug prescribing pattern of anti-diabetic drugs in newly diagnosed type 2 DM patients.

Misuse of drugs is a serious health problem all around the world. Rational drug use can be characterized as follows: patients receive drugs that meet their clinical needs, at doses that meet their requirements, promptly and at the lowest cost to themselves and their region. Drug abuse, polypharmacy, and misuse are the most prominent drug use problems today. Misuse of drugs can occur for a variety of reasons at different levels, including recommended mistakes and over-the- counter medications. Inappropriate use of income can lead to real negative benefits and financial results. There are many irrational drug mixtures available. Appropriate rational use of medicines will increase personal satisfaction and lead to better local health services. A list of essential medicines recommended by the World Health Organization (WHO) can assist the countries around the globe in rationalizing the distribution and purchasing of medicines, thus decreasing the costs to healthcare systems. Irrational drug use has been a subject of concern for years as it affects the health system and patients badly. Irrational use of drugs can result from several factors such as patient, prescriber, dispenser, health system, supply system, or regulations. Thus, diverse strategies have been used to promote rational drug use and also to tackle irrational use. Thereby the concept of rational and irrational drug use and factors that lead to either result should be identified and monitored.

This study was designed to investing the drug prescribing pattern, the important factor to determine the rational or irrational use of drugs among patients dispensing their prescriptions from the private pharmacies in Al-Basrah governorate, Iraq for a period of 1 month.The data collected from prescriptions were calculated and analyzed according to the WHO prescribing guidelines.The data showed that the mean of drugs included in single prescription was 4%, and 13% of prescribed drugs were written as generic names; moreover, the percentage of antibiotics,corticosteroids and anxiolytics were 45.7%, 12% and 19.3% respectively. Those results indicate the irrationality of prescribing drugs when compared with the world health organization standard values of prescribing indicators; in addition to the bad prescribing pattern regardless of the degree of specialization of the physician, were 61% of those prescriptions have been written by specialized physicians.In conclusion, actual intervention and follow up, training on rational use of drugs and intervention strategies for prescribers is required to improve the rational use of drugs.

Objective: To acquire information about residents of Changshou District's knowledge levels and their behaviors of drug use, so that implementation strategies of rational drug use can be formulated accordingly to promote and spread health education of rational drug use. Methods: Online and offline surveys were randomly conducted about rational drug use conditions of residents in Changshou District by questionnaires. Online questionnaires were sent to residents of Changshou District by Wenjuanxing, an professional platform used for surveys. Offline questionnaires were mainly distributed to residents of communities in Changshou District. All the online and offline statistics were analyzed and counted. Results: Three hundred and nine (309) questionnaires were distributed (176 online questionnaires and 133 paper questionnaires), and the effective recovery rate was 75.4%. According to investigation and survey, conditions of resident’s rational drug use were optimistic. Only 8.15% residents who participated in the survey (or research subjects) took paracetamol tablets and vitamin C Yinqiao tablets (also known as VC Honeysuckle Pills) at the same time when they had a cold or fever. Among 8.15% residents, 5.15% frequently took paracetamol, caffeine and aspirin powder (also known as headache powder); 80.26%, checked expiration date of drugs before taking medicine; more than 50%, knew that drinking after taking medicines such as cephalosporin is prohibited. Common irrational problems caused by drug use were as follows: 40% research subjects took dietary supplements as drugs, and 28% of them failed to know the correct usage and dosage of drugs. Proportion of drugs that were taken with irrational usage and dosage were antibiotics (64%), antibacterial (52%), drugs for patients with diabetes mellitus (36%), drugs for patients with hyperlipidemia , hypertension and hyperglycemia (32%), vitamins (24%), drugs for treatment of common cold and cough(20%) and others. Conclusion: Publicity of rational drug use should not be restricted to specific population, and knowledge of safe drug use is supposed to be actively popularized. Contents of rational drug use are as follows: Guide the public to correctly understand the functions of vitamins and dietary supplements strengthen publicity of rational use of drugs such as antibiotics, antibacterial drugs, drugs for chronic diseases, cold and cough, etc. Focus should be given on usage and dosage of drugs, use of antibacterial drugs, and repeated and excessive use of drugs caused by joint use of drugs with same ingredients of OTC drugs for treatment of common cold and cough.

ObjectiveTo investigate the current status of knowledge and behavior about rational drug use in college students in different colleges and universities in a city in southwest China, providing reference for students’ education of rational drug use in colleges and universities.MethodsA questionnaire survey on knowledge and behavior in rational drug use was carried out on the students recruited by occasional sampling method in 6 colleges and universities in Zunyi, China. Statistical analyses on demographic information and answers to questionnaire questions were carried out with SPSS 18.0.ResultsA total of 865 valid questionnaires were recovered from 923 questionnaires sent out. Some knowledge and behaviors of the students on drug use were irrational. There was statistically significant difference in some specific questions of the knowledge in rational drug use between medical and non-medical students (P<0.05); the average score of rational drug use behavior of medical students was lower than that of non-medical students (P<0.05); the average score of the rational drug use behavior of female students was lower than that of male (P<0.05); the students’ major types had significantly different influence on their behavior in rational drug use (P<0.05). The school-carried pharmacy education can effectively improve students’ rational medication; the majority of college students believed that it is necessary to popularize the knowledge of rational drug use on campus; and students’ favorite way to acquire knowledge about rational drug use was to attend related lectures or elective courses.ConclusionThe knowledge and behavior of rational drug use among college students need to be improved. Professional medical education may exert a positive impact on rational drug use among college students. Thus, it is necessary to popularize the knowledge of rational drug use among college students, especially in non-medical colleges and universities.

Introduction: The current study was aimed to evaluate the attitudes and behaviors of individuals 90 years and older living in Malatya regarding rational drug use. Methods: This cross-sectional, descriptive study was carried out with people aged 90 and over (n=1022) living in Malatya province and its districts. Face-to-face interview method was used to collect study data. In the first part of the form used for data collection, the descriptive characteristics of the participants were questioned, and in the second part, the attitudes and behaviors towards rational drug use were examined. Rational drug use features are evaluated by World Health Organization (WHO) prescribing indicators. Results: The frequency of rational drug use was 84.1%, and the rate of over-the-counter drug use was 19.2% among individuals 90 years and older. 52.3% of the participants had over-the-counter medication at home for use, when necessary, without doctor's recommendation. The most commonly available over-the-counter group of drugs at home were painkillers. Conclusion: The frequency of rational drug use in individuals aged 90 and older has been determined higher than in the literature on individuals aged 65 and older. Education, guidance and counseling programs can be created to increase rational drug use within elderly people communities. Keywords: rational drug use; oldest-old; elderly; attitude; behavior

Applying the health belief model to the rational use of drugs for hemodialysis patients: A randomized controlled trial

Background: &#x0D; Rational use of drugs plays a role in reducing morbidity and mortality in the community associated with the treatment of disease. Acute respiratory infections (ARI), diarrhea, and myalgia are diseases that are still commonly found and treated in primary&#x0D; health centers, so far the three diagnoses are considered potential for irrational treatment. Data from existing reports can actually be used to identify the rationality of rational drug use, but until now the quality of report data is still poor. Therefore, how interventions can improve the quality of reporting the performance indicators of rational drug use in the Karawang District.&#x0D; Objective: To improve the quality of reporting on performance indicators of rational drug use (POR) in Karawang District.&#x0D; Methods: This study used a Quasi-Experimental research design with one- group pretest-posttest design, without a comparison group (control), in Karawang District in January - March 2020. Twenty officers reporting rational drug use in primary health centers were&#x0D; selected by purposive sampling.&#x0D; Results: Training interventions can improve the quality of reporting the performance indicators of rational drug use from the results of increased pretest after the training intervention (posttest) namely; report preparation process 25% to 80%, report completeness from&#x0D; 45% to 95%, timeliness from 15% to 75%, report compliance with technical instructions from 0% to 75%.&#x0D; Conclusion: Providing interventions in the form of explanations of technical guidelines for rational drug use and training has been proven to improve the quality of reporting on performance indicators of rational drug use.&#x0D; &#x0D;

This paper discusses the rational use of traditional Chinese medicine based on chemical composition, body state and biological effect. The essence and connotations of traditional Chinese medicine are explained by modern scientific theory and technical means, and the mechanism of traditional Chinese medicine in the treatment of diseases is defined in modern medicine language, which is conducive to promoting rational and safe clinical use of drugs. Based on the chemical composition of traditional Chinese medicine,the selected genuine medicinal materials were collected and processed in a standardized way, and then used in the combination with other traditional Chinese medicines, with the aim to improve the efficacy of traditional Chinese medicine in clinical indications, increase the advantages, eliminate the disadvantages, and adapt to flexible and safe clinical drug demands. Based on the body state elements, clinical diagnosis and treatment shall be patient-centered, and doctors shall distinguish the differences of pathogenesis, symptoms and diseases, and consider the drug contraindications of special groups. According to the &quot; dose-effect-toxicity&quot; relationship, doctors shall select the appropriate dosage form, control the drug dosage, balance the benefits and risks of drugs, and carry out appropriate medical treatment. Based on the biological effect elements and the regulatory mechanism of traditional Chinese medicine on the target and pathway of disease, traditional Chinese medicine shall strengthen the precise positioning, provide accurate treatment; evaluate the safety of traditional Chinese medicine combination, explore the adverse reaction mechanism, strengthen the clinical safety monitoring of traditional Chinese medicine, and guide the clinical rational use of drugs, in the expectation of ensuring the safe use of traditional Chinese medicine and maximize the clinical efficacy of traditional Chinese medicine.

The effect of illness perception levels of liver transplant patients receiving immunosuppressive therapy on their rational drug use levels