Administration Of Medicines Research Articles

The Burden of Managing Medicines for Older People With Sensory Impairment: An Ethnographic-Informed Study.

Background: Older age is associated with increased prevalence of sensory impairment and use of medicines. Objectives: To explore the daily "medicine journey" of older people with sensory impairment. Methods: The study used ethnographic-informed methods (using audio-, photo- and video-recordings, diary notes and semi-structured interviews with researchers) and involved community-dwelling adults (aged > 65) in Scotland, with visual and/or hearing impairment and using >4 medicines. Data analysis used the constant comparative method. Results: Fourteen older people with sensory impairment participated and used a mean of 11.0 (SD 5.0) medicines (range 5-22). Participants reported difficulties with medicine ordering, obtaining, storage, administration and disposal. They used elaborate strategies to manage their medicines including bespoke storage systems, fixed routines, simple aids, communication, and assistive technologies. Conclusion: Older people with sensory impairment experience substantial burden, challenges and risk with medicines management. Tailored medicine regimens and assistive technologies could provide greater support to older people with sensory impairment.

Nanotechnology for Novel Drug Delivery: A Systematic Review of Classification, Preparation, Characterization, and Applications of Nanoparticles in Drug Delivery

ABSTRACT: The goal of nanotechnology is to develop new nanoscale components by designing, fabricating, and using materials that are atomically, molecularly, and macromolecular organized. For several decades, there has been an abundance of scientific curiosity in the administration of medicines using particle delivery systems as carriers for small and big molecules. Particulate systems, such as nanoparticles, have been utilized as a physical method to modify and improve the pharmacokinetic and pharmacodynamics aspects of numerous pharmaceutical molecules. A typical nanoparticle is between 1 and 100 nm in size and has one or more dimensions. Nanoparticles are usually categorized as inorganic, organic, or carbon-based particles according to their superior characteristics in comparison to larger sizes of the corresponding materials. They have been utilized in vivo to protect the drug entity in the systemic circulation, limiting drug distribution to the targeted areas, and to transport the drug at a controlled and sustained rate to its site of action. The most innovative and promising medication delivery technique at the moment is nanoparticle technology. This methodical research examines the categorization, characteristics, techniques, characterizations, and applications of nanoparticles in the delivery of drug molecules.

Cardiac and physico-chemical responses to xylazine and fentanyl analgesia in Bubalus bubalis

The minor surgical intervention and safe restraining requires sedation and analgesia especially in furious animals like buffaloes which can be achieved by using proper combination of sedative and analgesic drugs. The combination of xylazine with opioids is an effective way to achieve sedation and analgesia in cattle and horses. Six apparently healthy buffaloes having minor wounds were included in the present study. The sedation was accomplished by fentanyl (5 µg per kg b.wt) plus xylazine (0.05 mg per kg b.wt) intravenously. Physiological, hematobiochemical and electrocardiographic parameters were observed at different time interval after the administration of drugs. Following the administration of medicine, there was a significant reduction in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, hemoglobin, and packed cell volume. Respiration rate increased significantly at 30 minutes interval. PR interval and QT interval increased significantly at 20 minutes and 15 minutes respectively of the observation period, whereas a significant increase in the duration of ST segment was noticed from 15 minutes to 30 minutes. The present study revealed that the drug combination has no deleterious effects on cardiopulmonary, hematobiochemical and physiological parameters during the observation period.

Lab-Pharmacy Nexus: Unveiling the convergence of scientific research and medication management

The synergies and vital interdependence between scientific research labs and pharmacies within the healthcare ecosystem have been thoroughly explored in this topic. Scientific research labs were portrayed as centers of creativity, experimentation, and cross-disciplinary cooperation that shaped how we perceive the natural world. Pharmacies were acknowledged as essential to patient care for their ability to dispense prescription drugs, promote health, and guarantee regulatory compliance. The discussion shed light on situations in which miscommunication between pharmacies and labs resulted in avoidable mistakes in medicine administration. The story went on to highlight the growing importance of pharmacists in the monitoring of therapeutic drugs, chronic illness care, and diagnostics. The need for collaboration between lab technicians and pharmacists was emphasized as a means of promoting innovation, managing the challenges associated with medication monitoring, and guaranteeing the best possible outcomes for patients. This comprehensive investigation highlights how important it is to collaborate seamlessly in order to promote patient safety, advance healthcare innovation, and improve the standard of care as a whole.

Factors associated with viral suppression and rebound in children and adolescents living with HIV on antiretroviral treatment at the Bangui pediatric complex, Central African Republic

Background: Suppression of viral load and its maintenance is the necessary condition for reducing mortality linked to HIV infection in children. This study aimed to investigate the factors associated with viral load rebound in children receiving antiretroviral treatment. Methods: This was a cross-sectional study with analytical purposes, running from August 1 to 31, 2023. Were inclusive, all children living with HIV under 15 years of age, with at least two viral load results and whose parents have agreed to participate in the study. Results: A total of 286 children were included in the study. The mean age was 11.5 years (±2.8). More than half (55.2%) of the children were not informed of their HIV status and for the majority (50.3%). Among the 198 children with a suppressed viral load at the first test, 46 (23.2%) experienced a rebound in viral load at the last test. The factors significantly associated with rebound were the low level of education of the parents (p=0.012), the administration of medicines to the children by the parents (p=0.000), the long duration of taking the medicines (p=0.021) and poor compliance with treatment (0.000). Conclusions: The rebound in viral load after suppression is a disastrous reality for children. Efforts must be made to strengthen early therapeutic education for children, training of health workers on the process of announcing results and ongoing dialogue with children and adolescents on compliance are ways to improve the maintenance of viral suppression.

Telemedicine and homeopathy united for wellness and health in Brazilian veterinary.

The objective of this work is to argue about the possibility of remote work and the utilization of communication technology, enabling Tele-veterinary homeopathy to emerge as a specialized field for prescribing medical materials, primarily in cases of behavioral changes. However, the institutions regulating veterinary telemedicine and veterinary medical activities assert that face-to-face care remains the gold standard for practicing veterinary medical procedures. Teleconsultation is only permissible in cases where there exists a prior Veterinary-Animal-Responsible Relationship (RPVAR) that has been established through face-to-face interactions and duly registered.The administration of medicines is considered safe, as they are non-toxic and devoid of side effects due to their ultra-diluted and dynamized formulation, exclusive to this scientific modality. Furthermore, when recommended by a professional specialist and facilitated through telemedicine resources, the continuity of patient care and monitoring will face no hindrances. It is important to emphasize that even though the prescribed medications for veterinary patients are safe, they should be vigilantly monitored by a specialist. This monitoring involves assessing the expected symptoms and effects associated with the prescription, allowing the specialist to intervene and decide whether to modify or continue with the chosen medication.

Laporan Kasus: Infeksi Isospora sp. Dan Toxocara cati Pada Kucing Lokal

Cats are a pet that is popular with many people. Cat health is an aspect that needs to be considered. Several diseases that are often found in cats are caused by worm parasites such as toxocariasis and protozoa such as coccidiosis. Diseases caused by these parasites show almost the same symptoms, namely diarrhea, decreased appetite, weakness, anorexia, and others which can be confirmed by fecal examination. Based on the results of laboratory examinations, the results showed that there were isospora sp oocysts. and Toxocara cati worm eggs. The treatment given was an antihelminthic, namely Pirantel Pamoate and antibiotics, namely Metronidazole. Prevention for Isospora sp infection. and T. cati need to pay attention to sanitation and cleanliness or cage management including a good environment as well as regular inspection and administration of worm medicine and regular health checks.

Carica papaya Crude Extracts Are an Efficient Source of Environmentally Friendly Biogenic Synthesizers of Silver Nanoparticles

Metallic nanoparticles are very useful, effective, and usually synthesized by toxic and expensive chemicals. Silver nanoparticles (AgNPs), measuring less than 100 nm, have shown promising impact in several biomedical investigations. These can inhibit microbial growth and aid in medicine administration. Six substrates of Carica papaya were used to synthesize silver nanoparticles that can limit the growth of bacteria and fungi. In this article, we report the synthesis of AgNPs from the leaf, seed, callus, peel, fruit juice, and bark of Carica papaya. AgNPs synthesized from callus showed the most promising results when tested against the growth of bacteria like Xanthomonas campestris, Erwinia carotovera, Bacillus subtilis, and fungi (Aspergillus niger and Fusarium oxysporum) when compared with other extracts’ efficacy, and the callus was regenerated from petiole and midrib explants of Carica papaya in MS basal media supplemented with NAA and Kinetin (1 + 0.5 mg/L). A ratio of 1:20 of substrate extract to 1 mM AgNO3 produced the most effective nanoparticles in terms of capping, quality, and stability when tested through surface plasmon resonance (SPR) within the 400–435 nm range. The nanoparticle sizes of all six types were measured using Image J software on micrographs of SEM at 200 nm resolution. The average diameters were analyzed through Origin software, and the finest AgNPs were observed to be synthesized from callus extract, i.e., 18.91 nm with rod-like morphology. Energy dispersive X-ray (EDX) at 2.6 keV revealed 43.38, 75.39, 70.611, 36.54, 58.57, and 45.94 percent elemental silver in AgNPs formed from the leaf, callus, juice, seed, bark, and peel extract, respectively. Silver nanoparticles synthesized from callus extract were smaller and exhibited the most effective antimicrobial potential, with the highest inhibitory zone of 19 mm against Xanthomonas campestris bacterium and up to 14 mm against Aspergillus niger fungus. Furthermore, the percentage of elemental Ag (measured through EDX) was found to be highest in the nanoparticles synthesized from callus compared to those synthesized from the leaf, seed, peel, fruit juice, and bark of Carica papaya. Hence, the callus extract is the most suitable substrate for the reduction of silver nitrate solution in 1:20 to form the finest silver nanoparticles in an effective biogenic way.

Compliance with Clinical Pathways and Pilot Implementation Impact on Financial Outcome in Hospitals Using National Health Insurance: An Action Research

Payment for health services with national health insurance applies a prospective method. Hospitals must make efforts so that health services can run efficiently and not cause losses. The problem in this research is the negative difference between the Indonesian Case Based Group (INA-CBG) rates and service costs based on actual patient rates with national health insurance. This study aimed to develop a clinical pathway on 10 top CBG codes with the largest negative differences between INA-CBG and hospital rate. It also evaluated its pilot implementation impact on financial outcomes. Action research was conducted on a sample of the top 10 Case Based Group (CBG) codes with the largest negative difference between INA-CBG rates. One thousand ninety-nine (1099) medical records were analyzed and taken randomly using simple random sampling. Most of the variants found were the provision of consumable medical materials that exceeded standards and the administration of patent medicines outside the national formulary without written medical indications. The value of compliance with the clinical pathway was still below the expected standard (< 80%), especially in medical consumables. Researchers carried out a three-month intervention of a new clinical pathway implementation. The results showed increased compliance with clinical pathways and reduced negative differences between INA-CBG and hospital rates. Clinical pathway audits could reduce the negative difference between INA-CBG and hospital rates.

Compliance with Glasgow Modified Alcohol Withdrawal Scale Guidelines within Emergency Medicine Utilising Electronic Prescribing Protocols

Abstract Introduction Glasgow Modified Alcohol Withdrawal Scale (GMAWS) allows evidence-based management of patients at risk of alcohol withdrawals within the hospital setting. Adherence to this guideline mitigates risk of patients developing Wernicke-Korsakoff syndrome, a neurological disorder resulting from a thiamine deficiency induced by chronic alcohol consumption1. As Scotland has particularly high rates of alcohol misuse, utilisation of this guideline avoids development of this serious complication with a large at-risk population. However, non-compliance and incorrect prescribing has been prevalent as this can be difficult and time-consuming to manually prescribe leading to errors. This can be avoided by utilising the novel electronic prescribing protocol on Hospital Electronic Prescribing and Medicine Administration (HEPMA) programme. Aim The aim of this quality improvement project was to increase compliance with the GMAWS guideline and ensure correct prescribing within Emergency Medicine. Methods Data collection was supported by the HEPMA team, with daily reports of all identified patients to allow evaluation of GMAWS prescribing as per protocols. Identified patients were confirmed to be on GMAWS and not prescribed thiamine/benzodiazepines for another indication with presence of GMAWS paper chart. Data was initially collected over a two-week period to establish a baseline, with further two-week periods of data collection after interventions. Intervention 1 was distribution of a hospital wide memo regarding GMAWS protocol. Intervention 2 was buzzword teaching on GMAWS with small groups of prescribers. This study did not require ethics approval due to it being a service evaluation / improvement project. Results The data collection following interventions demonstrated improved compliance with HEPMA protocols, evidenced by an increase from 33.3% at baseline to 82.1% compliance. The intervention of buzzword teaching was most impactful with 82.1% compliance recorded following this. An overall increase of 55.6% in the total prescribing of GMAWS signifies an increased awareness of the guidelines and increased confidence with prescribing. Discussion/Conclusion As novel electronic prescribing continues to evolve, pharmacy is a main contributor for advocating optimised prescribing and supporting best practice. Significant learning points included that many patients were on unnecessarily prolonged courses of parental thiamine, which has significant cost and nursing time implications. This is supported by the fact that oral thiamine costs 0.5% of the total cost of giving parental thiamine daily and reduced risks from unnecessary prolonged cannulation. We were able to incorporate this learning into the buzzword teaching to prompt review of parental thiamine prescribed without a clear duration. This project has prompted a review of our health board’s GMAWS guideline to streamline and update guidance in line with updated NICE guidelines. Feedback from the buzzword teaching sessions has been incorporated to improve readability and aid use, via the rationalisation of the GMAWS paperwork. The corresponding HEPMA protocols will then be updated to reflect these changes. Furthermore, this work has influenced other specialities to create and teach the use of HEPMA protocols to optimise treatment.

A systematic review of pregnancy-related clinical intervention of drug regimens due to pharmacokinetic reasons

Background and objectivePublished works have discussed the pharmacokinetic interactions of drugs with pregnancy, but none comprehensively identify all the approved United States Food and Drug Administration (FDA) and European Medicines Administration (EMA) drugs that have a pregnancy-related intervention. The objective of this systematic review is to comprehensively identify medications that have clinically meaningful interventions due to pharmacokinetic reasons.MethodsAn in-depth search of clinical data using the PDR3D: Reed Tech Navigator™ for Drug Labels was conducted from 1 June to 12 August 2022. The PDR3D was analyzed using the search terms “pregnant” and “pregnancy” within the proper label section. Regarding the US labels, the terms were searched under the “dosage and administration” section, whereas with the EU labels, the terms were searched within the “posology and method of administration” section. If a finding was discovered within the search, the rest of the label was analyzed for further information. Clinical relevance was based on whether an intervention was needed.ResultsUsing the search strategy, 139 US and 20 EU medications were found to have clinically meaningful interventions in pregnancy. The most common explanations for clinical relevance included hepatic metabolism, protein binding, renal elimination, and P-gp influence. Of the US labels: 40 were found to undergo hepatic metabolism, 11 were found to be influenced by renal elimination, 12 were found to be influenced by protein binding, 7 were found to be influenced by P-gp, and the remaining drugs required further research. Of the EU labels: 11 were found to undergo hepatic metabolism, 3 were found to be influenced by renal elimination, 3 were found to be influenced by protein binding, 1 was found to be influenced by P-gp, and the remaining drugs required further research.ConclusionThis comprehensive review of clinically relevant interventions in pregnancy will potentially aid in the treatment of pregnant females when they are undergoing therapy, provide intervention and dosing guidance for physicians, and save time for prescribers and pharmacists. Advances in non-clinical predictions for pregnancy dosing may guide the need for a future clinical evaluation.

Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions

Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected.A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart–Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected.A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one.

Identification of antidiabetic inhibitors from Allophylus villosus and Mycetia sinensis by targeting α-glucosidase and PPAR-γ: In-vitro, in-vivo, and computational evidence

Diabetes mellitus (DM) is a metabolic disorder arising from insulin deficiency and defectiveness of the insulin receptor functioning on transcription factor where the body loses control to regulate glucose metabolism in β-cells, pancreatic and liver tissues to homeostat glucose level. Mainstream medicines used for DM are incapable of restoring normal glucose homeostasis and have side effects where medicinal plant-derived medicine administrations have been claimed to cure diabetes or at least alleviate the significant symptoms and progression of the disease by the traditional practitioners. This study focused on screening phytocompounds and their pharmacological effects on anti-hyperglycemia on Swiss Albino mice of n-hexane, ethyl acetate, and ethanol extract of both plants Mycetia sinensis and Allophylus villosus as well as the in-silico investigations. Qualitative screening of phytochemicals and total phenolic and flavonoid content estimation were performed significantly in vitro analysis. FTIR and GC–MS analysis précised the functional groups and phytochemical investigations where FTIR scanned 14, 23 & 17 peaks in n-hexane, ethyl acetate, and ethanol extracts of Mycetia sinensis whereas the n-hexane, ethyl acetate, and ethanol extracts of Allophylus villosus scanned 11 peaks, 18 peaks, and 29 peaks, respectively. In GC–MS, 24 chemicals were identified in Mycetia sinensis extracts, whereas 19 were identified in Allophylus villosus extracts. Moreover, both plants' ethyl acetate and ethanol fractioned extracts were reported significantly (p < 0.05) with concentrations of 250 mg and 500 mg on mice for oral glucose tolerance test, serum creatinine test and serum alkaline phosphatase test. In In silico study, a molecular docking study was done on these 43 phytocompounds identified from Mycetia sinensis and Allophylus villosus to identify their binding affinity to the target Alpha Glucosidase (AG) and Peroxisome proliferator-activated receptor gamma protein (PPARG). Therefore, ADMET (absorption, distribution, metabolism, excretion, and toxicity) analysis, quantum mechanics-based DFT (density-functional theory), and molecular dynamics simulation were done to assess the effectiveness of the selected phytocompounds. According to the results, phytocompounds such as 2,4-Dit-butyl phenyl 5-hydroxypentanoate and Diazo acetic acid (1S,2S,5R)-2-isopropyl-5-methylcyclohexyl obtained from Mycetia sinensis and Allophylus villosus extract possess excellent antidiabetic activities.

What to consider for successful administration of oral liquids via enteral feeding tubes? a case study with paediatric ibuprofen suspensions

Administration of medications via enteral feeding tubes (EFTs) is a common practice for children who cannot swallow properly. Although liquid formulations are the preferred dosage forms for this route of administration, little attention has been paid to the amount of drug that reaches the site of absorption after administration via an EFT. This systematic in vitro study aimed to identify formulation parameters and administration approaches that are critical for successful dose delivery via EFTs. For this purpose, drug recovery after administration of three different paediatric ibuprofen suspensions via different types of EFTs was studied using derivative UV spectrophotometry for quantification. Study results indicate that in addition to formulation parameters, feeding tube characteristics and the administration process can have a significant impact on the administered dose. The ratio between the total administered fluid volume (TAV), represented by the sum of dose- and flushing volume, and the feeding tube volume (FTV) proved to be a valuable indicator for assessing successful administration. Incorrect dosing and complications could be avoided if the TAV/FTV ratio was greater than 4. This and other knowledge gained in the study will help to make the administration of liquid paediatric medicines via EFTs both more effective and safer.

Severe Parasite Co-Infection in a Captive Bactrian Camel: Case Report

The aim of this study was to document a case of parasite co-infection in a captive Bactrian camel and to supply morphometric data of the found pathogens. It concerned a 20-year-old male animal inhabiting Sofia Zoo, Bulgaria. A decreased appetite and gastrointestinal disorders were observed in it during the summer of 2022. Improvement in the animal’s condition was achieved after the administration of antibiotics, sulfonamides, and other symptomatic medicines. However, two weeks after treatment, clinical symptoms reappeared. Then, a diarrheal fecal sample from the animal was subjected to parasitological examination by direct smear and flotation and sedimentation techniques. Multiple infections by helminths (Trichostrongylus sp., Haemonchus sp., Oesophagostomum sp., Trichuris sp., and Dicrocoelium sp.), ciliates (Buxtonella cameli), and protozoa (Eimeria cameli) were found, with E. cameli being reported for the first time in zoo conditions. Deworming led to the recovery of the general condition and appearance of the animal’s feces, but two weeks later, it died suddenly. We considered that the parasitic infection was not the direct cause of the fatal outcome, and its presence, other health disorders, and the advanced age of the animal were among the contributing factors. This case reveals the need to combine planned preventive deworming with routine parasitological diagnostics to take timely and targeted actions to protect the health of animals inhabiting zoo facilities.

Improving Parkinson's Medicine Administration in Hospitals: The Impact of an Out-of-Hours Drug Box.

Background Parkinson'sdisease (PD) is a progressive neurodegenerative condition characterised by the loss of dopaminergic neurons and the presence of Lewy bodies. PD medications, notably Levodopa, are critical in controlling patients' symptoms and improving their quality of life. These medications are time-critical, and a delay in administration can have a negative impact on a patient's mobility, quality of life and symptoms. Objective The objective of this quality improvement project (QIP) was to (1) determine the occurrence and underlying factors contributing to delays in PD medication administration at Huddersfield Royal Infirmary and (2) evaluate the impact of subsequent interventions in improving the administration of time-critical PD medications. Methods A total of 20 patients were recruited from Ward 5, a care of the elderly ward, at Huddersfield Royal Infirmary for the entire duration of this QIP; 10 in the pre-intervention phase and 10 for the post-intervention phase one month following the implementation of three interventions: 'Parkinson's Drug Box', ward-based teaching and a hospital-wide screensaver reminder. Datawascollected from the electronic patient record (EPR) to determine and compare the following measures before and after the interventions: the percentage of PD medications administered within the 30-minuterecommendedwindow, the admission-to-medication reconciliation time, scheduled-to-actual dose administration time, and factors causing delays. Results Following the implementation of three interventions, the percentage of patients receiving PD medications within the recommended 30-minute window doubled, increasing from 10% to 20%. Moreover, the average delay in patients receiving their initial PD medication dose decreased from 7.8 hours to 3.7 hours. The percentage of patients experiencing medication delays due to stock shortages also dropped from 50% to 10%. Conclusions Earlier medicines reconciliation and the availability of time-critical drugs out of hours are both key factors in helping to ensure PD medication is administered on time in hospitals. Staff education and a 'Parkinson's Drug Box' are two relatively simple measures that have resulted in improved outcomes for Parkinson's inpatients.

Intradermal Vaccination against Influenza with a STING-Targeted Nanoparticle Combination Adjuvant Induces Superior Cross-Protective Humoral Immunity in Swine Compared with Intranasal and Intramuscular Immunization.

The development of cross-protective vaccines against the zoonotic swine influenza A virus (swIAV), a potential pandemic-causing agent, continues to be an urgent global health concern. Commercially available vaccines provide suboptimal cross-protection against circulating subtypes of swIAV, which can lead to worldwide economic losses and poor zoonosis deterrence. The limited efficacy of current swIAV vaccines demands innovative strategies for the development of next-generation vaccines. Considering that intramuscular injection is the standard route of vaccine administration in both human and veterinary medicine, the exploration of alternative strategies, such as intradermal vaccination, presents a promising avenue for vaccinology. This investigation demonstrates the first evaluation of a direct comparison between a commercially available multivalent swIAV vaccine and monovalent whole inactivated H1N2 swine influenza vaccine, delivered by intradermal, intranasal, and intramuscular routes. The monovalent vaccines were adjuvanted with NanoST, a cationic phytoglycogen-based nanoparticle that is combined with the STING agonist ADU-S100. Upon heterologous challenge, intradermal vaccination generated a stronger cross-reactive nasal and serum antibody response in pigs compared with intranasal and intramuscular vaccination. Antibodies induced by intradermal immunization also had higher avidity compared with the other routes of vaccination. Bone marrow from intradermally and intramuscularly immunized pigs had both IgG and IgA virus-specific antibody-secreting cells. These studies reveal that NanoST is a promising adjuvant system for the intradermal administration of STING-targeted influenza vaccines.

Medication Safety Gaps in English Pediatric Inpatient Units: An Exploration Using Work Domain Analysis.

Medication is a common cause of preventable medical harm in pediatric inpatients. This study aimed to examine the sociotechnical system surrounding pediatric medicines management, to identify potential gaps in this system and how these might contribute to adverse drug events (ADEs). An exploratory prospective qualitative study in pediatric wards in three hospitals in the north of England was conducted between October 2020 and May 2022. Analysis included a documentary analysis of 72 policies and procedures and analysis of field notes from 60 hours of participant observation. The cognitive work analysis prompt framework was used to generate a work domain analysis (WDA) and identify potential contributory factors to ADEs. The WDA identified 2 functional purposes, 7 value/priority measures, 6 purpose-related functions, 11 object-related processes and 14 objects. Structured means-ends connections supported identification of 3 potential contributory factors-resource limitations, cognitive demands, and adaptation of processes. The lack of resources (equipment, materials, knowledge, and experience) created an environment where distractions and interruptions were unavoidable. Families helped provide practical support in medicines administration but were largely unacknowledged at an organizational level. There was a lack of teamwork with regards to medication with different professionals responsible for different parts of the system. Mandated safety checks on medicines were frequently omitted because of limited resources and perceived redundancy. Interventions to support adherence to safety policies were also often bypassed because they created more work. The WDA has provided insights into the complex system of medication safety for children in hospital and has facilitated the identification of potential contributory factors to ADEs. We therefore advocate (in priority order) for processes to involve parents in the care of their children in hospital, development of skill-mix interventions to ensure appropriate expertise is available where it is needed, and modified checking procedures to permit staff to use their skills and judgment effectively and efficiently.

The Efficacy and Safety of Shashen-Maidong Decoction Combined with Western Medicine in the Treatment of Omicron Infected Individuals Over 85 Years Old: A Retrospective Study.

During the Omicron variant outbreak of COVID-19 (2022-2023), Chinese healthcare institutions combined traditional Chinese medicine (TCM) with Western medical practices to treat COVID-19 patients, especially the elderly. The efficacy and safety of this approach, especially for individuals aged over 85, need further investigation. In this retrospective study, a cohort of 62 patients aged over 85 years, diagnosed with COVID-19 infection, was examined. Among them, 34 patients were administered Shashen-Maidong decoction in conjunction with Western medicine (SMD+WM group), while the remaining 28 patients received only Western medicine (WM group). Comparative analysis was conducted between the two groups, encompassing parameters such as the duration for the nucleic acid test to turn negative, length of intensive care unit (ICU) stay, mortality rate, utilization of high-flow nasal cannula oxygen (HFNC), occurrence of endo-tracheal intubation, frequency of recurrent respiratory infections within three months, and various laboratory indicators. There were no significant differences observed between the two groups in terms of the duration for the nucleic acid test to turn negative, the length of ICU stay, mortality rate, utilization of HFNC, performance of endo-tracheal intubation, or the frequency of recurrent respiratory infections within three months (P > 0.05). However, in comparison to the WM group, the SMD+WM group exhibited notably lower growth rates in white blood cell (WBC) and neutrophil (NEUT) values. Additionally, the SMD+WM group demonstrated superior improvement in cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) values. In contrast to the administration of Western medicine alone, the combined use of Shashen-Maidong decoction with Western medicine significantly suppresses the increase in WBC count, particularly in NEUT levels, in elderly patients diagnosed with COVID-19. Moreover, this combined treatment exhibits a protective effect on cardiac function and demonstrates a relatively safe profile.

A clinical study to ascertain the effectiveness of homoeopathic medicines in the treatment of scalp psoriasis

Objectives: Psoriasis was recognised as a major non-communicable disease in the World Health Assembly decision WHA67 on 24 May 2014. One of the most typical locations for psoriasis manifestations is the scalp; this has a detrimental effect on the patient’s quality of life. Materials and Methods: Study participants were chosen from among patients who attended the psoriasis research outpatient clinic at the Government Homoeopathic Medical College Thiruvananthapuram, Kerala. With the help of a dermatologist, the patients were clinically identified and case documentation was completed using a standardised case record format. The gathered data were analysed using the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) following the administration of the homoeopathic medicine. Results: It is clear from the current study of 30 instances that by comparing the PASI scores and DLQI ratings for the area of psoriasis lesions on the scalp before and after therapy, the study’s overall effectiveness was determined. After the medication was administered, PASI scores and DLQI considerably reduced and patients reported an improvement in their quality of life. Conclusion: Homoeopathy can effectively treat scalp psoriasis. It most frequently affects the scalp, which has a detrimental effect on people’s quality of life. The proper treatment and limiting of impairments depend on early detection and intervention. In the current scenario, our statistical data depict that homoeopathy holds a pivotal role in the choice of various health systems for cost-effective and successful treatment of scalp psoriasis.