Correct Dose Research Articles

The road map to proper dental pulp experiments in animal models

Animal models are essential for the development and comparison of new dental materials. However, working on the dental pulp of animal models can be challenging. To provide guidance for conducting proper dental pulp experiments in animal models. The author conducted a literature search on the Google Scholar database to find papers related to pulp capping and animal modeling in dentistry. Based on her own experience in animal research and the findings from the literature review, the author provides practical advice for new researchers in this field. Dogs and monkeys have the size and morphology of teeth that facilitate accessibility while operating in the dental pulp. However, the response of rat dental pulp has been found to be identical to that of humans. Rat maxillary molars are often used for dental pulp studies. Anesthesia using a combination of ketamine and xylazine provides a suitable time for pulp procedures in rats, but it's important to note that anesthetized rats may remain alert despite receiving the correct dose. Attempting to increase the dosage can result in the rat being unable to recover from anesthesia. To ensure safe and effective anesthesia, it is recommended to administer only one-third of the ketamine dose. Xylazine re-dosing should be avoided. Dental researchers in the Middle East and Africa may face unique challenges, but working on rats is challenging worldwide. In the future, virtual reality and simulation may offer alternatives for experimental animals. Wister Albino is the more suitable animal model to be used in dental pulp experiments. The checklist and flow chart of PRAISE 2021 are mandatory for dental researchers experimenting with the dental pulp of animal models.

Evaluation of Levofloxacin Prescription Pattern Based on International Standards in a Tertiary Hospital in Iran

Background: The emergence of antibiotic-resistant bacteria poses a significant global concern. The improper use of antibiotics, identified as a leading contributor to this problem, is a widespread issue in medical centers worldwide. Objectives: This study aimed to investigate the utilization pattern of levofloxacin, a commonly prescribed antibiotic. Methods: We conducted a retrospective descriptive study in Ahvaz, Iran, focusing on patients who had received levofloxacin over a 6-month period. Data collection involved a questionnaire comprising patient demographic details, diagnosis information, details concerning levofloxacin administration, and outcomes, all extracted from the patients' medical records. During the assessment, we considered factors such as the correct dosage, frequency of administration, potential drug interactions, and adverse effects. Data analysis was performed using SPSS v. 20. Results: A total of 35 patients, with a mean age of 55.17 ± 20.36 years, received levofloxacin during the study period, and 48.6% of them were women. On average, each patient received 3.20 ± 2.85 grams of levofloxacin, with a minimum dose of 0.500 grams and a maximum of 11.50 grams. The average treatment duration was 3.813 ± 4.26 days. In only 8.6% of cases, the prescribed dosage was deemed inappropriate, while in 40% of cases, the duration of antibiotic use was found to be inadequate. Conclusions: The utilization of levofloxacin was deemed irrational in 40% of cases. Although the prescribed dosage for the respective diagnoses was generally accurate, the treatment duration was often incorrect, potentially contributing to antibiotic resistance.

Impact of a Mobile App (LoAD Calc) on the Calculation of Maximum Safe Doses of Local Anesthetics: Protocol for a Randomized Controlled Trial.

Local anesthetics (LAs) are regularly used to alleviate pain during medical or surgical procedures. Their use is generally considered safe, but exceeding the maximum recommended doses can lead to LA systemic toxicity, a rare but potentially lethal complication. Determining maximum safe doses is therefore mandatory before performing local anesthesia, but rules are often unclear and the factors affecting dose calculation are numerous. Mobile health apps have been shown to help clinical decision-making, but most currently available apps present significant limitations. The Local Anesthetics Dose Calculator (LoAD Calc) app was designed to overcome these limitations by taking all relevant parameters into account. Before deploying this app in a clinical setting, it should be tested to determine its effectiveness and whether clinicians would be willing to use it. The primary objective will be to evaluate the effectiveness of the LoAD Calc app through written simulated cases. The secondary objective will be to determine whether physicians find this app easier, faster, and safer than the methods they generally use. We describe a parallel-group randomized controlled trial protocol. Anesthesiologists working at the Geneva University Hospitals will be invited to participate. Participants will be asked to compute the maximum dose of LA in 10 simulated clinical cases using 3 different LAs. The maximum safe dose will be determined manually using the same calculation rules that were used to develop LoAD Calc, without using the app itself. An overdose will be considered any dose higher than the correct dose, rounded to the superior integer, while an underdose will be defined as the optimal calculated dose minus 20%, rounded to the inferior integer. Randomization will be stratified according to current position (resident vs registrar). The participants allocated to the LoAD Calc (experimental) group will use the LoAD Calc app to compute the maximum safe LA doses. Those allocated to the control group will be asked to use the method they generally use. The primary outcome will be the overall overdose rate. Secondary outcomes will include the overdose rate according to ideal and actual body weight and to each specific LA, the overall underdose rate, and the time taken to complete these calculations. The app's usability will also be assessed. A sample size of 46 participants will be needed to detect a difference of 10% with a power of 90%. Thus, a target of 50 participants was set to allow for attrition and exclusion criteria. We expect recruitment to begin during the winter of 2023, data analysis in the spring of 2024, and results by the end of 2024. This study should determine whether LoAD Calc, a mobile health app designed to compute maximum safe LA doses, is safer and more efficient than traditional LA calculation methods. PRR1-10.2196/53679.

Hydroxychloroquine as an important immunomodulator: a novel insight into an old drug.

Hydroxychloroquine (HCQ) is an increasingly popular drug owing to its efficacy, long‑term safety, and a wide range of therapeutic effects. Currently, due to the numerous benefits it provides, the use of the drug goes beyond the treatment of rheumatic and dermatologic diseases. As HCQ shows anti‑inflammatory, immunomodulatory, antiproliferative, and photoprotective action, it has a great potential to be applied also in the treatment of oncologic diseases, multiple sclerosis, diabetes, cardiovascular diseases, or recurrent miscarriages. Nevertheless, antimalarial drugs are still most widely used in the long‑term treatment of systemic rheumatic disorders, such as systemic lupus erythematosus (SLE), rheumatoid arthritis, and primary Sjögren syndrome, as they continue to offer satisfactory outcomes. They reduce the need for glucocorticoids and immunosuppressants and increase their effectiveness. In addition, they reduce the risk of possible side effects and complications. This paper presents the latest data on HCQ, its mechanisms of action, its therapeutic potential in current clinical practice as well as future perspectives. It also discusses the correct dosing regimen and long‑term monitoring, with consideration of possible rare complications. Finally, it focuses on the enormous benefits for patients with rheumatic diseases in terms of reducing the disease activity and organ damage, preventing flares and pregnancy‑related complications, and, most importantly, lowering mortality rates in SLE patients.

Level of Awareness of Certified Non-critical Care Physicians in Diagnosing, Managing, and Disposing Anaphylactic Cases.

Anaphylaxis is known as an acute, severe hypersensitivity reaction that rapidly initiates after exposure to a triggering agent. It is a life-threatening condition, and early recognition and swift intervention are crucial to saving patients' lives. Objective: The objective of this study is to assess the ability of certified non-critical care physicians to recognize, manage, and dispose cases of anaphylaxis. A survey consisting of 19 questions was developed by expert emergency consultants to evaluate physicians' knowledge regarding the recognition, management, and disposition of anaphylactic episodes. Responses were collected through in-person surveys conducted with physicians from various specialties and varying clinical experience levels at a tertiary care center in the Eastern Province of Saudi Arabia. In this cross-sectional study, a total of 173 physicians completed the survey, with 81.5% being consultants and 18.5% specialists. Only 5.2% correctly identified all three proposed anaphylaxis clinical scenarios, 16.8% identified two scenarios correctly, and 51.4% identified only one scenario. While 42.8% recognized the first-line management of anaphylaxis, only 24.3% and 24.9% knew the correct epinephrine dose and route, respectively. Regarding the disposition of patients experiencing an anaphylactic episode, 61.9% of responders opted to dispose the case to the emergency department. Our study reveals a knowledge gap among non-critical care physicians practicing in a tertiary care center concerning the identification and management of anaphylaxis. Raising awareness of this life-threatening condition is imperative to address this serious issue.

A Systematic Critical Review of Clinical Pharmacokinetics of Torasemide.

Torasemide is a potassium-sparing loop diuretic used to treat fluid retention associated with congestive heart failure and kidney and hepatic diseases. This systematic review was conducted to combine all accessible data on the pharmacokinetics (PK) of torasemide in healthy and diseased populations, which may help clinicians avert adverse drug reactions and determine the correct dosage regimen. Four databases were systematically searched to screen for studies associated with the PK of torasemide, and 21 studies met the eligibility criteria. The review protocol was registered in the PROSPERO database (CRD42023390178). A decrease in maximum plasma concentration (C max ) was observed for torasemide after administration of the prolonged-release formulation in comparison to that after administration of the immediate-release formulation, that is, 1.12 ± 0.17 versus 1.6 ± 0.2 mcg/mL. After administering an oral dose of torasemide, a 2-fold increase in the area under the concentration-time curve (AUC) was reported in patients with congestive heart failure compared with the healthy population. Moreover, the patients with renal failure (clearance < 30 mL/min) showed an increase in value of AUC 0-∞ that is, 42.9 versus 8.091 mcg.h -1 .mL -1 compared with healthy subjects. In addition, some studies have reported interactions with different drugs, in which irbesartan showed a slight increase in the AUC 0-∞ of torasemide, whereas losartan and empagliflozin did not. The current review summarizes all available PK parameters of torasemide that may be beneficial for avoiding drug-drug interactions in subjects with renal and hepatic dysfunction and for predicting doses in patients with different diseases.

The Effectiveness of Using a Combination of Saponin and Vaccine Given In Ovo on Hatchability and Early Growth Performance of Local Chickens

A study has been carried out to determine the correct dosage for using a combination of saponin and vaccine in an in ovo formula on hatchability and early growth performance. There were four levels of saponin use (0.0; 1.5; 3.0; 4.5 microgram) arranged using a factorial design with two factors, namely saponin level as the first factor, while whether or not vaccine was used as the second factor, so there were eight formula combinations. Each formula combination was dissolved in phosphate buffered saline, then injected into the amnion of fertile eggs of Sentul chickens during incubation for 18 days (0.5 ml/egg) using an automatic injector machine with a 20G needle. The results showed that increasing saponin levels combined with vaccines as an ingredient in the in ovo feeding formula results in decreased hatchability. A very significant decrease occurred at the 4.5 µg level. The average hatchability of vaccine treatment was significantly better than those treated without vaccine. There is no interaction effect of the two materials on hatchability. However, the interaction effect was seen in all parameters of early growth performance of Sentul chicken during the 4 weeks of observation. The vaccine treatment will be more effective if it is used separately or not mixed with saponin (0.0 µg), while the use of saponin without vaccine will produce the best weight gain and feed efficiency when used at the highest dose level (4.5 µg).

Intrathecal baclofen therapy: a 30-year experience

The first pump for intrathecal administration of baclofen was implanted in 1984. Over thirty years, intrathecal prolonged infusion of muscle relaxants has occupied a worthy niche among all methods for correction of non-focal drug-resistant disabling muscle spasticity. However, this method has not become routine despite high awareness of specialists in Russia and abroad, as well as undeniable advantages for restoring the daily activity, improving the walking pattern and providing care and quality of life in people with limited mobility. This is due to scrupulous analysis of adverse events and accurate attitude towards its use. A review of national and foreign literature was performed. Prolonged intrathecal baclofen therapy is perspective for long-term treatment of severe spasticity interfering with quality of life and self-care if oral muscle relaxants are contraindicated or ineffective. This procedure is effective for impaired articulation, chewing and spastic pain syndrome. One can reduce the incidence of side effects via correct dosage of the drug, and tolerance to therapy can be reduced by timely elimination of problems with catheter.

Perception of Hepatitis B Infection: A National Survey on Knowledge, Practice, and Beliefs (KPB) of HBV in Nigeria

Hepatitis B continues to be a significant public health issue, contributing to substantial global morbidity and mortality. This study employed an electronic-based cross-sectional survey to assess the knowledge, practices, and beliefs regarding hepatitis B among a sample of 3,589 participants from Nigeria. Data were collected between June and September 2023 using Google Forms, with participants recruited via social media. The questionnaire, designed based on similar studies and validated by experts, consisted of six sections addressing sociodemographic characteristics, knowledge of hepatitis B, related practices, and beliefs about the infection and those infected. The study population consisted of 2,945 males (67.0%) and 1,184 females (33.0%), with most participants (83.5%) aged between 21 and 30 years. A majority held bachelor’s degrees (70.1%), and 46.4% were pursuing health-related educational majors. The geographical distribution included participants from 12 Nigerian states and the Federal Capital Territory, with Benue State having the highest representation (58.8%). The survey showed a moderately high awareness of hepatitis B (93.8% had heard of it), but only 66.0% knew it was caused by a virus, and 28.9% were aware that hepatitis B is curable. A considerable gap in vaccination coverage was identified, with 51.5% reporting being vaccinated and 48.5% unaware of the correct dosage for full vaccination. Participants displayed moderate knowledge of transmission routes, with 70.1% recognizing blood and blood products as a transmission medium, but only 44.4% aware that contaminated blades or needles also posed risks. Point-biserial correlation analysis revealed that factors such as travel history, educational background, smoking status, and alcohol consumption were significantly associated with higher knowledge scores (p &lt; 0.05). Practices regarding hepatitis B screening and vaccination were varied, with 63.9% of participants having been screened for the infection, and 96.9% willing to seek treatment if diagnosed. However, 17.5% did not know where to get screened, and 21.7% reported not knowing where to get vaccinated. The survey also highlighted misconceptions about hepatitis B, with 17.5% of participants believing in spiritual protection against the virus. This study emphasizes the need for targeted public health interventions in Nigeria to improve hepatitis B awareness, screening, and vaccination, particularly among populations with lower educational attainment and rural settlements. Efforts should focus on dispelling myths, increasing access to vaccines, and promoting screening to meet the World Health Organization’s hepatitis elimination goals.

Awareness of Periconceptional use of Folic Acid to Prevent Neural Tube Defects in Young Females of Dakshina Kannada Region, India: A Cross-sectional Study

Introduction: Neural Tube Defects (NTDs) are one of the common congenital anomalies leading to miscarriages and serious disabilities in newborns. NTDs are the second most common type of birth defects. Even though the aetiology of NTDs is multifactorial, Folic Acid (FA) deficiency is the most common cause. There are limited Indian studies on awareness of FA usage in the general public. Aim: To assess the awareness and usage of FA to prevent NTDs in young ladies of Mangaluru, Dakshina Kannada (DK) district, Karnataka, India. Materials and Methods: It was a community-based crosssectional study conducted at Father Muller Medical College in Dakshina Kannada district, Mangaluru, Dakshina Kannada (DK) district, Karnataka, India from August 2023 to October 2023. A total of 300 young Indian females aged 18-35 years, residing in the study district, were randomly chosen as participants. Data were collected by an interviewer using a semistructured questionnaire with two components. Part 1 focused on sociodemographic details, while Part 2 gathered information on the awareness of FA supplements, dietary sources of FA, the best time, and dosage of FA supplements to prevent NTDs. Descriptive analysis of the data was done. Results: The study included 90 married and 210 unmarried females. The average age of the participants was 23.7±5.7 years. The study results observed that only 103 (34%) of the participants had heard about FA supplements. A total of 240 (80%) of them said they were not aware of the preferred time for FA. Only 9 (3%) females could mention the correct dose of FA. Conclusion: The study results indicate a gross lack of awareness about FA supplements to prevent NTDs in the general population of the region.

Review: Cytohistophysiological Aspects of Blood Organ/Tissue Barriers

General physiology is the basis of basic and applied aspects of life processes and moleculo-biochemical aspects that ensures the survival of species efficiently. There is a need to maintain specific amount and numbers of metabolites in the body fluid and the fluid present in the organs. This needs a specific check on the body fluid that provides the required metabolites and removes unwanted ones. For this scrutiny, there is something like a ‘check post’ and it is referred to as ‘blood organ/tissue barrier’. Further, this ensures the restoration of appropriate ambient environment for the ongoing physiological processes in an organism. Structural, biochemical and molecular aspects of blood organ barriers have potential to illustrate on the survival mechanisms. Further, biotechnological research, artificial mode of physiological techniques and the technological advancement help to understand the intricacies of various physiological mechanisms occurring in the life activities and the remedial aspects in cases of pathogenesis. For normal physiological functioning a suitable physiological homeostasis is an important basis. The respective balanced biochemical and molecular interactions depend on processes like paracellular diffusion of metabolites, activated transport of hydrophobic and hydrophilic metabolites and drugs from the circulating blood stream. There is a specific need of an effective drug therapy along with appropriate drug delivery system that can regulate the correct dose of drug at the site to meet the remedial parameters while dealing with pathogenesis and dysfunctioning of the organ. The investigations relating blood barrier are significant while investigation the toxicological and pathological aspects of a given organ.

Pharmacist Role in Medication Safety in a Busy Public Sector Pediatric Emergency, Pakistan

INTRODUCTION: Medication safety is very crucial part of patient safety as emergency department of any hospital is the busiest place of hospital where the possibility and likelihood of errors are much higher than any other part of the hospital. Human factor inherently limits the safety of health care process and contribute to medication errors. Recently, medication error has justly received significant attention, as it causes mortality, morbidity and additional healthcare costs, for example wrong dose prescribed and wrong dose administered for a prescribed medication.so despite the improved technology in the health care setting errors related to medication use continue to occur. The pharmacist plays a crucial role to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety. OBJECTIVE: The aim of this study is to find out frequency of different types of prescription error in pediatric emergency to improve mediation as well as patient safety. METHOD: We conducted a retrospective study over a period of 6 months (from January 2023 to June 2023). The data were taken from electronic medical record (EMR) of all patients visiting in one of the pediatric emergency departments supported by child life foundation, who were prescribed intravenous medication were enrolled in the study. These prescriptions were checked by qualified pharmacist for correct dose, route, and timing of the drug. RESULTS: Total of 30,954 patient visited during the study period. 25,931 patients were prescribed intravenous medication. total of 784(3%) prescription errors were picked up. out of which 568 (68%) were due to wrong dose calculation and 76 (10%) patients were prescribed wrong medicine. 63(8%) patient were prescribed wrong units and 46(6%) each for wrong frequency and incomplete prescription. CONCLUSION: Unsafe medication practices leading to medication errors are the main causes of mortality and morbidity that can be prevented by a well trained and a qualified pharmacy department in ED of any hospital. the quality and safety of patient can be improved by preventing common medication error due to heavy flow of patient throughout the day.

Pola Penggunaan Obat Analgetik Antiinflamasi Nonsteroid di Pelayanan Farmasi IGD RSUD. Dr. Pirngadi Medan

Background: Pain is the main reason why patients come to the Emergency Room (IGD) with a prevalence of 78-86%. Non-steroidal anti-inflammatory Drugs (NSAIDs) are widely used to treat mild to moderate inflammatory pain. This study looked at the use of NSAIDs in the emergency room pharmacy services at Dr. Pirngadi Medan. Methods: This non-experimental, retrospective descriptive study was conducted at the Emergency Room Pharmacy Service at Dr. RSUD. Pirngadi Medan from January to June 2019. Results: Of the 11,257 NSAIDs used, mefenamic acid 500 mg three times a day (28.69%), diclofenac sodium 50 mg twice a day (24.96%), meloxicam 75 mg twice a day (2.29%), ketorolac injection 30 mg if needed (42.20%), meloxicam 15 mg suppository (0.07%), and proton suppository (1.79%) were given as needed. Conclusion: The use of NSAIDs in the emergency room at Dr. Pirngadi Medan in the January-June 2019 period had the correct indications, doses, drugs and patients.

Factors Influencing Folic Acid and Iron Supplement Use Among Pregnant Women at Hoima Regional Referral Hospital in Uganda

The study sought to assess adherence levels to Folic Acid and Iron supplementation among expectant women attending antenatal care at Hoima Regional Referral Hospital. Findings revealed a 58.8% adherence rate among pregnant mothers. Among adherents, the majority were younger than 30, Christians, rural residents, cohabiting, had primary education, and were homemakers. Notably, only a minority were experiencing their first pregnancy. Regarding awareness and advice, a significant percentage knew about the preventive benefits of Iron-folic acid supplements against anemia, had received advice on supplementation benefits and the necessity of not missing doses. However, awareness about the specific benefits, dosage, and sources of folic acid and iron was limited. While most attended early ANC visits, only a fraction knew about folic acid benefits and sources, the correct dosage, or foods containing folic acid. Additionally, just over half met the recommended ANC visit frequency. Factors influencing adherence were largely tied to demographics such as age, religion, residence, partnership status, education, and employment, alongside knowledge gaps about supplementation benefits and dosages. Conversely, behaviors like alcohol intake, late or infrequent ANC attendance, and negative experiences during ANC acted as barriers to adherence. Keywords: Pregnancy, Anaemia, Antenatal Care, Folic acid, Iron supplementation.

UPDATE REVIEW OF PHYSALIS: ETHNOGRAPHY VALUE AND ITS USEFULNESS IN STROKE ISCHEMIC DISEASE

One Indonesian herbal medicine that deserves attention is Physalis minimal Linn. Identifying medications and their use in the correct dosages is crucial for effective treatment. Country gooseberry, or Physalis minima Linn, has anti-cancer, anti-diabetic, analgesic, antipyretic, and anti-inflammatory properties. This paper aims to reveal the potential use of Physalis minima Linn in stroke ischemic disease, a substantial current health issue in Indonesia. We used Scopus and Google databases to screen the intended articles with keywords used are TITLE-ABS- KEY (stroke) AND physalis AND antioxidant OR antiinflammation, "Physalis minima" and stroke ischemic" and "thrombolytic" OR " Antiinflammatory" OR "Antioxidant". Two other fellow researchers screened the resulting articles and read the articles together, and resumed the narration. Ten articles resulted in the screening—however, only 1 article was included in this article from the Scopus Databases. However, we got five articles out of 10 articles from Google databases. We divided the narration based on several items, such as anti-thrombolytic effects, antioxidant and antiinflammation, and ethnography of the plant. Conclusions. Physalis minima have its potency to be explored as an alternative treatment to stroke ischemic. Firstly P.minima tends to thrombolytic clot in case of thrombosis in stroke ischemia. Secondly, P.minima have an effect of antioxidants and anti-inflammation that is useful in acute stroke ischemia.

A Three-Step Data-Driven Methodology to Assess Adherence to Basal Insulin Therapy in Patients With Insulin-Treated Type 2 Diabetes.

While health care providers (HCPs) are generally aware of the challenges concerning insulin adherence in adults with insulin-treated type 2 diabetes (T2D), data guiding identification of insulin nonadherence and understanding of injection patterns have been limited. Hence, the aim of this study was to examine detailed injection data and provide methods for assessing different aspects of basal insulin adherence. Basal insulin data recorded by a connected insulin pen and prescribed doses were collected from 103 insulin-treated patients (aged ≥18 years) with T2D from an ongoing clinical trial (NCT04981808). We categorized the data and analyzed distributions of correct doses, increased doses, reduced doses, and missed doses to quantify adherence. We developed a three-step model evaluating three aspects of adherence (overall adherence, adherence distribution, and dose deviation) offering HCPs a comprehensive assessment approach. We used data from a connected insulin pen to exemplify the use of the three-step model to evaluate overall, adherence, adherence distribution, and dose deviation using patient cases. The methodology provides HCPs with detailed access to previously limited clinical data on insulin administration, making it possible to identify specific nonadherence behavior which will guide patient-HCP discussions and potentially provide valuable insights for tailoring the most appropriate forms of support.

Interprofessional collaboration between general practitioners and community pharmacists to promote the safe and responsible use of direct oral anticoagulants.

Introduction: Direct oral anticoagulants (DOAC) are important assets in the prevention and treatment of thrombo-embolic disease due to the unrivalled combination of ease of use, safety and effectiveness compared to other antithrombotic treatments. However, many drug related problems appear while prescribing and/or dispensing DOAC. Different indications exist and different dosages are available. Moreover, dosage adjustments need to be done in several cases and DOAC are often involved in drug-drug interactions. &#x0D; Policy Context And Objective: In 2017, the Royal Association of Pharmacists in Antwerpen (KAVA) and Domus Medica have developed a quality improving program (QIP) in the context of Medical-Pharmaceutical Concertation (MPC). MPC is an initiative from the National Institute for Health &amp; Disability Insurance (NIHDI) in Belgium to promote the rational prescribing and dispensing of medication and the safe use of medication in general. The NIHDI provides financial incentives to general practitioners (GP) and community pharmacists (CP) to organize local MPC-projects, based on a QIP. A local MPC-project starts with a ‘kick-off meeting’, to make agreements of the rational use of medication. Most of the time, different cases are discussed in small interprofessional groups. After this meeting, the agreements are subsequently implemented into practice and can be evaluated with quality indicators.&#x0D; This specific QIP focusses on three challenges: (1) prescribing and dispensing of the correct dose, in function of all patients characteristics, (2) correctly dealing with possible drug-drug interactions, and (3) peri-operative management and switch between DOAC and other anticoagulants. Additionally, this QIP focusses on recent changes in DOAC therapy.&#x0D; Target Population: MPC targets the general practitioner and community pharmacist with mutual patients on DOAC-therapy.&#x0D; Highlights: The Royal Association of Pharmacists in Antwerpen (KAVA) and the GP organization Domus Medica strongly believe in this initiative. Currently 20 local MPC-projects based on this QIP have been organized in which 173 CP and 236 GP participated.&#x0D; Topics that were mostly involved in the local MPC-project were&#x0D; &#x0D; The importance of the correct dosage regimen (discussed in 95% of the projects, n = 19);&#x0D; Handling drug-drug interactions (80% - n = 16);&#x0D; Perioperative management and switch between vitamin K antagonists and DOAC (60% - n = 12).&#x0D; &#x0D; Different conclusions were made during these MPC-projects. Most decisions handled about the communication between het pharmacist and general practitioner, the need of shared data and the role of the pharmacist in checking dosage regimens and drug-drug interactions.&#x0D; All participants stated that DOAC treatment is still challenging because of the different dosage regimens and possible drug-drug interactions, therefore good collaboration between pharmacists and general practitioners is crucial.&#x0D; Conclusion: MPC is an initiative from the NIHDI in Belgium to promote the rational prescribing and dispensing of medication and the safe use of medication in general. KAVA and Domus Medica have developed a quality improving program, specifically targeted on DOAC. Currently, 20 local MPC-projects have been organized. Further research is necessary to analyze the impact of the MPC-project.

Formulation and Evaluation of Triamcinolone Acetonide-Loaded Oral Disintegrated Film with Different Polymers via Solvent Casting Method.

The study aimed to investigate the effect of different polymers and plasticizers on oral disintegrating films (ODFs) containing triamcinolone acetonide (TA), a glucocorticosteroid indicated for the treatment of oral wounds. Thirteen different formulations with the same amount of polymer and plasticizer were prepared by solvent casting. Briefly, the solutions containing polymer, plasticizer, and other ingredients were poured into Petri dishes and kept at room temperature for 20 hours to obtain ODFs. Physical properties of ODFs such as visual appearance, weight and thickness uniformity, pH, mechanical durability (tensile strength, elongation at break and folded insurance), and disintegration time were assessed and drug content analysis was performed on ODFs. Suitable ODFs were produced with hydroxypropyl methylcellulose (HPMC), polyvinyl alcohol, carboxymethylcellulose, gelatin, and pectin, while film integrity was not achieved with polyethyleneglycol 4000 (PEG 4000), chitosan and starch. Glycerin made ODFs more transparent, reduced their thickness, and improved their mechanical properties. On the other hand, PEG 400 reduced the weight variation. Regarding drug content, PEG-containing gelatin-based ODF (ODF10) and pectin-based ODF (ODF12) complied with pharmacopeial limits. In addition, all ODFs except HPMC-based ODFs had an appropriate pH range. When all features were evaluated together in terms of the applicability of an ODF to the patient, the most convenient formulation was found to be gelatin-based with PEG 400 ODF (ODF10). In short, patients will benefit from ease of application and transportation and effective therapy with correct dosing with the development of ODF forms of TA for which there are no preparations except for cream, gel, and pomade forms for topical use in Türkiye.

The Effect Of Giving Calcium As An Effort To Prevent Preeclampsia: A Literature Review

Preeclampsia is a pregnancy disorder accompanied by hypertension and proteinuria. Efforts to prevent preeclampsia can be made with medical prevention, namely, meeting the calcium needs of pregnant women. This research aims to determine the effect of givingcalcium to prevent preeclampsia. The method used in the literature review is a systematic mapping study obtained from 3 databases, namely Pubmed, Garuda, and Google Scholar, using inclusion and exclusion criteria. Key term used in searching literature: "Calcium for prevention of preeclampsia." from 10 journals, it was found that the correct dose of calcium and timing of giving calcium to pregnant women was found and that calcium had an effect on preventing preeclampsia. Data analysis techniques use Synthesize or compare. Conclusion: Mothers are advised to consume calcium because it can lower blood pressure. By reducing blood pressure in pregnant women, calcium can prevent the occurrence of preeclampsia, especially in pregnant women who have hypertension or a history of preeclampsia.

Lobelia inflata L. as an Alternative Medicine for Respiratory Problems Provoked by Covid- 19: A Review

Lobelia inflata (Indian tobacco, Campanulaceae) is an herbal remedy for many respiratory conditions such as asthma, bronchitis, pneumonia, and cough. The main objective of the current review is to document the potential use of L. inflata as respiratory stimulant in patients suffering from Covid-19 infection. Native Americans smoked the plant as a treatment for asthma and today, lobelia is sometimes suggested to help clear mucus from the respiratory tract, including the throat, lungs, and bronchial tubes. Although few studies have evaluated the safety and effectiveness of lobelia, some herbalists use lobelia as part of a comprehensive treatment plan for asthma. In the 19th century, American physicians prescribed the herb to induce vomiting in order remove toxins from the body. However, because of its properties as a respiratory stimulant and expectorant, the plant should be used at the correct dose and together with herbs that are soothing to the throat and lungs, and it is often used in a synergistic herbal formula that includes L. inflata herb and seed, Zingiber officinale, and Hyssopus officinalis. The study species should not be used as a substitute for drug therapy during an asthma attack and its use is contraindicated during pregnancy. Lobelia inflata has no known adverse drug interactions and it is therefore a promising complementary therapy for the management of respiratory disorders, in particular in light of the recent increase in the prevalence of respiratory diseases associated with Covid-19. In conclusions, data of the current study has proven the possibility of using the plant in treating the respiratory disorders resulting from infection with Covid-19.