Guidelines For Safe Use Research Articles

EXPRESS: Decoding Medical Educators' Perceptions on Generative Artificial Intelligence in Medical Education.

Generative AI (GenAI) is a disruptive technology likely to generate a major impact on faculty and learners in medical education. This work aims to measure the perception of GenAI among medical educators and to gain insights on its major advantages and concerns.A survey invitation was distributed to medical education faculty of colleges of allopathic and osteopathic medicine. The survey comprised twelve items assessing the role of GenAI for students and educators.Responses showed a positive attitude towards GenAI and disagreed on GenAI having a very negative effect on either the students' or faculty's educational experience. Eighty-five percent responded to have heard about GenAI, while 42% have not used it at all. Generating text (33%), automating repetitive tasks (19%), and creating multimedia content (17%) were some of the common utilizations of GenAI by school faculty. The majority agreed that GenAI is likely to change their role as educator. The greatest perceived strengths of GenAI were the ability to conduct more efficient research, task automation, and increased content accessibility. The faculty's major concerns were with cheating in home assignment (97%), tendency for blunder and false information (95%), lack of context (86%), the removal of human interaction in important feedback processes (83%), and the lack of guidelines for safe use of GenAI.Consensus-based guidelines at the institutional and/or national level need to start to be implemented to govern the appropriate use of GenAI while maintaining ethics and transparency. Faculty responses reflect an optimistic and favorable outlook on GenAI's impact on learning.

Comparative Biological Half-Life of Penthiopyrad and Tebufenpyrad in Angelica Leaves and Establishment of Pre-Harvest Residue Limits (PHRLs).

To prevent pesticides from exceeding maximum residue limits (MRLs) in crops during export and shipment, it is necessary to manage residue levels during the pre-harvest stages. Therefore, the Republic of Korea establishes pre-harvest residue limits (PHRLs) per crop and pesticide. This study was conducted to set PHRLs for penthiopyrad and tebufenpyrad in angelica leaves, where the exceedance rates of MRLs are expected to be high. The LOQ of the analytical method used was 0.01 mg/kg and it demonstrated good linearity, with a correlation coefficient of 0.999 or higher within the quantitation range of 0.005 to 0.5 mg/kg. The recovery and storage stability accuracy values were in the range of 94.5-111.1%, within the acceptable range (70-120%, RSD ≤ 20%). The matrix effect for both pesticides was in the medium-to-strong range, and it did not significantly impact the quantitative results as a matrix-matched calibration method was employed. Using the validated method, residue concentrations of penthiopyrad 20 (%) EC and tebufenpyrad 10 (%) EC were analyzed. Both pesticides exhibited a decreasing residue trend over time. In Fields 1-3 and their integrated results, the biological half-life was within 2.6-4.0 days for penthiopyrad and 3.0-4.2 days for tebufenpyrad. The minimum value of the regression coefficient in the dissipation curve regression equation was selected as the dissipation constant. The selected dissipation constants for penthiopyrad in Fields 1-3 and their integration were 0.1221, 0.2081, 0.2162, and 0.1960. For tebufenpyrad, the dissipation constants were 0.1451, 0.0960, 0.1725, and 0.1600, respectively. The dissipation constant was used to calculate PHRL per field. Following the principles of the PHRL proposal process, residue levels (%) on PHI dates relative to MRLs were calculated, and fields for proposing PHRLs were selected. For penthiopyrad, since the residue level (%) was less than 20%, the PHRL for Field 3 with the largest dissipation constant was proposed. For tebufenpyrad, as the residue level (%) exceeded 80%, the PHRL proposal could not established. It is deemed necessary to reassess the MRL and 'guidelines for safe use' for tebufenpyrad in angelica leaves.

Guidelines for safe use of Polygoni Multiflori Radix

Polygoni Multiflori Radix is a Chinese medicine widely used in clinical treatment and preventive healthcare. However, recently there have been frequent reports of liver injury caused by Polygoni Multiflori Radix and its related preparations, and some patients have serious adverse outcomes, attracting wide attention worldwide. The risk of liver damage caused by preparations containing Polygoni Multiflori Radix or Polygoni Multiflori Caulis has been repeatedly reported by the Chinese Food and Drug Administration. Fortunately, substantial progress has recently been made in revealing the basic properties, main causes, material basis, and molecular mechanism of Polygoni Multiflori Radix-related liver injury. The basic characteristics and biomarkers of susceptible people have been identified, indicating that Polygoni Multiflori Radix has the risk of inducing liver injury only in a few specific populations and is safe for most populations. This study provides a scientific basis for a correct and objective understanding of liver injury caused by Polygoni Multiflori Radix, and a reasonable formulation of safe medication measures for Polygoni Multiflori Radix and related preparations. The China Association of Chinese Medicine organized experts in relevant fields across the country to draft and formulate the “Guidelines for Safe Use of Polygoni Multiflori Radix,” with the aim of helping the public and relevant institutions at home and abroad to scientifically understand, evaluate, and avoid the risk of liver injury; guide the rational use; protect the health rights and interests of consumers; and promote the healthy and sustainable development of Polygoni Multiflori Radix and related preparations. These guidelines were issued by the China Association of Chinese Medicine (No.T/CACM 1328-2019).

ChatGPT in medicine: prospects and challenges: a review article.

It has been a year since the launch of Chat Generator Pre-Trained Transformer (ChatGPT), a generative artificial intelligence (AI) program. The introduction of this cross-generational product initially brought a huge shock to people with its incredible potential and then aroused increasing concerns among people. In the field of medicine, researchers have extensively explored the possible applications of ChatGPT and achieved numerous satisfactory results. However, opportunities and issues always come together. Problems have also been exposed during the applications of ChatGPT, requiring cautious handling, thorough consideration, and further guidelines for safe use. Here, the authors summarized the potential applications of ChatGPT in the medical field, including revolutionizing healthcare consultation, assisting patient management and treatment, transforming medical education, and facilitating clinical research. Meanwhile, the authors also enumerated researchers' concerns arising along with its broad and satisfactory applications. As it is irreversible that AI will gradually permeate every aspect of modern life, the authors hope that this review can not only promote people's understanding of the potential applications of ChatGPT in the future but also remind them to be more cautious about this "Pandora's Box" in the medical field. It is necessary to establish normative guidelines for its safe use in the medical field as soon as possible.

Features of fatal pesticide ingestion in South Australia.

Pesticides are used to kill, repel or control any animal or plant species which are considered pests, but have also been associated with intentional and unintentional human fatalities. A rapid increase in pesticide suicides was observed during 'The Green Revolution' after pesticides were introduced into low- and middle-income rural households without appropriate guidelines for safe use and storage. While national pesticide bans have contributed to a significant decrease in pesticide-related suicides, such cases still comprise a large proportion of all suicides around the world. The aim of the current study was to provide a profile of pesticide suicides in a high-income country as a point of comparison against studies from low- and middle-income countries. Statistical analyses were performed using R (version 4.2.3). Over the 20-year study period, there were a low, yet consistent number of pesticide suicides which were most common among males over the age of 40. Paraquat and methomyl pesticides collectively contributed to almost half (48.8%) of all fatalities. Consistent with the literature, such cases often occurred with little premeditation in response to an acute emotional crisis. While interpretation of autopsy findings was mostly limited, there were some pesticides that demonstrated findings consisted with previously reported characteristics (e.g., gastroesophageal erosions with paraquat). Given the high proportion of cases where paraquat and methomyl pesticides were implicated, it may be appropriate to review the availability and accessibility of such compounds to reduce the occurrence of pesticide suicides in South Australia and potentially the wider Australian population.

Rectal Foreign Bodies: A 10-Year Review of the National Electronic Injury Surveillance System.

Introduction Rectal foreign bodies may result in significant morbidity, potentially necessitating surgical intervention and ostomy creation. The sensitive nature of the diagnosis may lead to inaccurate patient history and possible delay in diagnosis. Currently, there is a paucity of large national studies addressing this diagnosis. Therefore, we present national data describing the demographics and incidence of patients presenting with rectal foreign bodies. Methods The National Electronic Injury Surveillance System (NEISS) was utilized to collect data regarding rectal foreign bodies. Ten years of data were collected from 2012 to 2021. Inclusion criteria focused on the diagnosis of "foreign body" coupled with pelvic and lower torso injuries. Exclusion criteria encompassed patients without a rectal foreign body clearly identified in the narrative. Patients were compared based on disposition as low severity (treated/examined and released or left without being seen) or high severity (treated and admitted/hospitalized, held for observation, or transferred to another facility). General descriptive and inferential analyses were performed regarding demographics and dispositions. Results A total of 1,806 emergency department (ED) visits were identified for inclusion. Patients ranged in age from 0 to 93 years, with a mean age of 30 years. The largest age group identified was 11-15 and 21-25 years. Most patients were male (64.6%) and white (47.1%). The most common foreign bodies were massage devices and vibrators (22.7%), jewelry (8.1%), pens and pencils (4.4%), fishing gears (activity, apparel, or equipment) (3.7%), and nonglass bottles or jars (2.6%). Patients requiring admission, observation, or transfer differed from those patients that were discharged from the ED by age, sex, race, and product involved. Discussion Rectal foreign bodies are a rare diagnosis with a growing incidence. Though the most common objects are massage devices and vibrators consistent with sexual stimulation devices, there are limited product guidelines for safe use. Further studies to help identify at-risk persons, safety precautions, and manufacturing guidelines may help prevent potential morbidity associated with rectal foreign bodies.

Accumulation and Pollution Risks of Heavy Metals in Soils and Agricultural Products from a Typical Black Shale Region with High Geological Background

Soil polluted by heavy metals (HMs) is an important environmental issue in China, and regional geological background is a vital factor that influences the enrichment of HMs in soils. Previous studies have shown that soils derived from black shales are commonly enriched in HMs and present high potential eco-environmental risks. However, few studies have investigated the HMs in different agricultural products, which inhibit the safe use of land and safe production of food crops in black shale regions. This study investigated the concentrations, pollution risks, and speciation of HMs in soils and agricultural products from a typical black shale region in Chongqing. The results showed that the study soils were enriched in Cd, Cr, Cu, Zn, and Se but not in Pb. Approximately 98.7% of total soils exceeded the risk screening values, and 47.3% of total soils exceeded the risk intervention values. Cd had the highest pollution level and potential ecological risks and was the primary pollutant in soils of the study area. Most of the Cd resided in ion-exchangeable fractions (40.6%), followed by residual fractions (19.1%) and weak organic matter combined fractions (16.6%), whereas Cr, Cu, Pb, Se, and Zn were dominated by residual fractions. Additionally, organic combined fractions contributed to Se and Cu, and Fe-Mn oxide combined fractions contributed to Pb. These results indicated that Cd had higher mobility and availability than those of other metals. The agricultural products presented a weak ability to accumulate HMs. Approximately 18.7% of the collected samples with Cd exceeded the safety limit, but the enrichment factor was relatively low, indicating low pollution risks of the heavy metals. The findings of this study could provide guidelines for safe use of land and safe production of food crops in black shale regions with high geological background.

The notorious B.I.T: The effects of a ransomware and a screen failure on distraction in automated driving

Connected and automated vehicles are vulnerable to cyber-attacks, which may jeopardise their safe and efficient operation and, as a result, negatively affect drivers’ behaviour. A major concern for such cyber-attacks is visual distraction inside the vehicle, which is one of the main causes of road accidents. In this empirical research using a driving simulator, 38 participants drove in a conditionally automated vehicle and experienced two types of failure: explicit (i.e., ransomware attack appearing on the in-vehicle screen) and silent (i.e., turn signals failed to activate on the in-vehicle screen and instrument cluster), while engaged in a non-driving related task. Drivers’ gaze behaviour, in terms of number and duration of fixation, were collected and analysed. Results showed that the HMI where the ransomware was displayed was the area of interest drivers looked at the most. The majority of drivers failed to notice that the turn signal was faulty. Nearly half of drivers looked at the ransomware for more than 12 s while driving. No effect on the timing of failure on gaze behaviour was observed. This research evidenced that ransomware attacks are distractive and pose significant risks to road safety – with one participant crashing the vehicle after resuming manual control. Data also evidenced that such connected vehicles are unlikely to meet NHTSA’s distraction guidelines for safe use of in-vehicle devices.

Change in Blink Rate in the Metaverse VR HMD and AR Glasses Environment.

Blink rate, a major physiological response in humans, directly affects ocular diseases such as keratitis and dry eye. The blink rate in normal eyes appears at a constant frequency of 6–30 times per minute and is constant for each individual. In a previous study, the blink rate decreased when viewing content with high intensity and realism. Therefore, we tried to investigate the change in blink rate when viewing the content in VR HMD (virtual reality head-mounted display) and AR (augmented reality) glasses environments. We compared and analyzed the blink rate in four environments: natural state, viewing monitor, viewing VR HMD, and viewing AR glasses. Twenty-one participants (age, 26.87 ± 3.31 years) viewed the content for 1 min in four environments. One-way repeated ANOVA was used to analyze the blink rate changes. The study showed that the blink rate was decreased in the monitor, VR HMD, and AR glasses environments compared to that in the natural environment. Comparing the VR HMD environment with the AR glasses environment showed that the blink rate decreased in the VR HMD environment. The results of this study can be used for content use safety recommendations (guidelines for safe use of contents due to decreased blink rate) in the VR HMD and AR glasses environments, which are currently attracting attention in the metaverse.

Dissipation characteristics of spirotetramat and its metabolites in two phenotypically different Korean vegetables under greenhouse conditions

This study involved analysis and method validation of spirotetramat applied to two phenotypically different Korean vegetables (e.g. Korean cabbage and shallots) to determine the safe pre-harvest residue limit (PHRL) and comparative dissipation patterns. Two steps of the investigation involved greenhouse monitoring during crop cultivation followed by LC-MS/MS analysis. Commercial spirotetramat was sprayed twice with seven-day intervals according to the spray schedule (0, 3, 7, 10, 14, and 21 days before harvest) at the dose recommended by the Ministry of Food and Drug Safety (MFDS), Korea. During the validation of the analytical method, good linearity, specificity, and acceptable recoveries (82%–114% for Korean cabbage and 82%–111% for shallot) were established for spirotetramat and its four metabolites. The calculated biological half-life derived from the first-order reaction (t1/2) of spirotetramat was 4.8 days for Korean cabbage and 4.0 days for shallot, respectively. The safe PHRL for Korean cabbage was suggested at 7 days, due to permissible spirotetramat concentration in terms of an acceptable MRL. The findings of the study will be used as the analytical reference point for developing spirotetramat safety guidelines for use in the vegetables investigated.

Predictive Environmental Microbiology for Safe Use of Sanitation Products in Agriculture: Challenges and Perspectives

Human excreta is a local resource of plant nutrients. The recovery of resources from human excreta and the use of excreta-derived organic fertilizer (sanitation products) for agriculture are compatible with the principle of the Circular Economy. Infectious disease risk associated with resource recovery activities is reduced by following the practices recommended in the guidelines for safe use of sanitation products. This study briefly reviews the domestic and international regulations and specifies the need for developing predictive environmental microbiology. Predictive environmental microbiology is a methodology that aims to predict the rate of inactivation of pathogens in sanitation products using mathematical models. We address the main challenges in applying modeling approaches to sanitization of human excreta matrices, specifically incorporating the heterogeneous nature of matrices and technology-specific factors into the kinetics parameters. In addition, the uncertainty in viral tolerance stems from the genetic nature of viral populations and should be considered in a model of inactivation kinetics for viral indicators. We emphasize the need for a fundamental understanding of pathogen adaptation mechanisms in developing a disinfection method for sanitation products. Disclosing a genetic/phenotypic factor underlying disinfection resistance and the consequent modification of model kinetics will lead to effective sanitization strategies against enteric viruses with varied tolerance.

Safety Assessment of Acer tegmentosum Maxim. Water Extract: General Toxicity Studies in Sprague-Dawley Rats and Beagle Dogs With Re-evaluation of Genotoxic Potentials.

Acer tegmentosum Maxim., commonly known as Manchurian stripe maple, is a deciduous tree belonging to the family of Aceraceae and has been traditionally used in folk medicine for its remedial effects in liver diseases and traumatic bleedings. With a growing body of experimental evidence for its pharmacological efficacies, such as neuroprotective, hepatoprotective, antioxidant, and anti-inflammatory activities, A. tegmentosum has gradually gained popularity as a health supplement and functional food. However, the large part of essential toxicity information still remained lacking despite the possibility of mutagenic potentials as previously suggested, posing safety concerns for human consumption. In this study, we evaluated 90-day repeated oral toxicity of A. tegmentosum Maxim. water extract (ATWE) in SD rats with acute toxicity assessment in beagle dogs, and reevaluated genotoxicity using a combination of in vitro and in vivo assays. During the oral study period, ATWE did not cause toxicity-related clinical signs and mortality in rodents without adverse effects observed in the analysis of hematology, serum biochemistry, and histopathology, establishing >5,000 mg/kg BW as the NOAEL. In addition, doses up to 5,000 mg/kg BW did not cause acute toxicity in beagle dogs. When assessed for genotoxicity using bacterial reverse mutation, chromosome aberration, and micronucleus formation, ATWE showed lack of mutagenicity and clastogenicity. These results demonstrated that AWTE was safe in the present preclinical study for systemic toxicity and genotoxicity at the tested doses, providing a guideline for safe use in humans.

Precipitation of Euglycemic DKA (euDKA) From the Initiation of SGLT2 Inhibitor (SGLT2i) and 0-Carb Diet Inpatient

Background: SGLT2i are increasingly prescribed for their cardiorenal benefits. Nationally renowned endocrinologists have begun to actively discuss the need for guidelines on safe use of SGLT2i inpatient, with the most common indication being treatment for advanced heart failure (HF). However, no consensus has been reached to date. While in the hospital, patients with HF who are taking SGLT2i are at an increased risk for developing euDKA due to volume depletion, critical illnesses, and restricted dietary intake. We present a case of euDKA inpatient in a man admitted for HF treated with empagliflozin (EMPA). Clinical Case: A 54-year-old man with HF and non-ischemic cardiomyopathy was admitted for decompensated HF. The patient was also newly diagnosed with T2D on admission when he presented with an elevated blood glucose (BG) of 395 mg/dL (n 62–125 mg/dL) and an elevated A1C of 13.6% (n 4–6%). Cardiologists initiated EMPA 25 mg PO daily on hospital day (HD) 2, in addition to MDI insulin. On HD3, a 0-carb diet was started for a planned FDG PET/CT scan to assess the etiology of cardiomyopathy. With an extremely limited food selection, the patient became largely fasting between HD3-6 while awaiting the PET scan, eating only eggs once a day. On HD6, patient developed chest pain and hypotension and was found to be in euDKA with AKI. Labs were notable for arterial pH 7.14 (n 7.35–7.45), CO2 12 meq/L (n 22–32 meq/L), anion gap (AG) 23 (n 4–12), BG 238 mg/dL (n 62–125 mg/dL), beta-hydroxybutyrate 7.29 mmol/L (n <0.30 mmol/L), and an acute rise in creatinine from 0.8 to 1.4 mg/dL (n 0.51–1.18 mg/dL). In addition to stopping the EMPA, the patient required treatment with IV insulin and fluids for 24 hours, with resolution of euDKA, hypovolemia, and AKI. Patient was safely discharged on HD14 on MDI insulin and metformin. Conclusion: While euDKA is increasingly recognized outpatient and perioperatively, it is under-recognized in the hospital setting. A study reported 94 patients at one center using SGLT2i inpatient experiencing no euDKA (1). However, hospitalized patients taking SGLT2i remain vulnerable to euDKA, especially with concurrent critical illnesses, volume depletion and restricted dietary intake. Zero-carb intake triggers energy production by ketosis, which greatly amplifies the risk of euDKA on SGLT2i. There are currently no guidelines for safe use of SGLT2i inpatient. When using SGLT2i inpatient, we advocate for clinicians to closely monitor patients’ symptoms and AG twice a day and consider holding SGLT2i with prolonged fasting of >24 hours to readily prevent, diagnose and treat euDKA. We recommend educating clinicians on the side effects associated with SGLT2i, developing EMR alerts, and involving endocrinologists with inpatient use of SGLT2i in high-risk patients.

Traditional Chinese Medicine (TCM) safety evaluation and pharmacovigilance

<p indent="0mm">In recent years, there has been an increase in the number of adverse reactions/events associated with Traditional Chinese Medicine (TCM). This could be due to the passive state of the safety and risk management of TCM, which has not only led to adverse effects but also restricted the healthy and long-term development of industrial disciplines in the field of TCM. To overcome the problems associated with the safe use of TCM, we propose to speed up the establishment of a pharmacovigilance technology system in line with the characteristics of TCM, and ensure the transformation of TCM safety risk management from a passive response to active prevention and control at the earliest. Therefore, this paper systematically discusses: (1) The basic context and issues related to drug safety, (2) main challenges in the safe clinical use of TCM, and (3) pivotal pharmacovigilance methods and approaches applicable for Chinese medicine products. Drug-induced liver injury (DILI) triggered by <italic>Polygonum multiflorum</italic> and other TCMs is a current worldwide concern. Thus, we established an integrated pharmacovigilance approach of “objective identification-mechanism analysis-risk prevention and control” to solve this problem. The established pharmacovigilance technology system applied an “integrated evidence chain-based causality evaluation method” and “three-level diagnostic criteria” for the causality assessment of DILI. A new toxicology evaluation model and method, named as “disease-syndrome-based toxicology”, was developed for the safety evaluation of TCM. This system was designed for the prevention and control of TCM safety risks based on the identification of susceptible individuals, control of factors that enhance susceptibility to adverse reactions, and clinical precision medicine. Moreover, this system enables multi-source data fusion, sharing, and co-creation for DILI active monitoring and evaluation to provide data support for safety supervision and clinical drug decision making. Additionally, it provided the first online safe drug information inquiry platform, named “Inquiring Drug Safety”, for online data sharing and co-creation. Moreover, it helped construct a new model for the prevention mechanisms of TCM safety risks in people. The proposed system has been successfully used in the formulation of strategies to prevent and control safety risks of TCM and related preparations, such as <italic>Polygonum multiflorum</italic> and Rhubarb. Furthermore, this system led to the development of the first technical standard for the safe use of TCM: “Guidelines for safe use of Polygoni Multiflori Radix”. In conclusion, the established pharmacovigilance technology system overcomes the problems of causality evaluation, as well as risk prevention and control of DILI caused by TCM. Furthermore, it supports the clinical rational and safe use of TCM, and makes important contributions to ensure the healthy and sustainable development of TCM disciplines and its industry.

Removing Unnecessary Medical Barriers to Contraception: Celebrating a Decade of the U.S. Medical Eligibility Criteria for Contraceptive Use.

In 2010, the Centers for Disease Control and Prevention (CDC) released the U.S. Medical Eligibility Criteria for Contraceptive Use, providing recommendations for health care providers on safe use of contraception for people with certain characteristics or medical conditions. Adapted from World Health Organization guidance, the goal of the recommendations is to remove unnecessary medical barriers to contraception. Over the past decade, CDC has updated recommendations based on new evidence, collaborated with national partners to disseminate and implement the guidelines, and conducted provider surveys to assess changes in attitudes and practices around contraception safety and provision. CDC remains committed to supporting evidence-based guidelines for safe use of contraception, as the basis for improving access to contraception and high-quality family planning services, reducing unintended pregnancy, and improving reproductive health in the United States.

Prevalence and socioeconomic factors in the prescription of concurrent amphetamine and alprazolam.

Goals were to determine the prevalence of concurrent prescription of amphetamine and alprazolam, and examine variation by socioeconomic factors. Washington State's Prescription Monitoring Program was reviewed for calendar years 2013 through 2017. Individuals receiving more than 180 days of amphetamine, alprazolam or both were tabulated for each zip code. Prescription rates were compared between zip codes with variation in rural/urban setting and fraction of low and high income households using a multiple regression. One in 3920 individuals in the general population of Washington State were taking a combination of alprazolam and amphetamine. The statewide prevalence of this combination increased 40.2% between 2013 and 2017. The prevalence of the combination in each zip code is significantly positively correlated with the fraction of high income households, p < 0.001, and urban area, p < 0.05. In contrast, the prevalence of amphetamine increased with both the fraction of high income, p < 0.001, and low income households, p < 0.01, with an incremental increase over twice as large with fraction of high income (b = 232 (25)) than low income households (b = 102 (38)). In contrast, alprazolam decreased in prevalence with the fraction of high income households, p < 0.05. The prevalence of concurrent prescription of alprazolam and amphetamine correlates with local socioeconomic factors, including greater household income, instead of the prevalence of FDA indications, including anxiety disorders or ADHD. More clinical studies are required to establish efficacy and guidelines for safe use to mitigate the increased risk of accidents in patients taking concurrent amphetamine and alprazolam.

Over the counter drug use: Assessing the perception of the community

The drugs that can be easily purchased from any medical store without prescription are known as “Non Prescription” drugs. Such non prescription drugs are used for self medication. Non Prescription drugs are commonly termed as “Over the counter” drugs. There is always certain degree of danger in consuming OTC drugs even though some people consider their use as completely safe. The study is designed with an objective to understand the pattern of Over the Counter drugs use in a locality of Dehradun by using a structured questionnaire. An Observational, Descriptive study was conducted. The data was collected using a Questionnaire. The present study was carried out in 350 participants. After analyzing the results it was found that 100% participants follow self medication and consume OTC drugs. The number of females (52%) were more as compared to males(48%). Paracetamol (62%) was the most commonly consumed OTC drug. Fever (37%) was the most common condition for which people use OTC drugs. The most general reason of practicing selfmedication that was reported in our study was easy convenience (23%). The study also concludes that the most common source of relevant information about OTC drugs were friends/relatives. (28%). The use of OTC drugs is fast increasing as they are easily available. However, poor awareness about their consumption end up in many side effects. This study will help gain knowledge about peoples perceptive which would ultimately help forming new guidelines for safer use of OTC drugs.

AORN Position Statement on the Role of the Health Care Industry Representative in Perioperative Settings

<scp>AORN</scp> Position Statement on the Role of the Health Care Industry Representative in Perioperative Settings

Polysubstance use patterns and novel synthetics: Acluster analysis from three U.S. cities.

The rapid emergence of novel psychoactive substances within the past decade has raised new concerns about the harms associated with unregulated drug use. Synthetic analogues—chemically related to established psychoactive substances like cannabis sativa and catha edulis—in particular have proliferated rapidly, allowing little opportunity for scientific research or the establishment of informal guidelines for safe use among consumers. To explore how synthetic substance use relates to other forms of use, this paper presents an analysis of polysubstance use among a sample of 676 people who use illicit substances in the United States. Participants were sampled from three greater metropolitan areas (Houston/Galveston, Texas; New York City; and New Orleans, Louisiana). Study researchers used cluster-type analyses to develop dendrogram visualizations of the interrelationships between substance types. Results suggest a considerable variation in substance and polysubstance use patterns across states in the U.S. Polysubstance use clustered around well-observed combinations like MDMA/cannabis and cocaine/heroin. Synthetic cannabinoids and cathinones showed no strong clustering with other substances. High rates of binge drinking among users of other substances further support the importance of interventions sensitive to the clinical challenges of polysubstance use.

Antileishmanial activity and cytotoxicity of ZnO-based nano-formulations.

IntroductionNanoparticles (NPs) can be toxic due to their nano-range sizes. Zinc oxide (ZnO) has good biocompatibility and is commercially used in cosmetics. Moreover, ZnO NPs have potential biomedical uses, but their safety remains unclear.MethodsA range of doped ZnO NPs was evaluated for antileishmanial activity and in vitro toxicity in brine shrimp and human macrophages, and N-doped ZnO NPs were evaluated for in vivo toxicity in male BALB/C mice. N-doped ZnO NPs were administered via two routes: intra-peritoneal injection and topically as a paste. The dosages were 10, 50, and 100 mg/kg/day for 14 days.ResultsTopical administration was safe at all dosages, but intra-peritoneal injection displayed toxicity at higher doses, namely, 50 and 100 mg/kg/day. The pathological results for the i.p. dose groups were mild to severe degenerative changes in parenchyma cells, increases in Kupffer cells, disappearance of hepatic plates, increases in cell size, ballooning, cytoplasmic changes, and nuclear pyknosis in the liver. Kidney histology was also altered in the i.p. administration group (dose 100 mg/kg/day), with inflammatory changes in the focal area. We associate pathological abnormalities with the presence of doped ZnO NPs at the diseased site, which was verified by PIXE analysis of the liver and kidney samples of the treated and untreated mice groups.ConclusionThe toxicity of the doped ZnO NPs can serve as an essential determinant for the effects of ZnO NPs on environmental toxicity and can be used for guidelines for safer use of ZnO-based nanomaterials in topical treatment of leishmaniasis and other biomedical applications.