Parenteral Route Research Articles

Oral Pharmacokinetics of sulfadiazine and sulfamonomethoxine in female Holstein milking cows.

The efficacy of orally administered drugs in cattle is thought to be slow because of the anatomical and physiological features of their forestomach. Thus, parenteral routes are mainly preferred to administer drugs. However, the effect of some drugs with unique physicochemical properties was promptly obtained even after oral administration in clinically ill cattle. Therefore, the present study aimed to investigate pharmacokinetically the usefulness of the oral route in cattle by comparing the oral pharmacokinetic properties of two sulfonamides with different physicochemical properties. Sulfadiazine (SDZ) and sulfamonomethoxine (SMM) were administered by intravenous and oral route to four female Holstein cows with a 4-weeks washout period. Blood samples were collected over time, and SDZ and SMM concentrations in plasma were analyzed by HPLC. Data obtained from the same animal after intravenous and oral administration were simultaneously analyzed with the one compartment model, and kinetic parameters were calculated. The Tmax (mean ± SD) of SMM (2.75 ± 0.96 hr) was significantly achieved earlier than that of SDZ (5.00 ± 1.15 hr). Further, the mean absorption time of SMM (5.24 ± 0.69 hr) was significantly shorter than that of SDZ (5.92 ± 1.11 hr). Also, the half-life of absorption of SMM (3.91± 0.51 hr) was significantly shorter than that of SDZ (4.51 ± 0.82 hr). These data suggest that the absorption rates of highly unionized drugs (such as SMM) from the forestomach of cattle may be markedly higher than less unionized ones (such as SDZ).

Microneedle and Polymeric Films: Delivery of Proteins, Peptides and Nucleic Acids.

In the last 20years, protein, peptide and nucleic acid-based therapies have become the fastest growing sector in the pharmaceutical industry and play a vital role in disease therapy. However, the intrinsic sensitivity and large molecular sizes of biotherapeutics limit the available routes of administration. Currently, the main administration routes of biomacromolecules, such as parenteral, oral, pulmonary, nasal, rectal and buccal routes, each have their limitations. Several non-invasive strategies have been proposed to overcome these challenges. Researchers were particularly interested in microneedles (MNs) and polymeric films because of their less invasiveness, convenience and greater potential to preserve the bioactivity of biotherapeutics. By facilitating with MNs and polymeric films, biomacromolecules could provide significant benefits to patients suffering from various diseases such as cancer, diabetes, infectious and ocular diseases. However, before these devices can be used on patients, how to upscale MN manufacture in a cost-effective and timely manner, as well as the long-term safety of MN and polymeric film applications necessitates further investigation.

A study of teaching module on subcutaneous drug administration and communication skills in pharmacology according to competency-based medical education curriculum

Background: Theory lectures in pharmacology are covering various oral and parenteral routes of drug administration, mainly focusing on knowledge domain, but soft and psychomotor skills were less taught in undergraduate students. Demonstrating correct method of subcutaneous route of drug administration and communication skills as introduced by competency-based medical education (CBME) competency-based curriculum will help in early acquisition of the skills and minimize the errors in administration in insulin, heparin, and vaccines. Aim and Objectives: The aims of this study were to teach the subcutaneous drug administration (S/C) and communication skills to undergraduate students in pharmacology and to evaluate the perception of students and teachers toward new CBME curriculum. Materials and Methods: Correct technique of subcutaneous drug administration was demonstrated on mannequins after browsing through the videos of S/C route. Students were told to perform it independently on mannequins. Perception of students and staff members were collected with pre-validated questionnaire provided after the practical teaching hours. Results: In our study, majority of students (94%) felt that learning S/C route of drug administration correctly will help in managing various patients like administration of insulin in diabetic patients in their near future days. They were well advanced in communicating with patients regarding usage of medications and were (90%) also in favor of introduction of this experiment in UG curriculum. Conclusions: Our study concluded that subcutaneous teaching technique introduced by CBME curriculum in practical classes was well accepted by students and were more confident in soft skills and psychomotor skills at the end of the study.

The current use of the artemisinin-based Combination Therapies in adult patients at a Tertiary Hospital, South-South Nigeria

Objective: The antimalarial preferences, tolerability, and cost of the Artemisinin-based combination therapies (ACTs) among adult patients and caregivers are largely understudied despite being the recommended treatment for Plasmodium falciparum. We, therefore, evaluated antimalarial preferences, tolerability, and cost of the ACTs among adult patients attending the University of Benin Teaching Hospital, Nigeria. Methods: This was a cross-sectional study conducted among adult patients and their caregivers at the University of Benin Teaching Hospital, Nigeria, using a semi-structured questionnaire. Their preferred antimalarial medication, previous use of antimalarial monotherapies, current ACT use; cost considerations, and adverse effects profile were sought. Result: Six hundred respondents were recruited with a mean age of 41.4±16.3years and M/F ratio of 1.4. The majority (88.0 %), reported that they had between 1-5 episodes of malaria fever in a year. Only 28.2% received doctors’ prescriptions while 85.8% purchased their antimalarial medications from a pharmacy. Sixty percent of the respondents used at least one ACT; mainly Artemether-Lumefantrine (AL) 312 (52.0%). Only 9.3% reported previous adverse effects with the ACTs with 4.0% of respondents discontinuing their medications. The mean (SD) cost of purchasing ACTs was 1,516.47±760.3 (3.65 USD) Naira. Conclusion: This study showed adult patients’ preference for the ACTs, especially Artemether-Lumefantrine despite some inclination towards antimalarial monotherapies and parenteral route. There was also a high rate of use of malaria presumptive treatment, but only a few reported adverse effects. There is a need to make ACTs affordable because the cost is still presently high for most Nigerians.

Effect of Supranutritional Dosage Selenium in Neonatal Goat Kids on Productive Performance, Physicochemical Profiles in Meat, Selenium Levels in Tissues, and Histopathological Findings.

Selenium (Se) is an essential element and antioxidant that catalyzes the destruction of hydrogen peroxide formed during cellular oxidative metabolism. Doses of Se as selenomethionine (SeMe) by oral route are 0.1-0.3 mgSe/kg DM, while the dose by parenteral route with sodium selenite (Na2SeO3) is 0.1 mgSe/BW. The effects of supranutritional Se supplementation on normal kids have rarely been studied. The objective of the study was to evaluate both Se sources on growth performance, Se in tissues, histopathological findings, and meat characteristics.Forty-five kids of the Pastoreña breed with 25-day age were distributed (4.7 ± 1.13kg) in three treatments: a) control group, C: consumption with goat milk (GM: containing 0.135mgSe/g); b) NaSe: GM plus Na2SeO3 injectable, 0.25 mgSe/kg BW; c) SeMe: GM plus oral dosage, 0.3mgSe as SeMe daily. Fifteen animals per treatment were slaughtered at 7, 14, and 21days.Feed conversion improved (P < 0.05) with Se supplement (P < 0.05) at 7 and 14days. SeMe had higher protein and fat meat content (P < 0.05). SeMe increased Se liver at 14 and 21days. NaSe and SeMe had higher (P < 0.05) levels of Se kidney. SeMe-21d showed 42% mononuclear and periportal cell infiltration lesions. In conclusion, Se administered through milk in goat kids was insufficient to prevent nutritional muscular dystrophy. The supranutritional dose of 0.25mg/kg as NaSe was sufficient to maintain the Se level in tissues. SeMe increased Se liver and kidney efficiently. Both Se sources improved the bioavailability of the mineral in kids.

Preparation and Evaluation of Vitamin D3 Supplementation as Transdermal Film-Forming Solution.

Vitamin D3 is available in oral and injectable dosage forms. Interest in the transdermal route as an alternative to the oral and parenteral routes has grown recently. In this study, several film-forming solutions for the transdermal delivery of vitamin D3 were prepared. They contained 6000 IU/mL of vitamin D3 that formed a dry and acceptable film in less than 5 min after application. The formulations consisted of ethanol and acetone 80:20, and one or more of the following ingredients: Eudragit L100-55, PVP, PG, limonene, oleic acid, camphor, and menthol. Vitamin D3 release was studied from both the film-forming solution and pre-dried films using a Franz diffusion cell. The film-forming solution released a significant amount of vitamin D3 compared to the dry film, which is attributed mostly to the saturation driving force due to the evaporation of volatile solvents. In vitro permeation studies through artificial skin Strat M® membrane revealed that the cumulative amount of vitamin D3 permeated after 24 h under the experimental conditions was around 800 IU across 3.14 cm2. The cumulative permeation curve showed faster permeation in earlier stages. Young's modulus, viscosity, and pH of the formulations were determined. Most of the formulations were stable for 3 weeks.

Design, Development and Evaluation of Eucalyptol Transdermal Patch for Anti-Diabetic Activity

For almost two hundred years, diabetes mellitus has been a major health problem worldwide. While there has been progress in our knowledge of its pathophysiology and treatment, the therapeutic choices available today are woefully inadequate. The goal of transdermal medication delivery systems is to provide therapeutically effective doses of a medicine via the skin. The medicine is released at a steady, regulated pace thanks to the design of these devices. As a result, it is well suited for the management of long-term conditions like diabetes. Thus, the risks and inconvenient nature of the oral and parenteral routes are avoided. The purpose of this study is to develop and test eucalyptol transdermal patches for the treatment of diabetes. Drug distribution from different polymer-based transdermal patches might be enhanced by using oleic acid as a penetration enhancer. Matrix-style transdermal patches, composed of PVP K30, HPMC K100, and solvent, were created utilizing solvent casting procedures. By using Fourier transform infrared spectroscopy, researchers were able to examine the drug's and polymers' physicochemical compatibility. No evidence of physical or chemical incompatibility between the medication and the polymers was found. The patches also underwent a battery of physical tests in addition to the in-vivo research. The patches with the polymers, that is, PVP K30, HPMC K100, and oleic acid as the penetration enhancer, were regarded the best formulations for the transdermal distribution of eucalyptol based on the findings obtained from the physical assessment, ex vivo investigations, and in-vivo studies.

CONSUMPTION DETAILS OF SYSTEMICALLY ACTING ANTIVIRAL AND ANTIMICROBIAL PREPARATIONS IN PERIOD OF NOVEL CORONAVIRUS INFECTION SPREAD IN RETAIL SECTOR OF SAMARA REGION PHARMACEUTICAL MARKET

An analysis of the medicinal preparation consumption structure in the period of the COVID-19 pandemic in the pharmacy network reflects the existing outpatient practice and makes it possible to draw generalized conclusions about its compliance with the pharmacotherapy standards.The aim. Comparative analysis of population consumption of antimicrobial and antiviral medicines sold in the retail pharmacies of the Samara region in 2015–2021.Materials and methods. The study was conducted in the retail sector of the Samara region pharmaceutical market. The material of the study was the information on the list of items and dispensing volumes of antibacterial and individual antiviral drugs during the novel coronavirus infection spread (in 2020) in the network of the Samara region pharmacies. The data are compared with the indicators of the drug sales in 2015–2019. Methods of retrospective, comparative, graphical, methodological, content analyzes and statistical methods of analyses were used.Results. The authors have established a significant distortion in the consumption of systemic antimicrobial preparations in the Samara region pharmacy segment in the period of 2015–2019 with the predominance of the ATC (Anatomical Therapeutic Chemical Classification System) J01D group, primarily cephalosporins (38%), mainly by the parenteral administration route. The share of macrolides (J01F) consumption in volume terms was 14.9%, of fluoroquinolones (J01M) – 11.3%, beta-lactam antibiotics with beta-lactamase inhibitors – 10.7%, beta-lactam antibiotics penicillins (J01C) – 8.1%. Compared to 2019, in 2020, under the conditions of the COVID-19 pandemic, the total consumption of AMPs increased by 2.1 times. In the “Other beta-lactam antibiotics” group with a predominant proportion of cephalosporins, there was an increase by 3.2 times, in the “Macrolides and lincosamides” group – by 3.5 times, in “Quinolone derivatives” – by 2.6 times. The noted facts should be assessed as the phenomenon that can have a direct impact on the growth of an antibiotic resistance on a population scale. Among antivirals, the largest consumption increase was noted for oseltamivir and rimantadine. In absolute terms, the volume of antiviral preparations consumption in 2020 increased by 2.4 times, which was accompanied by an increase in the cost of one package by 55.8%.Conclusion. In the period of spreading a novel coronavirus infection, a significant increase in the consumption of antimicrobial and antiviral preparations (up to 20 times for certain pharmacotherapeutic groups and names) was notified, which may negatively affect the growth of the antibiotic resistance in the population.

Effects of various mRNA-LNP vaccine doses on neuroinflammation in BALB/c mice

It has been proven that mRNA vaccines are highly effective against the COVID-19 outbreak, and low prevalence of side effects has been shown. However, there are still many gaps in our understanding of the biology and biosafety of nucleic acids as components of lipid nanoparticles (LNPs) most often used as a system for inctracellular delivery of mRNA-based vaccines. It is known that LNPs cause severe injection site inflammation, have broad biodistribution profiles, and are found in multiple tissues of the body, including the brain, after administration. The role of new medications with such pharmacokinetics in inflammation developing in inaccessible organs is poorly understood. The study was aimed to assess the effects of various doses of mRNA-LNP expressing the reporter protein (0, 5, 10, and 20 μg of mRNA encoding the firefly luciferase) on the expression of neuroinflammation markers (Tnfα, Il1β, Gfap, Aif1) in the prefrontal cortex and hypothalamus of laboratory animals 4, 8, and 30 h after the intramuscular injection of LNP nanoemulsion. It was shown that mRNA-LNP vaccines in a dose of 10–20 μg of mRNA could enhance Aif1 expression in the hypothalamus 8 h after vaccination, however, no such differences were observed after 30 h. It was found that the Gfap, l11β, Tnfα expression levels in the hypothalamus observed at different times in the experimental groups were different. According to the results, mRNA-LNPs administered by the parenteral route can stimulate temporary activation of microglia in certain time intervals in the dose-dependent and site specific manner.

Nano-formulations in treatment of iron deficiency anaemia: An overview

Iron deficiency anaemia (IDA) is a significant challenge to global health. The absorption and bioavailability depend on the delivery vehicle being used. Ferrous sulphate is a drug of choice for IDA but leads to frequent gastrointestinal tract side effects that force the patient to discontinue the treatment. Gastrointestinal side effects result from converting bivalent iron into trivalent iron accompanied by reactive oxygen species (ROS) formation. Due to lower absorption, oral preparations of trivalent iron are recommended in patients with intolerance to ferrous sulphate. Nanosized iron preparation can resolved these concerns. The particle size of iron salts has been observed to have a significant impact on iron absorption. The surface area of iron compounds is increased by reducing their particle size, which improves their solubility in gastric juice and boosts their absorption. Sucrosomial iron, ferric citrate complexes, and ferric maltol are some of the novel iron preparations that ensure high bioavailability and good tolerance in chronic kidney disease, congestive heart failure, and inflammatory bowel disease. However, the parenteral route of administration of iron is unacceptable to most patients. Moreover, it leads to high free iron levels in circulation, resulting in ROS generation. This article provides an informative summary of iron deficiency anaemia causes and treatment through nanoformulations and literature and in-depth patent analysis.

Novel trehalose-based excipients for stabilizing nebulized anti-SARS-CoV-2 antibody

COVID-19 is caused by the infection of the lungs by SARS-CoV-2. Monoclonal antibodies, such as sotrovimab, showed great efficiency in neutralizing the virus before its internalization by lung epithelial cells. However, parenteral routes are still the preferred route of administration, even for local infections, which requires injection of high doses of antibody to reach efficacious concentrations in the lungs. Lung administration of antibodies would be more relevant requiring lower doses, thus reducing the costs and the side effects. But aerosolization of therapeutic proteins is very challenging, as the different processes available are harsh and trigger protein aggregation and conformational changes. This decreases the efficiency of the treatment, and can increase its immunogenicity.To address those issues, we developed a series of new excipients composed of a trehalose core, a succinyl side chain and a hydrophobic carbon chain (from 8 to 16 carbons). Succinylation increased the solubility of the excipients, allowing their use at relevant concentrations for protein stabilization. In particular, the excipient with 16 carbons (C16TreSuc) used at 5.6 mM was able to preserve colloidal stability and antigen-binding ability of sotrovimab during the nebulization process. It could also be used as a cryoprotectant, allowing storage of sotrovimab in a lyophilized form during weeks. Finally, we demonstrated that C16TreSuc could be used as an excipient to stabilize antibodies for the treatment against COVID-19, by in vitro and in vivo assays. The presence of C16TreSuc during nebulization preserved the neutralization capacity of sotrovimab against SARS-CoV-2 in vitro; an increase of its efficacy was even observed, compared to the non-nebulized control. The in vivo study also showed the wide distribution of sotrovimab in mice lungs, after nebulization with 5.6 mM of excipient.This work brings a solution to stabilize therapeutic proteins during storage and nebulization, making pulmonary immunotherapy possible in the treatment of COVID-19 and other lung diseases.

Challenges and Strategies to Enhance the Systemic Absorption of Inhaled Peptides and Proteins.

Proteins and peptides-based therapeutics are making substantial access to the market due to their obvious advantages of strong potency, high specificity and desirable safety profile. However, most clinical products are mainly delivered via parenteral route with inferior convenience. Lung is an attractive non-invasive alternative passage for systemic administration of biologics with numerous outstanding features, as examples of large absorptive surface area, extensive vascularization and mild local microenvironment. Even so, mucociliary clearance, alveolar macrophage phagocytosis, enzymatic metabolism, pulmonary surfactant adsorption and limited epithelium permeability constitute major obstacles affecting the systemic absorption of inhaled proteins and peptides. This article begins by giving a brief overview of challenges for the systemic absorption of inhaled proteins and peptides, and then goes on to a comprehensive review of possible strategies for enhanced pulmonary absorption, including chemical modification, addition of protease inhibitors, incorporation of absorption enhancers, modification with fusion proteins and development of particulate-based drug delivery systems. These strategies can provide enhanced transmembrane absorption capacity while avoiding pulmonary clearance, offering a valuable reference for designing pulmonary delivery systems of protein and peptide drugs.

Malnutrition, nutrition support and dietary intervention: the role of the dietitian supporting patients with head and neck cancer

Malnutrition is prevalent in patients with head and neck cancer (HNC) at diagnosis but can occur at any stage of the treatment pathway. The impact of disease burden and treatment side effects can lead to altered anatomy, compromised quality and quantity of saliva and impaired swallowing function, which can result in deleterious effects on nutritional status. Optimising nutrition status is critical, as malnutrition is adversely associated with treatment tolerance and outcomes, wound healing, morbidity, mortality, quality of life and survival. Dietitians are integral members of the HNC multidisciplinary team and are uniquely qualified in the assessment, management and optimisation of nutritional status across the care pathway. This includes providing informational counselling to patients and carers on the short- and long-term nutritional impact of planned treatments alongside multidisciplinary members. Dietitians lead on the recommendation, provision and monitoring of nutrition support, which can be via the oral, enteral or parenteral route. Oral nutrition support includes dietary counselling, nourishing dietary, food fortification advice and high energy/protein oral nutritional supplements. Enteral nutrition support, or tube feeding, can be required on a short- and/or long-term basis and dietitians support appropriate decision-making for the type of tube and timing of placement across the care pathway.

Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study.

Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age ≥ 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates. We conducted a single-center quasi-experimental study for this quality improvement project using PCC among the preterm neonates admitted in a tertiary care level-III NICU at the Aga Khan University Hospital Karachi, Pakistan, received caffeine therapy, and survived at discharge. The researchers compared pre-PCC data (April-December 2017) with post-PCC data (April-Dec 2018) each for nine months, with three months intervals (January-March 2018) of PCC formulation and implementation phase. The study was conducted according to the SQUIRE2.0 guidelines. The Data were collated on factors influencing MA, including the cost of therapy, medication refill rates, and parental complaints as primary outcome measures. The Risk factors of HRA were included as secondary outcomes. After PCC implementation cost of therapy was reduced significantly from Rs. 97000.0 (729.0 USD) to Rs. 24500.0 (185.0 USD) (p&lt;0.001), significantly higher (p&lt;0.001) number of patients completed remaining refills (77.6% pre-phase vs 97.5% post-phase). The number of parental complaints about cost, ampoule usage, medication drawing issue, wastage, inappropriate dosage form, and longer duration of therapy reduced significantly in post-phase. HRA reduced from 25% to 6.6% (p&lt;0.001). Post-implementation of PCC (RR 0.14; 95% CI: 0.07-0.27) was a significant independent risk factor for reducing HRA using a multivariate analysis model. Longer duration of caffeine therapy after discharge (RR 1.05; 95% CI: 1.04-1.04), those who were born in multiple births (RR 1.15; 95% CI: 1.15-1.15), and those who had higher number of siblings were other significant independent risk factors for HRA. PCC dispensation in the appropriate dosage form at discharge effectively reduced cost, non-adherence to therapy, and risk of hospital readmissions. This neonatal clinical and compounding pharmacist-led model can be replicated in other resource-limiting setting.

DRUGS UTILIZATION STUDY IN NEONATAL SEPSIS IN TERTIARY CARE HOSPITAL

Objectives: The present study was taken up to evaluate the drug utilization pattern and adverse drug reactions (ADRs) seen in patients of neonatal sepsis admitted to sick newborn care unit of a tertiary care hospital in Uttarakhand. Methods: This was a prospective observational study. A suitable case record form was designed to collect all the necessary and relevant information. Data of 175 neonatal sepsis matching inclusion criteria were recorded. Pattern of prescription of drug for various diseases in sick newborns was analyzed. Information on ADR were analyzed. ADR was analyzed using Naranjo scale and the WHO causality assessment scale. Results: Blood culture was positive in 137 (78.29%) neonates. Staphylococcus aureus (45.26%) was the most common microorganism followed by Klebsiella pneumoniae (26.28%) and Escherichia coli (14.60%). Out of 137 blood culture-positive neonates, 30.66% were suffering from meningitis. Out of 38 blood culture-negative neonates, 63.16% were suffering from meningitis. Average number of drugs per encounter was 1.71. Percentage of drugs prescribed by generic name was 91%. Parenteral route was the most common route of drug administration. Ampicillin was the most common antimicrobial prescribed. Next common classes of drug used were vasopressor. Out of 10 (5.71%) ADRs identified, 70% were possible and 30% were doubtful as per Naranjo’s causality assessment scale. Case fatality rate was 27.42% during the course of study. Conclusion: Parenteral antibiotics (ampicillin plus gentamycin) and vasopressors remain the most commonly prescribed drugs in neonatal sepsis in sick newborn unit. The study concluded that doses and duration, for which drugs were used, were in accordance to AIIMS protocol for neonatal sepsis.

Renal tubular response to titanium dioxide nanoparticles exposure

Titatinum dioxide nanoparticles (TiO2-NPs) are frequently used in several areas. Titanium alloys are employed in orthopedic and odontological surgery (such as hip, knee, and teeth implants). To evaluate the potential acute toxic effects of titanium pieces implantations and in other sources that allow the systemic delivery of titanium, parenteral routes of TiO2-NPs administration should be taken into account. The present study evaluated the impact of subcutaneous administration of TiO2-NPs on renal function and structure in rats. Animals were exposed to a dose of 50 mg/kg b.w., s.c. and sacrificed after 48 h. Titanium levels were detected in urine (135 ± 6 ηg/mL) and in renal tissue (502 ± 40 ηg/g) employing inductively coupled plasma mass spectrometry. An increase in alkaline phosphatase activity, total protein levels, and glucose concentrations was observed in urine from treated rats suggesting injury in proximal tubule cells. In parallel, histopathological studies showed tubular dilatation and cellular desquamation in these nephron segments. In summary, this study demonstrates that subcutaneous administration of TiO2-NPs causes acute nephrotoxicity evidenced by functional and histological alterations in proximal tubule cells. This fact deserves to be mainly considered when humans are exposed directly or indirectly to TiO2-NPs sources that cause the systemic delivery of titanium.

Antibiotic point prevalence survey at a tertiary healthcare hospital in India: Identifying strategies to improve the antibiotic stewardship program immediately after a COVID-19 wave

BackgroundThe COVID-19 pandemic has substantially affected the antibiotic stewardship activities in most hospitals of India.AimsWe conducted an antibiotic point-prevalence survey (PPS) immediately after the decline of a major COVID-19 wave at a dedicated COVID-19 hospital. By doing so we aimed to identify the antibiotic prescription patterns, identify factors influencing the choice of antibiotics, and identify/develop strategies to improve the antibiotic stewardship program in such setups.MethodsThe PPS was single-centred, cross-sectional, and retrospective in nature. Patients admitted in various wards and intensive care units (ICUs) between September 2021 to October 2021 were included in our PPS.ResultsOf the included 460 patients, 192 were prescribed antibiotics. Of these 192 patients, ICU-admitted patients had the highest number of antibiotics prescribed i.e. 2.09 ± 0.92. Only a minor fraction (7.92 %) of antibiotics prescriptions were on the basis of culture reports. Most of the antibiotics were prescribed empirically by the parenteral route. The most common group of antibiotics prescribed were third-generation cephalosporins. Carbapenems were the most common designated antibiotics prescribed. A large number of patients (22.40 %) were prescribed double anaerobic cover.ConclusionThe strategies that we identified to improve the antibiotic stewardship program at our institute included reviving the culture of sending culture reports to prescribe antibiotics, improving surgical prophylaxis guidelines, training resident doctors to categorize antibiotic prescriptions appropriately, closely monitoring prescriptions providing double anaerobic cover, and improving the electronic medical record system for improving prescription auditing.

DEVELOPMENT OF INJECTABLE DOSAGE FORM OF PHYTODRUG ON THE BASIS OF HELLELLOW, YARROW, AND NETTLE FOR THE PREVENTION AND TREATMENT OF POSTPARTUM DISEASES IN COWS

This paper discusses the prospect of developing an injectable form of herbal medicine as a uterotonic, antimicrobial, ruminatory, anti-inflammatory, hemostatic and immunostimulating agent, which includes alcohol tinctures of nettle, yarrow and hellebore, as well as propylene glycol. The methods of pharmaceutical analysis of medicinal plant raw materials, physicochemical and empirical methods were used to determine the optimal composition of the phytocomposition in the following ratio of components per 100 ml: hellebore tincture - 2.5 ml, yarrow tincture - 15.0 ml, nettle tincture - 15, 0 ml, propylene glycol - 67.5 ml. Phytopreparation is a transparent alcohol solution, dark green in color, without foreign impurities and sediment, with a specific smell, soluble in water and alcohol. The results of the safety assessment of the phytopreparation, carried out on laboratory animals, indicate its low toxicity in the enteral and parenteral routes of administration. In pilot studies conducted on cows with signs of acute catarrhal endometritis, which were injected intravenously with the test composition of the phytopreparation at a dose of 30 ml per head, positive results were obtained. 10-15 minutes after the intravenous administration of the phytopreparation in cows, a contraction of the muscles of the uterus and the release of exudate were recorded. The results of early gynecological medical examination of cows, carried out 14 days after calving, confirm the high therapeutic efficacy of the developed composition in acute purulent-catarrhal endometritis and subinvolution of the uterus in cows.

Hepatitis E Virus Prevalence Amongst Blood Donors in Kenya

Introduction: Hepatitis E (HEV) is an emerging cause of viral hepatitis mainly transmitted through the fecal-oral and parenteral routes. It has greatly affected populations in many parts of Kenya due to declined sanitation practices. The objective of the research was to determine IgM and IgG seroprevalence of HEV prevalence among blood donors in Kenya as well as its Anti-HEV sero-reactivity by demographic factors.&#x0D; Material and Methods: Cross sectional research design was used to collect blood samples from six from regional blood collecting centers, with blood donors selected through proportionate stratified sampling. Serum were matched to the age and gender distribution of the blood donors and tested by IgM and IgG enzyme immunoassays (EIA). The screening was carried out using human MP Diagnostics (0721150096T-96 wells) HEV ELISA kit. To test for IgM and IgM anti-HEV antibodies, microplates with 96-well plate were used. Results were averaged to generate a signal-to-noise ratio with ≥1.0 designated as positive per the manufacturer’s recommended cutoff.&#x0D; Result and Conclusion: On the analysis, IgM reactivity was associated with HEV (RR 1.66, 95%CI 1.07, 2.60; p = 0.024) while IgG reactivity was associated with increasing age (p &lt; 0.001) and HIV (RR 1.93, 95%CI 1.52, 2.46; p &lt; 0.001). AFI case-patients were more likely to be IgM (p = 0.002) and IgG (p&lt;0.001) reactive compared to healthy residents. All the 19 hepatitis E virus IgM and/or IgG seropositive blood samples tested negative for HEV RNA since no bands were detected using RT-PCR technique. Serologic evidence for HEV in blood samples from selected areas suggests a high burden of infection, though age and gender exhibited no significant difference in prevalence of HEV among the blood donors in Kenya (p&gt;0.05).

Impact of doubling peptide length on in vivo hydrogel stability and sustained drug release

Peptide-based hydrogels represent promising systems for the sustained release of different types of drugs, ranging from small molecules to biologicals. Aiming at subcutaneous injection, which is a desirable parenteral administration route, especially for biologicals, we herein focus on physically crosslinked systems possessing thixotropic behaviour. The purpose of this study was to evaluate the in vitro and in vivo properties of hydrogels based on the amphipathic hexapeptide H-FQFQFK-NH2, which served as the lead sequence. Upon doubling the length of this peptide, the dodecapeptide H-FQFQFKFQFQFK-NH2 gave a significant improvement in terms of in vivo stability of the hydrogel post-injection, as monitored by nuclear SPECT/CT imaging. This increased hydrogel stability also led to a more prolonged in vivo release of encapsulated peptide cargoes. Even though no direct link with the mechanical properties of the hydrogels before injection could be made, an important effect of the subcutaneous medium was noticed on the rheological properties of the hydrogels in post in vivo injection measurements. The results were validated in vivo for a therapeutically relevant analgesic peptide using the hot-plate test as an acute pain model. It was confirmed that elongation of the hydrogelator sequence induced more extended antinociceptive effects. Altogether, this simple structural modification of the hydrogelating peptide could provide a basis for reaching longer durations of action upon use of these soft biomaterials.