Pharmaceutical Items Research Articles

Paediatric dosage ‘need of hours among family physicians/other speciality physicians’

Dear editor, We read the article with bated breath by Sil et al.[1] ‘A study of knowledge, attitude and practice regarding administration of paediatric dosage forms and allied health literacy of caregivers for children’. It is an essential topic because it serves as a reminder to prescribers to emphasise the dose pattern to caregivers. They have very nicely concluded that Physicians must be mindful of the limitations of their knowledge as well as the likelihood of incorrect administration practices among childcarers. Medication errors can be reduced by taking corrective action in this area. Paediatricians, for example, are notorious for emphasising and stressing dosage, approach and patterns. Other speciality physicians are forced to manage paediatric cases in low-developed countries such as India, where paediatricians are few in rural settings. In the current pandemic crisis, dextromethorphan is often used to treat dry cough in in-patients or as a prescription for out-patients. Because its dosage is based on age rather than body weight, there is a lot of variation in the amount of medicine given.[2] The clinical effectiveness of syrup or any other formulation of dextromethorphan for treating acute cough is unknown, and the American Academy of Paediatrics does not recommend it. With this as a backdrop, we tried to focus on current issues that have been highlighted in the media and by India’s drug regulatory authorities. It is with reference to the recent news and official order given by Directorate General of Health Services (DGHS) of India regarding the report of dextromethorphan poisoning admitted at Kalawati Saran Children Hospital in New Delhi.[3] There is another crucial factor to consider with respect to the advisory as per the National Formulary of India (NFI) and Current Index of Medical Specialities (CMIS). In NFI, the age for which drug dextromethorphan advised is 2–12 years with dosage mentioned in Table 1. In CIMS India the dosage for 2–12 years is mentioned and provided information that individualized dose for children up to 2 years has to be followed.Table 1: Information regarding dextromethorphan for childrenIn all the drug resources, there is an indication with a clear distinction between giving doses to children and prescribing doses to adults. Even though, depending on the amount or the components of the exact formulation taken, the medicine dextromethorphan might cause a variety of side effects, the majority of cases with dextromethorphan abuse improve just with supportive care. However, seriously affected patients may need more attention. Because dextromethorphan is typically misused in younger age groups, early detection and treatment of dextromethorphan abuse may be critical in preventing broader substance dependence in these kids.[4] In light of the foregoing, we were intrigued to investigate the labelling of a few pharmaceutical items available at a nearby pharmacy. Again, it is surprising to our knowledge that just a small percentage of the preparations still contain children aged 2 and up. This banning of dextromethorphan for children less than 4 years of age is also an alert for all the family Physicians and Paediatricians and provides us a signal to be vigilant before prescribing any paediatric drug and by sticking to the guidelines or drug dosage information in existence from time to time. As a result, it is now required to follow the DGHS’s new instructions on the use of children above the age of four, regardless of the label. It is also an earnest request for all the prescribers to update knowledge over the over the counter drugs. Ethical approval Not required Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. I would like to submit the letter entitled ‘PAEDIATRIC DOSAGE ‘NEED OF HOURS AMONG FAMILY PHYSICIANS/OTHER SPECIALITY’ to letter to editor, in your esteemed journal. I declare there is no conflict of interest and no completing financial support is required for this work. And also, I confirmed that the manuscript has been read and approved for submission by all the named authors.

A fuzzy quantitative model for assessing the performance of pharmaceutical supply chain under uncertainty

PurposeThis study aims to investigate a reliability-level demand-oriented pharmaceutical supply chain design with maximal anticipated demand coverage. Different hospitals with the particular reliability value associated with the various pharmaceutical items (PIs) are considered. An inter-connected multi-period supply chain comprising manufacturers, distribution centers, hospitals and patients is assumed for the smooth flow of health-care items, enhancing supply chain reliability. A reliability index for PIs is depicted to highlight product preference and facilitate hospitals’ service levels for patients.Design/methodology/approachA mixed-integer multi-objective programming problem that maximizes maximal demand coverage minimizes the total economic costs and pharmaceutical delivery time is depicted under intuitionistic fuzzy uncertainty. Further, a novel interactive neutrosophic programming approach is developed to solve the proposed pharmaceutical supply chain management (PSCM) model. Each objective’s marginal evaluation is elicited by various sorts of membership functions such as linear, exponential and hyperbolic types of membership functions and depicted the truth, indeterminacy and falsity membership degrees under a neutrosophic environment.FindingsThe proposed PSCM model is implemented on a real case study and solved using an interactive neutrosophic programming approach that reveals the proposed methods’ validity and applicability. An ample opportunity to generate the compromise solution is suggested by tuning various parameters. The outcomes are evaluated with practical managerial implications based on the significant findings. Finally, conclusions and future research scope are addressed based on the proposed work.Research limitations/implicationsThe propounded study has some limitations that can be addressed in future research. The discussed PSCM model can be merged with and extended by considering environmental factors such as the health-care waste management system, which is not included in this study. Uncertainty among parameters due to randomness can be incorporated and can be tackled with historical data. Besides, proposed interactive neutrosophic programming approach (INPA), various metaheuristic approaches may be applied to solve the proposed PSCM model as a future research scope.Practical implicationsThe strategy advised is to provide an opportunity to create supply chains and manufacturing within India by helping existing manufacturers to expand, identifying new manufacturers, hand-holding and facilitating, teams of officers, engineers and scientists deployed and import only if necessary to meet timelines. Thus, any pharmaceutical company or organization can adopt the production and distribution management initiatives amongst hospitals to strengthen and enable the pharmaceutical company while fighting fatal diseases during emergencies. Finally, managers or policy-makers can take advantage of the current study and extract fruitful pieces of information and knowledge regarding the optimal production and distribution strategies while making decisions.Originality/valueThis research work manifests the demand-oriented extension of the integrated PSCM design with maximum expected coverage, where different hospitals with pre-determined reliability values for various PIs are taken into consideration. The practical managerial implications are explored that immensely support the managers or practitioners to adopt the production and distribution policies for the PIs to ensure the sustainability in supply chain design.

Pharmaceutical expenditure: what has changed in ten years in Italian Health Care System?

Abstract Introduction In the last 20 years, Italian pharmaceutical policies have moved to contain public expenditure. This study analyses the trajectory of retail pharmaceutical expenditures to investigate whether there has been a switch from public to private expenditure, how the composition of private and public expenditure has changed, and whether there are correlations with supply/demand variables. These research questions have received little attention in the literature. Methods This study used secondary data from Italy covering the period 2010 to 2019. A time-trend analysis was performed using the average annual percent change (AAPC) as the summary measure for the rate of change over the period 2010/19. The AAPC was estimated by fitting a linear regression model for the logarithm of each aggregate indicator. Kendall's τ coefficient investigates the correlation between the 2010-19 pharmaceutical expenditure items and other relevant health statistics (ages, categories of practising physicians, Gini coefficient, etc.). Results Italy's public pharmaceutical expenditure did not change significantly between 2010 and 2019 (AAPC = +0.03%, 95% CI = -1.4% to + 1.4%), nor did private spending (AAPC = +0.6%, 95% CI = -0.2% to + 1.3%). Public expenditure without the direct distribution of drugs in class A experienced a slowdown (-3.9%), and public expenditure with the direct distribution of drugs in class A exhibited a significant increase (+8.4%). The regression analysis evaluates the relationship between supply/demand variables and pharmaceutical expenditures. A significant result relates to the positive correlation between income inequality and out-of-pocket expenses for over-the-counter drugs (τ = 0.62, p-value = 0.046). Conclusions Pharmaceutical spending has increased over time, especially for drugs reimbursable by the NHS but paid for by citizens. This could be an alarm for a public healthcare system that should be able to guarantee healthcare services to all citizens. Key messages Public expenditure with the direct distribution of drugs in class A exhibited a significant increase (+8.4%). There has been increasing expenditure on drugs reimbursable by the NHS but paid for by citizens.

Antidiabetic Potential of Aloe barbadensis Miller

Background: Diabetes mellitus (DM) is a metabolic disease of the endocrine system, characterized by chronic hyperglycemia, resulting either from insulin resistance or defective insulin production due to dysfunction of pancreatic ?-cells. Approximately 80% of diabetic patients live in developing and underdeveloped countries. Pakistan is ranked on 7th position regarding the prevalence of DM. In developed nations, DM is the 4th leading reason for death. Several conventional and traditional methods i.e., allopathic medicines, herbal and medical plants have being used to treat DM and its complications for several decades. Diet-based approaches are considered safe, economical, and sustainable by individuals suffering from various health disorders.
 Objectives: The current review has been generated to highlight and compare the utilization of various conventional and traditional methods i.e., allopathic medicines, herbal and medical plants as an alternative source to treat DM and its complications.
 Methodology: Existing relevant literature (both research / review articles) published in last many years was looked over numerous sources like Google Scholar, Medline, PubMed, Research Gate, Science Direct, Scopus and Web of Science.
 Results: Complementary and Alternative Medicine (CAM) is considered a holistic approach for the treatment of Diabetes that combines the use of dietary supplements with herbs. Worldwide, approximately 30% of DM patients and 50% in Pakistan are using CAM. Aloe vera (AV) is known as a “miracle plant” and extensively used in commercial products. AV contains numerous bioactive components such as vitamins, saponins, salicylic acid, minerals, lignin, enzymes, anthraquinones, and amino acids which are responsible for health-promoting activities in the body. Isolated bioactive components have extensively been employed in nutraceuticals and pharmaceutical items and claimed to have antioxidant potential. Phytosterol compounds such as phenol and cycloartenol have claimed to downregulate the synthesis of fatty acid and increases the oxidation in the liver that in results decrease in lipid deposition.
 Conclusion: From the above analysis, it is therefore concluded that the utilization of herbaceous plants as medicine can be encouraged to treat and prevent numerous health problems.

Inventory pooling decisions under demand scenarios in times of COVID-19

Governments have been challenged to provide timely medical care to face the COVID-19 pandemic. The aim of this research is to propose a novel inventory pooling model to help determine order sizes and safety inventories in local hospital warehouses. The current study attempts to portray the availability of pharmaceutical items in public hospitals facing COVID-19 challenges. Different from previous studies, this research builds upon the consecrated theory of inventory pooling, extending it to pandemic circumstances where the intractability of kurtosis and skewness in inventory models are critical issues for making sure that medicines have high availability at a low cost. These effects on the total cost of inventory are explored and compared to a supply system with no consolidation. A continuous-review model is assumed with allocation rules for centralization and regular transshipment given different skewness and kurtosis structures for the demand, describing them by the copula method. This method models a multivariate demand considering that the marginal distributions of the demand can be specified by the Generalized Additive Model for Location, Scale and Shape, which offers advantages to model demands considering virtually any marginal statistical distribution. Numerical simulations and an illustrative example show that distributions of demands with more negative skewness and high kurtosis favor to a greater extent obtaining lower total costs with regular supply transshipment systems. Our study points out important considerations for supply chain decision makers when having demands with skewness and kurtosis patterns.

The new evidence reasoning based pharmaceutical inventory models with stochastic deterioration rates and lead times using PSO and GA

Pharmaceutical inventory management is critical because insufficient pharmaceutical items and their misusage affect the lives of humans and cause financial losses. Conversely, deteriorating items and lead-time have special importance in pharmaceutical inventory issues, especially as uncertainty appears in both. Different procedures are considered to deal with uncertainty, including fuzzy systems as well as probabilistic techniques. The present study develops a novel technique according to the evidential theory approach, aimed at solving an inventory model with stochastic deterioration rates and lead-times appearing in a single-vendor (pharmaceutical company) multi-buyer (hospitals) inventory system. It seems that the evidence approach is effective in dealing with interval, imperfect, inaccurate, and missing (ignorance) data. The lead time demand of the hospitals is log-normal, and the shortage of hospitals is thoroughly back-ordered. Particle swarm optimization (PSO) and genetic algorithm (GA) solve this problem. Ultimately, the results are illustrated using the numerical example and the impacts of the main parameters. Highlights Develop the new pharmaceutical supply chain models based on the evidential theory approach Design single-vendor (pharmaceutical company) multi-buyer (hospitals) system with stochastic deterioration rates and lead times Considering interval, incomplete, imprecise and missing (ignorance) data in healthcare systems for make decision in the inventory problem Using genetic algorithm (GA) and particle swarm optimization algorithm (PSO)

Block Chain in Fake Product Identification System Using QR Code

Every popular brand has fake manufacturers selling a counterfeited item at cheaper rates. Mostly counterfeiting medicine are selling to customer. For these factors combined with block chain technology can lead to an efficient comprehensive approach to reduce counterfeiting. Pharmaceutical organizations face many challenges regarding counterfeit medicines. Detecting fault medicines so that it will save public life. To discover the consciousness of the fake medication issue which requires an expanding security level for the appropriation of lawful pharmaceutical items. Manufacturing to user can be recorded, and the user is assured that the scans weren’t faked. The fake products can be identified by using QR code and it handles the product data

The health scare of COVID-19 amidst pandemics and the immune-related pharmaceutical products spillovers in the USA.

In view of the sector-wide effect of the nCOVID-19 pandemic in the USA and the probable effect on certain over-the-counter (OTC) pharmaceutical products, the current study examined potential inflation in the pharmaceutical industry arising from the pandemic-related uncertainty. In this case, the USA’s producer price indexes vis-à-vis inflation of the immune-related pharmaceutical items: multivitamin, vitamins nutrients and hematinic (V-N-H), other vitamins (other-V), antidepressant, and antidiabetic were examined alongside the uncertainties arising from the world pandemic and economic policy. Thus, the (Diebold and Yilmaz in Int J Forecast 28(1): 57–66, 2012) result implied that the world pandemic uncertainty contributed a significantly huge shock to the examined pharmaceutical compounds, thus affirming the vulnerability of certain pharmaceuticals to pandemic-related uncertainty. The total spillover increased from 34.2% (with economic policy uncertainty) to 47.6% (when pandemic uncertainty is incorporated). In specific, there are negative net spillovers from the multivitamins, other vitamins, antidiabetic, and antidepressant especially due to high pandemic and economic policy uncertainties. However, the statistical evidence implied that higher uncertainty arising from the pandemic is responsible for the severity of shock received by the indicated pharmaceutical products as against economic policy uncertainty. Thus, a relevant policy inference is posited from the result of the study.

What can we learn about reshoring after Covid-19?

While the World is still dealing with the health and safety issues raised by the Covid-19 pandemic, it is already quite apparent – and acknowledged – that this event will have a substantial impact over the national and global economies, as well as on the structure, the organization and the management of operations and supply chains, as highlighted in the June 2020 editorial (Samson 2020). In particular, a certain consensus is found among authoritative experts, analysts, and Institutions (e.g., Javorcik 2020; The Economist Intelligence Unit 2020; UNCTAD 2020; World Economic Forum 2020), that the pandemic will undermine the “Global value chain” model – a production network paradigm which has deeply characterized the World economy over the past 30 years, and one of the most visible “trademarks” of Globalization. This likely reshaping of the supply chains will be driven by both managerial (i.e., firm-level) and political (i.e., Sub-National, National, or Supranational-level) factors. At the firm level, many companies experienced dramatic exposure to supply chain disruptions during the pandemic and the subsequent lockdowns (Strange 2020) due to their reliance on offshore supplies. While the increased hazards of global operations had been highlighted in supply chain risk management literature (Manuj and Mentzer 2008), the 2020 pandemic has represented an unprecedented demonstration of how disruptive their effects could be. It is now difficult to believe that managers could simply restart to focus solely on efficiency and growth, without paying the necessary regard to risk-related practices (The Economist Intelligence Unit 2020), especially when considering that the pandemic happened as a shock in an already turbulent context of trade battles, raising protectionist policies (Javorcik 2020), and increasing pressures for more sustainable business models. Further, the pandemic unveiled in many countries their lack of self-sufficiency for needed products – like those required to hinder the spread of the contagion, such as masks and other personal protective equipment (PPE), or to ensure medical assistance to the people affected by the virus, such as ventilators) – as well as their dependency on China for several others (Gurvich and Hussain 2020). The latter include strategic supplies like pharmaceutical items but also components of key industrial supply chains (e.g., automotive, chemicals) whose stoppage can dramatically hurt the GDP of an advanced economy. As a consequence, the call for more self-reliance will – and in some cases has already started to (e.g., in the case of Japanese Government that started to incentivize relocation initiatives) – raise in the political debate, urging measures to better protect, reinforce, or even reinstate the macro-regional or national production of these goods. In particular, this editorial focuses on the “reshoring” phenomenon, defined as the decision to relocate a manufacturing activity either back to the home country (back-reshoring) or to a nearby country that belongs to the same macro-region (near-shoring).

Factors associated with stockout of Nevirapine syrup in Oshana Region, Namibia.

Infants who are born with HIV/AIDS is still a public health concern in developing countries, especially in Sub Saharan Africa. In Namibia, it is estimated that the prevalence rate of HIV pregnant women is around 17.2%, makes it to be among the countries with the highest prevalence rates among HIV women in sub-Saharan Africa (SSA). Some improvement regarding Prevention of Mother to Child Transmission has been made, however, frequent stock out of Nevirapine syrup continues to slow down, government efforts to foster the emergence of an HIV-free generation of Namibians. Given the nature of current conditions, justification exists for a study to determine the factors associated with stock out of Nevirapine (NVP) syrup.Mixed method was employed. In which descriptive approach was employed to acquire data from a period of five years retrospectively (2012-2016) and informants from different levels of supply chain in Oshana region. Initial, order receiving is not a predictor of NVP syrup. Lack of pharmaceutical knowledge is the biggest challenge which leads to sporadic stock out of NVP syrup. Pharmaceutical knowledge of ordering NVP syrup is needed to prevent stock out of NVP syrup. It is a recommendation of this study that training is needed for staffs who are involved in ordering of pharmaceutical items.

Factors associated with stock out of malaria test kit in Oshana region, Namibia.

Malaria continues to be a serious communicable disease whose impact on public health in Namibia is massive. Some improvement in reducing the number of malaria cases has been made in the country, but the sporadic availability of malaria diagnostic test kits (mRDT) continues to slow down government efforts to eliminate malaria in the country. Given the nature of current conditions, justification exists for a study to determine the factors associated with stock out of malaria rapid test kit (mRDT) in Namibia. Mixed method approach was employed, whereby in quantitative aspect, the study adopted a descriptive approach to acquire data from a period of five years retrospectively (2012-2016). To gain insight into qualitative aspects of the study, key informants at all levels of the supply chain in Oshana region were interviewed. Pharmaceutical knowledge of ordering mRDT is needed to prevent stock out of mRDT. It is a recommendation of this study that training is needed for staffs who are involved in ordering of pharmaceutical items.

Designing an integrated pharmaceutical relief chain network under demand uncertainty

This paper addresses an integrated relief network design problem for pharmaceutical items. The proposed bi-objective model accounts for perishability of pharmaceutical items, mobility of relief facilities, and benefits from a cooperative coverage mechanism in designing the network. A min–max robust model is developed to tackle the demand uncertainty. Several numerical experiments are conducted to explore the performance of the robust model. Also, by conducting a real case study, useful managerial insights are derived through performing several sensitivity analyses. The numerical results reveal that using the min–max robust model enhances the pharmaceutical relief network’s effectiveness and efficiency considerably.

An inventory system for varying deteriorating pharmaceutical items with price-sensitive demand and variable holding cost under partial backlogging in healthcare industries

This paper presents an inventory system for deteriorating pharmaceutical items with price-sensitive demand. Mostly existing studies of pharmaceutical inventory models consider the rate of deterioration as constant, which is not logical in the context of healthcare industries because pharmaceutical products (medicine or drugs) deteriorate significantly. Hence, the rate of deterioration is considered as time-dependent and follows a three-parameter Weibull distribution. In most of the developed models it is believed that the different costs related with inventory remain the same all the time whereas in realistic situations, manufacturing cost of medicine, the cost of maintaining the pharmaceutical products in the cold store or even the cost of keeping the patient’s record increases with time. Thus, the cost of the holding of items is taken as time-dependent. Shortages are allowed in this study and are partially backlogged. The main objective of this study is to optimize the total average cost of the system by computing the optimal ordering quantity and the optimal time interval. Finally, a numerical illustration with sensitivity analysis is given to exemplify the proposed study.

Quality by Design: A new practice for production of pharmaceutical products

This is the advanced approach for development of pharmaceutical product with full range and specified limits of variables during procurements, storage and manufacturing process with a qualification, at desired level of quality within the limits of low and higher values of variables to ensures the Pharmaceutical product Quality by design (QbD) of manufacturing a finished product. The Quality by Design is depicted and a portion of its components recognized and process parameters with quality characteristics are identified for every unit activity. Advantages, openings and steps engaged with Quality by Design of Pharmaceutical items are depicted. The point of the pharmaceutical advancement is to plan a quality item and it’s assembling procedure to reliably convey the proposed execution of the item. Quality can't be tried into items however quality ought to be worked in by outline. It incorporates the Quality target item profile, basic quality traits and key parts of Quality by Design. It likewise gives correlation between item quality by end item testing and item quality by Quality by Design. The establishment of Quality by Design is ICH Guidelines. It depends on the ICH Guidelines Q8 for pharmaceutical improvement, Q9 for quality hazard administration, Q10 for pharmaceutical quality frameworks. It moreover gives utilization of Quality by Design in pharmaceutical improvement and assembling of pharmaceuticals.
 Keywords: Quality by Design, Design Space, Target Product Quality Profile, Critical Quality Attributes

An EOQ model for deteriorating items with different types of time-varying demand in healthcare industries

Demand is the major factor of pharmaceutical inventory in Healthcare industries. The pharmaceutical inventory system in which the demand size is known is referred as a deterministic system. The pharmaceutical demand size may be fixed (static) or can vary (dynamic) from time to time. The dynamic inventory model for deteriorating items with different types of time-varying demand for Healthcare Industries is considered. The demand of the pharmaceutical inventory is dealing with three cases: (i) exponential time-varying demand (ii) stock-dependent demand and (iii) linear demand. The holding cost and deterioration rate of the pharmaceutical items are considered as a constant. The purpose of this study is to investigate the optimal replenishment time, economic order quantity and total cost of three different types of the proposed model. The main focus of this work is to get the minimum total cost of three kinds of variable demand and researching which one write gives the minimum (optimal) total cost for Healthcare Industries. Finally, the numerical examples are provided for three different types of demand to illustrate the solution procedure, and a sensitivity analysis of the optimal solution to three cases with respect to major parameters is carried out.

Inventory routing problem for hazardous and deteriorating items in the presence of accident risk with transshipment option

In this study, we address an Inventory Routing Problem for hazardous and deteriorating pharmaceutical items in a healthcare network. Each hospital's demand is assumed to be deterministic but time varying over a finite planning horizon. Demand can be satisfied through a supply network, either from the main central pharmacy, or from other related hospitals' drugstores by allowing the transshipment option. The medicines deteriorate under a constant rate during the storage period. The proposed model is a bi-objective mixed integer mathematical programming. The first objective aims to minimize the total cost of logistics including ordering, transportation, delivery, pickup, shortage and inventory holding costs. The second objective function attempts to minimize the maximum accident loss during distribution among all periods. To consider the accident loss, for each route, two essential parameters are estimated based on historical data; the occurrence probability and severity index of accident. The model therefore attempts to utilize the best configuration of the routes and transshipment option to satisfy the demand while minimizing the costs and accident loss simultaneously. Several numerical examples are generated and solved by CPLEX and compared with the solutions of an efficient Hybrid Genetic Algorithm (HGA). The results show that the transshipment option not only can be used as a lever to increase the economic supply network performance through saving the routes, but also it can help the system to avoid risky routes.

EOQ Pharmaceutical Inventory Model for Perishable Products with Pre and Post Discounted Selling Price and Time Dependent Cubic Demand

In this article we propose pharmaceutical inventory model for perishable products with pre and post discounted selling price and time dependent cubic demand. Mostly the pharmaceutical company considered the constant rate of deterioration. In the majority of the earlier studies, the demand and holding cost has been considered to be constant function, which is not true in most of the practical situations as the manufacturing medicine/setting machine cost and patient record keeping costs or even cost of keeping the pharmaceutical items in the cold storage increases with time. In view of this, we develop a pharmaceutical inventory model in which the time dependent demand is cubic and holding cost is linear function of time. Also we introduce both pre and post-deterioration discounts on unit selling price which determine discount to be given on unit selling price during deterioration so as to maximize the total pro?t. Finally, numerical examples and sensitivity analysis are given for illustration of the model.

Biological Scope of β-amino Acids and its Derivatives in Medical Fields and Biochemistry: A Review

Beta amino acids are the important macromolecules on earth and building blocks. They play key role in biological systems of living organisms. They are utilized as a part of arrangement for the most part pharmaceuticals. They have huge part in human science. They have pharmaceutical properties like as hypoglycaemic, antiketogenic, antibacterial properties, antifungal exercises and powerful insecticidal properties. They have pharmaceutical applications as they are utilized to get ready pharmaceutical items and agrochemical target atoms. Not just them, but their derivatives also play significant roles in different systems of organismal bodies. They also act as essential enzymes in humans as well as in animals. So, this review explores the scope of Beta amino acids.

Sensitivity Analysis of Average Inventory Level (AIL) at a Specialized Hospital

. Hospital inventory management play a very significant role in hospital's performance. Too much inventory wiil lead to excessive inventory cost but too low inventory might result in dissatisfactions of patiens and lack of performance of physicians or doctors. Economic order Quantity (EOQ) is an inventory control method that can help hospital to minimize total inventort cost. However, managers might find difficulties in deterimining the right amount of ordering and holding cost which are needed in calculating EOQ. This research is a case study from a class “A” specialized hospital. Inventory data of pharmaceutical items are calculated to measure the sensitivity of changes in ordering and holding cost to average inventory level which will lead to understock or overstock. Different ordering cost and holding cost will lead to different proportion of overstock and understock but will not give a significant differences. This research recommend EOQ model to be used in hospital inventory management inspite of the difficulty and hesitation of hospitals to estimate ordering and holding cost.

A Cross-Sectional Study of Client Satisfaction to Wards Services Received at Boru Meda Hospital Pharmacy on OPD Basis and Community Pharmacy

Background: Client satisfaction is a multidimensional construct that reflects the quality of service provided by healthcare providers. The objective of this study was to develop a client satisfaction scale that could be used to assess the quality of pharmacy services provided in Boru meda hospital community and hospital pharmacy in respect of client perception of specific aspects of service performance. Methods: Institutional based quantitative cross sectional study was conducted with clients exit interview at hospital outpatient pharmacy and community pharmacy during the period from February 30, 2017 to March 30, 2017. The study was carried out in 417 participants who were selected by systematic random sampling technique. The data was collected on predesigned and pretested questionnaire. Results: Regarding availability of pharmaceutical items at community pharmacy114 (54%) had gotten a chance of all prescribed items. About patronage of participants 153(72.5%) were repeat visit in community pharmacy. with regards the courtesy and respect shown by the pharmacy staff 96.7%, 95.6% participants were found satisfied in community and hospital pharmacy respectively. Near about 39(18.5%) participants in community pharmacy and 70(34%) participants in hospital pharmacy replied that they were unsatisfied with information gives about the proper storage of their medication.Conclusions: This study showed that the overall satisfaction level of clients of both hospital and community pharmacy was high. About fairness of cost of medications in the community pharmacy only 6(2.8%) were found very dissatisfactory, whereas 3(1.5%) Participants at hospital pharmacy were very dissatisfactory.