Clinical Pharmacology articles list

Schizophrenia is treated with antipsychotic drugs and is a chronic neuropsychiatric disorders. The influence of antipsychotics on the cytokine systems may be responsible for their clinical efficacy in schizophrenia. Granulocytopenia and agranulocytosis are severe side effects of antipsychotic therapy. The objective of this study was to estimate incidence of drug-associated agranulocytosis in newly diagnosed schizophrenic patients in and to evaluate the risk factors and outcomes. Seven participants groups were designed. Healthy persons as control. Schizophrenic patients before treatment. Schizophrenic patients after one-month of treatment. Schizophrenic patients after two - month of treatment. Schizophrenic patients after three - month of treatment. Schizophrenic patients after chronic treatments. Schizophrenic patients one month after chronic treatment. This study included screening for the expression and function of circulating leukocyte granulocyte-macrophage colony-stimulating factor receptor, screening of patient's biochemistry and haematology picture. Granulocyte-macrophage colony-stimulating factor expression was decreased after antipsychotic treatment for one month and continued to decrease after two months' treatment. Granulocyte-macrophage colony-stimulating factor expression starts to increase after the two-month treatment and continues increasing to controls or newly diagnosed schizophrenics or after chronic treatment. Complete blood counts were not changed compared. Liver function showed a transient increase in serum alkaline phosphatase after one and two month of treatment. All other parameters were not changed. Kidney function showed that urea and creatinine levels were within the normal range during the different treatments. Concerning lipid profile, low density lipoproteins levels were increased after one month, two months of treatment and after chronic administration of the antipsychotic drugs. It is concluded that antipsychotic treatment produces a decrease in granulocyte-macrophage colony-stimulating factor expression; the decrease reach the maximum effect after two months, then starts to increase back to normal levels. A transient increase in serum alkaline phosphatase in the first two months' treatment. Urea and creatinine levels and lipid profile were within normal range, except low density lipoproteins levels were increased during the two months treatment and after chronic administration of the antipsychotic drugs.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Prevalence of hypovitaminosis D is not restricted to the elderly and hospitalized population. Worldwide, the rate of prevalence of vitamin D deficiency has grown up rapidly in adults over the past decades. Among Libyan population including young students may has a high risk of vitamin D deficiency. The aims of this study were to examine vitamin D status among pharmacy students of Sebha University and to study the hematological profile as well as correlation of vitamin D deficiency with incidence of anemia among the students. This study was carried out on Pharmacy students from 13th January to 12th March, 2020. This is a cross-sectional study designed to determine vitamin D status among healthy young pharmacy students studying at the Sebha University. The blood samples were collected randomly from 62 pharmacy students to analysis complete blood count and 25-hydroxyvitamin D. The concentration of hemoglobin on total student was 12.5 ± 1.9 g/dl which was normal according to the WHO level (12.0 g/dl). Out of total, 36 students (59.1%) were found to have normal hemoglobin concentration (13.7 ± 1.4 g/dl) and 26 students (40.9 %) were found to have low hemoglobin concentration (10.8 ± 1.1 g/dl). Other blood profile as HCT, MCV, MHC and MCHC where statistically significant lower but the counts of RBCs, WBC and platelets were not on anemic group comparing to normal group. The present study reported that majority of pharmacy students in male and female blood donors have low vitamin D levels which represent (87.0%). Out of the total participants (n = 54) who have low vitamin D (n = 49, 79.0%) were classified under vitamin D deficiency category while (n = 05, 08.0%) of students had vitamin D insufficiency. In conclusion, prevalence of hypovitaminosis D (low 25-hydroxyvitamin D) among the pharmacy students at Sebha University was highly occurrence with concomitant a high rate of prevalence of anemia. Thus, vitamin D deficiency at this age represents a public health problem that should be addressed.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The application of clinical pharmacokinetic is the responsibility of all pharmacists providing pharmaceutical care. An appropriately applied clinical pharmacokinetic is expected to result in improved patient outcomes: decreased mortality, reduced length of treatment, reduced length of hospital stays and cost-savings. Data on the extend of pharmacokinetic application in Libyan hospitals remain scarce but available subjective evidence suggests that services related to clinical pharmacokinetic are mostly provided and performed by professionals other than clinical pharmacists. To explore the training background and perceptions of pharmacists on the pharmacokinetic course contents they received during their undergraduate pharmacy programs. Also, to determine the attitudes and barriers experienced by the pharmacists when applying pharmacokinetic principles in their current practice. This is a cross-sectional, descriptive study that was conducted between July 2018 and November 2019 using a self-administered survey. The study targeted hospital pharmacists practicing in different hospitals in Libya. A total of 104 pharmacists completed the questionnaire and submitted it back. The majority of participants learned pharmacokinetic courses as a mandatory course during undergraduate courses 81.0% with 37.0% selecting that course was taught as a separate course or courses. Around 80.0% of the participants agreed or strongly agreed that pharmacokinetic courses received in undergraduate studies are useful in pharmacy practice with over 75.0% of the participants agreeing or strongly agreeing on relevance of those course to their current clinical practice. About 40.0% of the participants described their current skills in allowing optimal patient care as can be better. Different barriers were highlighted by the participants to allow sufficient clinical pharmacokinetic practice including lack of sufficient information, lack of awareness of pharmacists’ role and skills in applying clinical pharmacokinetic by other pharmacists and by other health care providers. Thus, this study shows that most practicing pharmacists showed a positive attitude of current pharmacokinetic practice and to the impact of their undergraduate studies on their successful practice. However, they have clearly addressed the room for improvement.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The present study deals with the phytochemical analysis and evaluation of antibacterial activity of hydroalcohol, acetone, and hexane extracts of the leaves of Psidium guajava. The antimicrobial activity was measured by the agar well diffusion method. Gastric volume, pH, total and free acidity and the ulcerative index was also measured in hydroalcoholic extract of Psidium guajava on gastric ulcer pyloric ligation in rat. Glycosides, terpenoids, and tannins are only present in the hydro alcohol extract. The extracts are tested against gram-negative (Escherichia coli) and gram-positive (Staphylococcus aureus, Bacillus subtilis) bacterial strains. The zone of inhibition against microorganisms is direct proportional to the concentration of extract. Maximum zone of inhibition (24mm) against Staphylococcus aureus except hexane extract was seen. Psidium guajava leaves show maximum phytochemicals compounds and inhibition of microorganisms in hydroalcoholic extract. So the hydroalcoholic extraction was used for anti-ulcer activity. The present study was performed in pylorus ligation induced gastric ulcer model in albino rats in which the ability of hydroalcoholic extracts of Psidium guajava was tested at a dose level of 400 mg/kg body weight orally and compared with Ranitidine (10 mg/kg) as standard. From the results it is concluded hydro alcohol leaf extracts of Psidium guajava 400 mg/kg dose level showed significant anti-ulcer activity when compared to that of standard drug.

Sudha Rameshwari.K Assistant Professor

Anemia, iron deficiency and iron deficiency anemia are common blood disorders. The role of vitamin D was agreed to be regulating in calcium and phosphate absorption and bone metabolism and its deficiency is observed as a crucial nutritional problem. Vitamin D is created under the skin by ultraviolet light. It is usually get vitamins from the food; however, in the case of vitamin D, there simply are not enough rich food sources for people to get adequate amounts in their diet. Its effects on the prevention of diseases such as cardiovascular disease and anemia has received much attention recently. To get sufficient vitamin D, need to be exposed to sunshine or use supplements. Vitamin D3 was found in the largest population as a deficiency. With regard to hemoglobin was the subject whom has less normal range of hemoglobin (19.05%) than international normal range, and in ferritin the low population number was the subject whom has less normal range of ferritin than WHO normal range. The population who has low ferritin also has low vitamin D3 and variable hemoglobin. According international guidelines, optimizing nutrition with daily or intermittent (1 to 3 times per week) iron supplementation, should be considered a first-line intervention in high-risk or high-prevalence groups. Although it is probably less effective than daily iron supplementation, intermittent iron appears to be a useful and cost effective way of controlling anemia and iron deficiency anemia. This may indicate that a positive relation between the low concentration parameter of vitamin D3 and ferritin level but no significant correlation with hemoglobin.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Background: The determinants of medication adherence in people with diabetes may differ between populations of an area due to social environment, cultural beliefs, socioeconomic conditions, education, and many other factors differences. Objective: Therefore, this study aims to explore, identify and classify the determinants of medication adherence in several Asian regions. Methods: A systematic literature review was conducted to gain insight into the determinants of medication adherence. Seven relevant databases (EBSCO, ProQuest, PubMed, ScienceDirect, Scopus, Wiley, dan Taylor, and Francis) and hand-searching methods were conducted from January 2011 to December 2020. Keywords were compiled based on the PICO method. The selection process used the PRISMA guidelines based on inclusion, and the quality was assessed using Crowe’s critical assessment tool. Textual summaries and a conceptual framework model of medication adherence were proposed to aid in the understanding of the factors influencing medication adherence. Results: Twenty-six articles from countries in several Asian regions were further analyzed. Most studies on type 2 diabetes patients in India used the MMAS-8 scale, and cross-sectional study is the most frequently used research design. The medication adherence rate among diabetic patients was low to moderate. Fifty-one specific factors identified were further categorized into twenty-three subdomains and six domains. Furthermore, the determinants were classified into four categories: inconsistent factors, positively related factors, negatively related factors, and non-associated factors. In most studies, patient-related factors dominate the association with medication adherence. This domain relates to patient-specific demographics, physiological feelings, knowledge, perceptions and beliefs, comorbidities, and other factors related to the patient. Several limitations in this review need to be considered for further research. Conclusion: Medication adherence to diabetic therapy is a complex phenomenon. Most determinants produced disparate findings in terms of statistical significance. The identified factors can serve various goals related to medication adherence. Policymakers and health care providers should consider patient-related factors.

Much Ilham Novalisa Aji Wibowo

Kepatuhan terhadap terapi farmakologi merupakan kunci utama pengobatan penyakit diabetes, tetapi belum mendapat perhatian penuh oleh para klinisi. Beberapa systematic review faktor kepatuhan telah dilakukan di beberapa kawasan negara. Namun, tidak menampilkan studi dari Indonesia. Penelitian ini bertujuan untuk meninjau secara sistematis faktor-faktor yang dapat memengaruhi kepatuhan minum obat diabetes melitus (DM) di Indonesia. Systematic literature review dilakukan melalui pencarian pada database jurnal Nasional (Garuda dan Sinta) dan Internasional (PubMed dan Science Direct). Penelitian yang sesuai dengan kriteria inklusi dan dipublikasikan pada Januari 2011 – Desember 2020. Kualitas penelitian dinilai menggunakan panduan SQAT. Metode pelaporan penelitian menggunakan pedoman PRISMA. Faktor kepatuhan diklasifikasikan berdasarkan domain faktor kepatuhan menurut World Health Organization (WHO). Sebanyak 370 artikel ilmiah penelitian dari database Garuda (n=36); Science Direct (n= 108); PubMed (n= 18); Sinta (n= 208). 341 artikel penelitian dieksklusi, 29 artikel skrining full text, dan 16 artikel penelitian memenuhi kriteria inklusi untuk dianalisis. Faktor yang memengaruhi kepatuhan minum obat diabetes adalah faktor sosial dan ekonomi (penghasilan, tingkat pendidikan, dan pekerjaan), faktor tenaga dan sistem kesehatan (tenaga kesehatan), faktor terapi pasien (jumlah obat diabetes, frekuensi minum obat, dan produk obat), faktor penyakit pasien (kadar gula darah, durasi penyakit), faktor pasien (jenis kelamin, faktor emosional, dukungan sosial, tingkat pengetahuan, dan kepuasan pengobatan), dan faktor pengelolaan penyakit (konseling dan edukasi farmasi). Faktor yang memengaruhi kepatuhan minum obat DM di Indonesia sangat beragam, dan multi faktor. Faktor tersebut dapat berfungsi sebagai target intervensi yang relevan. Para klinisi perlu mempertimbangkan penyesuaian frekuensi minum obat dan pemberian dukungan sosial kepada pasien DM.

Much Ilham Novalisa Aji Wibowo

Diabetes mellitus (DM) is considered as ”the mother of all diseases" because it causes many complications. Knowing and measuring medication adherence may have a greater effect on DM patients. Several studies in Indonesia used a questionnaire scale to measure adherence, however they do not validate the study population, so it could still be found anomalous correlation analysis between adherence and clinical data even though it measured in the same country and scale. This study measure the adherence level of type 2 diabetes patients, evaluates the validity of the medication adherence scale, and analyze the correlation with the clinical outcome of type 2 diabetes patients in four health centers in Banyumas district. The study uses a cross-sectional design in Prolanis type 2 DM patients of January -April 2020. The adherence is measured by MARS-10, backward-forward translation method followed by content and internal validation. Clinical outcome is evaluated based on fasting blood glucose measurement. The results of the MARS-10 Gregory index analysis showed content validity in the high category (IG ≥ 0.8). The content validity showed the results of 9 questions with the value of r count> r table (n = 30, r table = 0.361). Reliability analysis showed Cronbach's Alpha 0.747> 0.6. The measurement showed 80.3% were adherent patients and 19.3% were non-adherent patients. Correlation analysis showed that there was no significant relationship (p> 0.05) between patient adherence and clinical outcome. Those results showed that type 2 diabetes mellitus patients in 4 health centers were categorized as adherent but not correlated with the clinical outcome. This was enabled due to the clinical outcome was simultaneously influenced by several factors: general factors, individual factors, and unpredictable factors.

Much Ilham Novalisa Aji Wibowo

Compliance with pharmacological therapy is the primary key to treating diabetes, but it has not received full attention from clinicians. Several systematic reviews of compliance factors have been conducted in several regions of the country. However, it does not feature studies from Indonesia. This study aims to systematically review the factors that can influence adherence to diabetes mellitus (DM) medication in Indonesia. A systematic literature review was conducted by searching the National (Garuda and Sinta) and International (PubMed and Science Direct) journal databases. Research that met the inclusion criteria was published from January 2011 to December 2020. The quality of the study was assessed using the SQAT guidelines. The research reporting method uses the PRISMA guidelines. Compliance factors are classified based on the domain of compliance factors, according to the World Health Organization (WHO). A total of 370 scientific research articles from the Garuda database (n=36); Science Direct (n = 108); PubMed (n = 18); Sinta (n= 208). Three hundred forty-one research articles were excluded, 29 full-text screening articles, and 16 research articles met the inclusion criteria for analysis. Factors that influence adherence to taking diabetes medication are social and economic (income, education level, and occupation), factors of personnel and health systems (health workers), factors of patient therapy (amount of diabetes medication, frequency of taking medication, and drug products), factors patient's disease (blood sugar levels, disease duration), patient factors (gender, emotional factors, social support, level of knowledge, and treatment satisfaction), and disease management factors (pharmacy counseling and education). Factors that influence adherence to taking DM medication in Indonesia are very diverse and are multi-factor. These factors can serve as relevant intervention targets. Clinicians must consider adjusting the frequency of taking medication and providing social support to DM patients.

Much Ilham Novalisa Aji Wibowo

Inhalation of a gas anesthetic produces rapid induction of anesthesia without the need for intravenous drugs. Although it is specifically useful for patients who are afraid of injections or if their intravenous access is difficult, single-breath induction may also allow patients to wake up more quickly than intravenous induction drugs. The object of this study is to compare isoflurane and sevoflurane during inhalation in Libyan patients undergoing surgery in terms of side effects like blood pressure and heart rate changes and complications. Seventy- five patients were recruited in this study from different hospitals in Benghazi City, Libya (January to March, 2022) including Aljalaa Hospital and Alatfal Hospital, and data including side effects and complications were collected through data collection. Surgeries that used isoflurane, or sevoflurane or both inhalation gases for anesthesia were included in our data. While the surgeries which did not use any of these inhalation gases were excluded from our data. When we compared the side effects of using isoflurane with sevoflurane according to the age group, we found that hypotension is the most occurring side effect companies to the use of isoflurane in our adult population (28.6%) and in pediatrics (14.3%) but there was a low incidence of other side effects related to sevoflurane administration. Regarding to side effects related to the use of sevoflurane according to the age groups, 16 adult Libyan patients experienced no side effects (61.5%) compared to 10 children (38.5%). It can be concluded that both isoflurane and sevoflurane are suitable for daycare anesthesia. Sevoflurane might be an ideal drug for single-breath inhaled induction of anesthesia due to it has fewer side effects and complications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Bone resorption is created by different etiological factors, such as tumors, infections, and trauma. When defects are too large and healing is not possible in a spontaneous way, the defect is called a critical size defect, which is defined as the smallest size of an intra-osseous wound that will not heal spontaneously during the lifetime of the individual. This study was conducted to evaluate the use of a mineralized plasmatic matrix versus bone graft alone or in the augmentation of bony cavities in animals. Ten adult male dogs ranging in age from 12 months to 18 months with a mean weight of ten kilograms were used in this study. Bone cavities were made in the tibia of each animal. The upper holes were implanted with a bovine bone material substitute the medial holes were implanted with a mineralized plasmatic matrix and the lower holes were left free from any implant material acting as control. The dogs were euthanized at 2, 4, and 6 weeks and prepared for H and E stain and trichrome stain. The healing process of bone cavities implanted with mineralized plasmatic matrix was better compared to cavities filled with bone grafts and those left to heal spontaneously. Mineralized plasmatic matrix facilitates graft application, in its stabilization, and improves cell penetration into the graft.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Over the years, pharmacy has developed from a simple floor stock system to a complex unit dose, I.V. additive, and clinical pharmacy program. This development would have never been possible without the support of the nursing, medical, and administrative staff. The support of obtained slowly by developing services that increase the pharmacist's credibility as a team member concerned with the pediatric and neonate patients. These services include a unit dose program, I.V. additive program, drug information services, and pharmacy medication program. One area in which pharmacist does not obtain a background from generalized training is the area of pediatric dosing. Pediatric pharmacists must learn in clinical practice the proper dosing of the pediatric patient and neonate patient. The dose must be checked periodically. In the premature or newborn infant, the pharmacist must consider the immature renal and hepatic function so that he/she does not overdose initially and then underdose as the infant grows and matures. Neonates are a special group of children, they are less than 30 days, and within this group preterm babies (that means less than 37 weeks). Determining the correct dose for drugs used to treat neonates is a critically vital factor. Prematurity affects kidney and liver function and the proper adjustment of drug doses is crucial [1]. The absence of drug level necessitates the adjustment of drug doses and the presence of qualified oriented dependable pharmacists. Drug doses are not numbers, or decimals used within the therapeutic range. Neonatal Intensive Care Unit (NICU) needs a system for the calculation and preparation of drugs [2].

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Prescription drug misuse has emerged as a significant problem over the past decade, particularly topical corticosteroids for skin lightening. This study aimed to assess the misuse of topical corticosteroids among the female population in southern Libya; to determine prevalence, awareness, attitude, and practice regarding this drug misuse. A descriptive, cross-sectional questionnaire was distributed on January 2022 to females aged between 16-45 years old in southern Libya. Out of 200 distributed questionnaires, 155 were returned with a response rate of 77.5%. The majority of the participants were aged 16-25 years (n=138, 89.0%) and over two-thirds of participants, said they obtained lightening products containing cortisone from pharmacies (n=107, 69.0%) while 36 participants indicated they obtained these products from cosmetic shops (23.2%). More than three-quarters of the participants said they were aware that they should read product ingredients (n=120, 77.4%). Just over one-quarter of respondents indicated they used the product on their face almost daily (n=41, 26.5%) while 28 participants denied using it (18.1%). The most common source of information about topical corticosteroids among participants was the Internet (n=51, 32.9%), followed by dermatologists (n=41, 26.5%), and pharmacists (n=31, 20.0%). Almost half of respondents were aware that topical corticosteroids can cause harmful effects (n=75, 48.4%). The most common indications reported for using topical corticosteroids were whitening (23.3%), and acne treatment (54.2%). Over two-thirds of participants, declared they would not use topical lightening products if they contained corticosteroids (n=107, 69.0%). In a similar attitude, nearly a third of participants stated that they would never use corticosteroid medications again if they knew about the negative effects of whitening (n=51, 32.9%). The majority of females, (87.7%), concur that only pharmacies should be able to sell and prescribe topical corticosteroid medications. The study's findings indicate that topical corticosteroids are frequently misused and that to lessen contraindications, especially for prolonged use, it is imperative to provide basic care to females who continue using topical corticosteroids in public or unlicensed marketing settings.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hyperoxaluria is a metabolic disorder responsible for calcium oxalate nephrolithiasis. The study was conducted on glass slides to observe the growth patterns of urinary calcium oxalate monohydrate crystals and their inhibition by 5, 10, 15 and 20 % infusion of Macrotyloma uniflorum seeds. For this purpose, a drop of gel medium (sodium metasilicate of 1.06 specific gravity and 3M acetic acid solution) at pH 5.02 - 5.17 was placed in the middle of a glass slide and converted into a gel. A 1 M oxalic acid drop was dropped to the left, and 1 M calcium chloride and magnesium acetate (1:1) solution was dropped to the right side of the properly formed gel. The glass slide was observed under a microscope till it was completely dried. In the case of the crystal inhibition study, a drop of M. uniflorum infusion was also added on the right side just after adding calcium chloride and magnesium acetate solution. The results without infusion showed detailed morphology and aggregation patterns of observed crystals such as donut, dumbbell, needles, platy, prismatic, rosette, round edges, X-shape crystals, loose and compact aggregates. All infusions of M. uniflorum affected the crystals, forming defective crystals. 5 % infusion inhibited crystals of all morphologies except donuts, X-shaped crystals, donuts, platy crystals and rosettes. Defected rosettes were observed in 10 % infusion, which was reduced gradually in the crowd by 15 and 20 %, respectively. From this study, it can be concluded that M. uniflorum seeds infusion is effective against calcium oxalate nephrolithiasis.

Dr. Salman Ahmed

Cancer is one of the most extreme medical conditions in both developing and developed countries around the world, causing millions of deaths each year. Chemotherapy and radiotherapy are critical treatment approaches, but both have numerous adverse health effects. Furthermore, the resistance of cancerous cells to anticancer medication leads to treatment failure. The rising burden of cancer overall requires novel, efficacious treatment modalities. Natural medications offer feasible alternative options against malignancy in contrast to western medicines. Furanocoumarins’ defensive and restorative impacts have been observed in leukemia, glioma, breast, lung, renal, liver, colon, cervical, ovarian, and prostate malignancies. Experimental findings have shown that furanocoumarins activate multiple signalling pathways, leading to apoptosis, autophagy, antioxidant, antimetastatic, and cell cycle arrest in malignant cells. Additionally, furanocoumarins have been shown to have chemopreventive and chemotherapeutic synergistic potential when used in combination with other anticancer drugs. Here, we address different pathways which are activated by furanocoumarins and their therapeutic efficacy in various tumors. Ideally, this review will trigger interest in furanocoumarins and their potential efficacy and safety as cancer-lessening agents.

Dr. Salman Ahmed

Vitamin E is extensively available in the natural world and is produced by prototrophs such as plants, algae, and blue-green algae. Vitamin E is used as a dietary supplement, an antioxidant food stabilizer, a pharmaceutical additive, and a preservative in livestock feed. Several types of vitamin E can be differentiated by the position and number of the methyl functional group, and each form has a unique biological role. The function of antioxidants such as vitamin E is to defend cells from the effects of oxidative stress. Vitamin E is a free radical scavenger converted to vitamin E radical, then converted back to vitamin E by ascorbic acid. Vitamin E was discovered by Evans and Bishop in 1922; it has proved to be an effective nutrient for reproduction. It is also possible for vitamin E to act by a mechanism not directly linked to the inhibition of oxidation. Such non-antioxidant actions of vitamin E may result from gene regulation and specific cell signalling. The function of vitamin E in cellular signalling, especially its biological impact, is undoubtedly an imperative subject for future studies. The explicit roles of the several isomers and esters of vitamin E analogues should also be the subjects of future studies.

Dr. Salman Ahmed

Monkeypox, an infectious disease caused by the Orthopoxvirus, was identified in humans in 1970. It has recently emerged as a global health concern due to outbreaks beyond its endemic regions in Central and West Africa. This review examines the current state of medical treatments for monkeypox as of 2024, focusing on antiviral agents, immunotherapies, and supportive care measures. Monkeypox manifests with symptoms including fever, rash, and lymphadenopathy, with severe cases more common in immunocompromised individuals. Antiviral therapies such as tecovirimat and brincidofovir are central to treatment strategies, with tecovirimat demonstrating efficacy in alleviating symptoms and reducing viral shedding. Emerging treatment strategies involve novel lipid-based formulations and combination therapies that integrate antivirals with immune-modulating agents. Supportive care remains essential, involving analgesics and antibiotics for secondary infections, while the MVA-BN vaccine plays a critical role in prevention. Research emphasizes the need for a deeper understanding of viral pathogenesis and host immune responses to improve therapeutic and preventive measures. Despite significant advancements, challenges remain, including potential antiviral resistance, disparities in healthcare access, and the necessity for enhanced diagnostic and surveillance capabilities. This review highlights the imperative for ongoing research, international collaboration, and investment in healthcare infrastructure to advance the management and prevention of monkeypox and to prepare for future outbreaks.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Metformin is considered the first-line treatment as a monotherapy for patients with type 2 diabetes mellitus. Emerging evidence suggests that metformin may have a renoprotective role; therefore, understanding the impact of metformin dose and therapy duration on renal function may significantly improve renal outcomes in type 2 diabetes patients. This study aims to investigate the renoprotective effects of metformin by analyzing its dose-dependent impacts on the estimated glomerular filtration rate in patients with type 2 diabetes mellitus. A retrospective cross-sectional study design was used from September 2022 to October 2023. Data from 302 type 2 diabetes patients were collected from patient files at the Benghazi Diabetic Center and the Aljabal Al-Alkdar Diabetic Center, including all with type 2 diabetes mellitus patients on varying doses of metformin. The collected data included age, gender, metformin dose, duration of metformin therapy, urea, and creatinine. Exclusion criteria included patients with significant comorbidities such as chronic kidney disease (other than diabetic nephropathy), liver disease, heart failure, or malignancy; those taking nephrotoxic medications; individuals with recent acute illnesses or surgical procedures; pregnant or lactating women; participants with inadequate medical records; and patients who were non-adherent to metformin therapy. Survival analysis was conducted to evaluate the effect of different metformin doses on the estimated glomerular filtration rate. The study analyzed 302 diabetic patients, of whom 46.0% were male and 54.0% were female. The age was 58.3±11.9 years. The HbA1c was 7.7%±1.3%. The duration of diabetes was 11.4±8.1 years. The creatinine was 1.0±0.9 mg/dL, and the urea was 36.7±23.8 mg/dL. Data analysis revealed a statistically significant difference in survival distribution across the dose groups. Different metformin doses significantly impact the estimated glomerular filtration rate, suggesting that dosage plays a crucial role in maintaining renal function.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena