Clinical Pharmacy articles list

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

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

Ayurvedic formulations are of three types, Herbal, Mineral and Herbo-Mineral. Of which, Herbomineral is prepared either by Khalweeya or by Bhasmeekarana procedures. The quality of Bhasma depends on the number of putas given. Rasa Bhasma is one such kind of a Herbo-mineral preparation which can be obtained by Puta procedure as described in texts of Rasa Shastra. Though there are different procedures mentioned for preparation of Rasa Bhasma, maarana done with Gorvara puta seems to be an apt way to obtain the final product. Puta is the generalised way of heat application used during the pharmaceutical procedures of Rasa dravyas, where the purified organic Metal/Mineral is converted completely into powder form which can be absorbed easily into the body without causing any ill effects. Different types of Puta have been explained for bhasmeekarana of different metals and minerals. Among them, certain putas have been mentioned where Mandaagni plays a crucial role in Maarana (Incineration). These Mandaagniputas are in use of preparing certain Bhasmas like ShilajitBhasma, HaratalaBhasma, GouripashanaBhasma, and PaaradaBhasma. As these drugs are having relatively low boiling and melting points when compared to other dravyas, and are easy to evaporate when exposed to high temperatures, they need a standardized quantum of heat by which they can be transformed into Bhasma. Gorvara puta is one such kind where agni plays a major role in the preparation of Bhasma. So, the present study A Comprehensive Study of Gorvara Puta in Preparation of Rasa Bhasmahas has been under taken.

Suri abhiram

Rasa aushadhis are known for their uniqueness in curing the diseases with a very low dosage. These formulations are divided into two types based on their mode of preparation i.e., Single drug and Compound drug formulations. Based on their origin, the drugs are divided into three types, Herbal, Mineral and Animal. Any of these two or three together is combined to make a compound formulation. Apart from these, the other major factor which is needed for a formulation is the Rasa Panchaka of a Drug. Many of the formulations are being prepared based on their availability, keeping their Rasa Panchaka and Samprapti vighatana in mind. These formulations are designed in such a way that two or more drugs will be having one common quality, or Opposite Qualities or an Antidote of a particular Vishadravya, which can help in curing the disease. So an attempt is made to Review Tribhuvanakeerti Rasa with its Probable mode of action.

Suri abhiram

Identifying the targets for improving antimicrobial prescription and development of antimicrobial stewardship interventions can better serve to combat the situation of antimicrobial resistance. The primary objective was to determine the prevalence of antimicrobial use at tertiary care teaching hospital with both acute and long-term care patients. A periodical point prevalence survey was done in a tertiary care hospital of South India during 2019 using manual and webbased GLOBAL-PPS tool. Of 945 patients eligible for the study, 645 (69.5 %) received at least one antibiotic, with highest rates in the adult surgical ward and pediatrics. Of 645 therapeutic antibiotic prescriptions, 58.6% prescriptions have an infectious indication of them, 62.6% are community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. The prevalence of antibiotic use is very high, and our study evidence that the country needs a robust antimicrobial stewardship intervention program.

Vineela chadalavada

The rate of aging is rapidly increasing and the term of geriatric refers to offer a medical care to elderly people. Drug consumption study on geriatric population is a vital issue since this group is totally neglected in Libya. The aim of this study was to assess drug utilization pattern among elderly patients in terms of world health organization core prescribing indicators and to evaluate the treatment cost. A total of 106 prescriptions were randomly collected from different community pharmacies located in Tripoli during the summer 2019, and were evaluated (total number of prescribed drugs is 359) for their clinical efficacy and safety. The findings revealed that 60 drugs acting on GIT (16.7%), 50 antimicrobial drugs (13.9%), 31 antihypertensive drugs (8.6%) and 30 drugs for respiratory diseases (8.4%) were prescribed to patients who are 65 years old or more. With regard to disease pattern in the elderly Libyan patients, 27 drugs were prescribed for diabetes mellitus (7.5%), 24 drugs for cardiovascular drugs (6.7%) and 14 drugs for anti-hyperlipidemia (3.9%). According to the WHO core drug use indicator pattern, the average number of drugs prescribed per encounter was 3.3. Prescription by generic name was low (41.5%). Antibiotics were 36.8% while injections were 26.6%. Thus, this study suggest that geriatric medicine and rational drug use should strongly be implanted in medical schools and teaching hospitals. Besides, a drug pattern use of the Libyan community is urgently required to avoid drug prescribing errors.

Fathi M. Sherif

Thrombocytopenia is a recurrent hematological disturbance in pregnancy. In pregnant women with thrombocytopenia, the risk of excessive bleeding during or after child-birth is high, particularly when they require a cesarean section, other surgery during pregnancy, labor or in the puerperium period. The objective of this study was to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Tripoli University Hospital, Libya. A cross-sectional analysis was used to determine the prevalence thrombocytopenia in pregnant women attending prenatal care services from July to December, 2020 at Tripoli University Hospital. A structured pretested questionnaire was used to obtain socio-demographic data, nutritional factors, obstetrics and gynecological factors, history and clinical conditions. Venous blood samples were collected for platelet count and other platelet parameters, which determined by using Sysmex automation. A total of 72 participated women; about 40%, 35% and 259% of the participants were in the third, second and first trimester, respectively. The mean number of children that women have was 2, with 2.7% having just one child and 47% having three or more children. This study concluded that the prevalence of thrombocytopenia and mostly with mild form is 8.3% and as being greater among pregnant women living in rural areas. Health care providers should do thrombocytopenia test regularly for every pregnant woman in order to prevent excessive bleeding during pregnancy, especially whom living in rural areas.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

During COVID-19 pandemic health professional need to develop good communication skills. Good communication skills will lead to professionalism. The information that are given to patients, their families and the community has to be transparent, true and scientifically relevant. The awareness one creates about the pandemic includes mode of infection, transmission, symptoms, vaccines, vaccination, viral heterogeneity and mutations. Such transmission of true information requires proper training of health personnel including the social media in developing good communication skills

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

A medication error is any preventable event that may cause or lead to inappropriate use of drugs or patient harm if it is not under the control of the health care professional. Despite the fact that healthcare professionals take the responsibility very seriously, it has been estimated that 250 000 Americans die annually due to medication errors. Although, estimates show that one in ten patients worldwide is affected by medication errors while receiving hospital care, the harm can be caused by a range of incidents or adverse events. The exact incidence of medication errors in the neonatal intensive care unit (NICU) is unknown. In neonates especially premature infants, the immaturity of developing body systems affects the absorption, distribution, metabolism and excretion of drugs and therefore an exponential risk for medication errors is present. The risk of medication errors in children are much greater than adults.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypertension is a public health issue that significantly increases the risk of health problems and decreases health quality of life of the patients. Angiotensin converting enzyme inhibitors are used to control hypertension by preventing production of angiotensin II in turn decrease blood pressure, thus it may enhance the quality of life. This study aims to assess the effect of angiotensin converting enzyme inhibitors on the quality of life of patients with hypertensive aging 40 years or older in Benghazi city in comparison with other classes of hypertension medications. A case control observational study was conducted, adopting the structured face-to-face interviewing survey technique. Over 150 patients who visited Benghazi medical center during the study period (November, 2019 to March, 2020), to follow up their chronic disease. The investigators used a pre-validated, pre-piloted questionnaire that has been adopted from SF 36 and modified according to the updated literature review; responses to each question were coded and analyzed. The results display that antihypertensive medications were found to be significantly related to the limitation on the physical activity domain and found that medications decrease the limitation on the activity with about 20% of the patients who taking angiotensin receptor blockers (20%) and 30% of the patients taking angiotensin converting enzyme inhibitors, 40% of the patients had no limitations on bending kneeling and stooping. Moreover, on the limitations on walking more than one kilometre, the results were about 15% of the patients taking angiotensin receptor blockers and 30% of the patients taking angiotensin converting enzyme inhibitors had a slightly or no limitation on walking more than a kilometre. Thus, the findings indicate that antihypertensive medications have a positive effect on quality of life of the patient in limitation on activity domain but no conclusive difference was found between angiotensin converting enzyme inhibitors and angiotensin receptor blockers medications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Colon is part of the digestive system in the human body responsible for absorbing water and nutrients from food residues. There are many problems affecting the colon including irritable bowel syndrome, constipation, hemorrhoids, anal fissures, abscess, colitis and colon cancer which considered one of the most common diseases among the Libyan community. The aim of this study was to search the presence of colonic disease and the tendency of those diseases to transform into colonic cancer at Benghazi medical center in Benghazi-Libya. A survey was comprised of 15 questions concerning colon diseases, proper diagnosis and treatment type. The survey was distributed to the physician specialized in medicine at Benghazi medical center and they fill it voluntary. The initial part of the questionnaire designed to obtain demographic data concerning the physicians who diagnose the colon illness. The rest part of the questionnaire was concerning special questions to define frequency of the diagnosed disease. There were 20 participants at this study. The response to all questionnaires were collected and analyzed for drug use, patients and disease distribution. In conclusion, this study demonstrates that the correct diagnosis, prescribing the appropriate treatment for the colon disease and using the medicine properly is one of the most important things that help in treating the disease and reducing its exacerbation. In some cases, eradication procedures may be required if the medicine is not sufficient to treat the disease without the need for operations

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Cardiovascular drugs constitute one of the largest and most widely used among other diseases and cardiovascular drug market has largely been exploded . Although these drugs have the potential to significantly improve the treatment of various cardiac diseases. They are potent agents with potential for serious adverse effects, toxicity and drug interactions. Newer agents are considerably costly than older drugs and, therefore, cost-effective strategies must be developed. Thrombolytics are pharmacological agents come from bacterial origin as streptokinase and staphylokinase or from human origin as urokinase or t-PA. Thrombolytics are used to restore blood flow to infracted artery quickly. Only streptokinase, alteplase, reteplase and tenecteplase are approved by US-FDA for treatment of ST-elevation myocardial infraction (ST-EMI) [3]. This reopens blood vessels after their occlusion and prevents tissue necrosis. Although, the safe and effective use of each of these drugs requires a thorough understanding of appropriate patient selection, drug timing, dosing regimens and monitoring parameters. The greatest benefit to risk ratio for specific drugs is seen in certain subsets of patients the complexities of cardiovascular drug therapy illustrate the need for an in depth current knowledge of clinical trial evidence.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Self-medication with antibiotics is becoming a trend that threats the health systems worldwide through developing bacterial resistance which is associated with high health care costs and increased rate of morbidity and mortality. The main objective of this study is to assess antibiotic self-medication practice among Libyan university pharmacy students. This is a cross-sectional study conducted among pharmacy students at Sabratha University in the western region of Libya. A validated questionnaire was used to collect relevant data which were statistically analyzed. A total of 170 undergraduate Pharmacy students participated in the study during spring 2021. About 80% of the participants reported the use of antibiotics without consulting a physician. The major reason for using antibiotics was to get a quick relief of emergency conditions which was reported by 35% of the students. About 25% of the students used antibiotics to relieve their pains and aches. The most commonly used antibiotic was amoxicillin (55%). Most antibiotics were obtained over the counter from community pharmacies (85%). Half of the participants were not sure if they can advise patients to use antibiotics without a prescription, although 60% of them believed that it was good practice. In conclusion, prevalence of antibiotic self-medication among university pharmacy undergraduate students is high. Thus, serious interventions are required to ensure safe and effective use of antibiotics among the population in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Tuberculosis is communicable disease which is common and often deadly infectious disease caused by mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem in the world. The aim of this study is to assess prevalence and associated risk factors of pulmonary tuberculosis. Treatment and development of multidrug-resistant tuberculosis were also considered. Drugs for Pulmonary tuberculosis confirmed cases used in calculating tuberculosis prevalence in Libya which is obtained from archive department of Abu Seta Hospital. Data obtained from 427 files during 2019 determine the incidence and epidemiology of tuberculosis in Libya. For a total of 427 confirmed cases of pulmonary tuberculosis, about 75.0% of the cases were male and most of the patients (55.0%) were within the age group of 20 - 40 years old. Of the study patients, 114 patients (26.7%) were viral infected and most of the viral infected cases were in the age group of 20 - 40 years and the majority of this age group patients (n = 41, 53.2%) were infected with HIV/HCV, while the least percentage in this group age were infected with HIV/HBsAg (01.3%). Among 427 cases, 73 cases (17.1%) were comorbid with other chronic diseases. Of the 73 cases, 54 cases (74.0%) were diabetes mellitus whereas only 1.4% of them had bronchial asthma, Parkinsonism and renal failure. The drug therapy of active tuberculosis disease needs combination chemotherapy to escape the selection of naturally occurring drug-resistant mutants. Amongst current anti tuberculosis drugs, the rifamycins hold the highest potential for shortening treatment and improving effects. Prevalence of smear positive tuberculosis and bacteriologically confirmed that a high rate of tuberculosis among unemployed population. This study reported that the highest incidence rate is found in people who are smokers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences