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.
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.
Tuberculosis (TB) is an infectious disease caused by bacteria called Mycobacterium tuberculosis. The disease mainly affects lungs and causes pulmonary tuberculosis. It can also affect intestine, meninges, skin, bones and other tissues of the body. Although the drugs alone can cure TB, it still remains a major public health problem worldwide. The aim of the study was to assess the quality of life and medication adherence in TB patients. The Quality of life was assessed using SF-36 in patients receiving DOTS treatment in initial or continuous phase while the medication adherence was analyzed using Morisky Green Levine Scale. Subjects were also counselled about their disease during their first visit and a follow up was done after a month. A total of 152 subjects were enrolled in the study of which majority of the subjects had Pulmonary TB (55.26%). Diabetes was found to be the most common comorbidity followed by HTN. The average Physical Component Summary (PCS) and Mental component summary (MCS) were found to be 44.34 and 39.60 respectively. Females had a better quality of life scores compared to males. High adherence was seen in 32.24% of patients while 28.29% had low adherence. Follow up was done for 135 subjects. 15 subjects defaulted and 2 of them died. There was a significant increase in the QoL scores and medication adherence after one month. A significant association was found between the Physical functioning (p=0.001) and emotional wellbeing (p=0.01) with Duration of treatment indicating that subjects who had completed more than one month of their treatment had marked improvement in Physical functioning and emotional well-being scores
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.
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.
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.
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.
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.
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.
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.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
Pharmacists stand alongside with other professionals in representing essential healthcare during health emergencies such as COVID-19 pandemic. The present study seeks to explore the behavior and attitude of community pharmacists across various pharmacies throughout this pandemic towards the safety of workplace environment for staff and patients. An online questionnaire has been prepared and distributed to 145 community pharmacies during March to May, 2020. The collected results and data showed that community pharmacists in Libya have a good knowledge and adherence to preventive and protective measures published by FIP, WHO and other health-related organizations to protect themselves and society from infection. The pharmacist role in educating and information provision of the current disease and its management is still going on regardless the pandemic. A negative evaluation to the government support during the pandemic is clear from participant's replies. In Conclusion, this study looks forward to disclosing the current activities undertaken across various community pharmacy settings concerning safety of the workplace environment for both staff and patients. A clear and relatively realistic picture of the extent of commitment and knowledge of pharmacists of the necessary aspects needed to deal with this pandemic within community pharmacies is suggested. The extent of community pharmacist's knowledge, readiness and speed of their response to such a pandemic have been identified.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
The pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs in the prevention and treatment process. At present, there is no proven therapy for this disease, although therapeutic approaches continue to be carried out using traditional medicines (herbal) and pharmacological therapy. Information about SARS-CoV-2 virology has rapidly developed and scientists try to provide a number of potential drugs. Remdesivir has strong in vitro activity against SARS-CoV-2. Several potential drugs are currently underway in a clinical trial. Chloroquine, hydroxychloroquine, and oseltamivir have not been proven to have efficacy, and the benefits of corticosteroids are still diverse. Current clinical evidence does not support the termination of angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers, coagulation therapy in patients with COVID-19 concomitant with comorbidities.
The present study was designed to investigate the in-vitro thrombolytic activity of various extracts of seeds of Salvia hispanica by Clot lysis method. In this study, Streptokinase was used as a positive control and the human blood was taken as test sample. The mean % of clot lysis for streptokinase was found to be 66.8%. Similarly the methanolic, ethanolic, aqueous and acetonic extracts of salvia hispanica exerted 48.5%, 35.8%, 33.3%, 27.7% lysis of the blood clot in thrombolytic activity test respectively. From our findings it was observed that all the extracts of Salvia hispanica revealed remarkable thrombolytic activity
Pharmacy education has evolved from the outdated changing 5 to 4 year dispensing pharmacy program that focus on the medicines value the compounding and dispensing to patient-oriented pharmacy program (Pharm D) that focus on patient, experiential learning (practicum courses), evidence -based program that does foster critical thinking, and clinical reasoning skills [1] and improving patient care.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
Newborn or neonate denotes to an infant in the first few days after birth. They are not small children when it comes to medicinal use and formulation development. Neonates include term, post-term and preterm babies. The neonatal period for preterm newborn infants is defined as the day of birth through to the expected date of delivery plus 27 days. The majority of drugs used in sick newborns receiving intensive care are unlicensed and off-label, exposing infants to a greater risk of adverse drug reactions (ADRs). This study is extremely important due to the presence of a variety of drug information sources if used together lead to medication errors. From this point of view, this approach is suggested to eliminate or minimize these varieties. Where the most important challenges in neonatal intensive care unit (NICU) is proper and correct calculations and administration. Drug-related events in a hospital setting are the highest cause of recorded errors such as in the USA and UK
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
Good prescription writing is essential for dispensing the right drug formulation and dose. When prescriptions are not legible, inaccurate and do not include complete information, there is a possibility of prescribing errors occurring, which leads to adverse events. Poor handwriting is another important issue that makes the information unclear; especially look-alike drug names that may be confused by the pharmacist. World Health Organization has issued a practical manual for Good Prescribing that includes the essential information that should be included in a prescription. In this study, we attempt to investigate the problem of bad prescribing habits in out-patient prescriptions in Benghazi, Libya. Two hundred seventy-five out-patient prescriptions were collected from two private pharmacies on four consecutive days. These prescriptions were scanned for any errors or missing information depending on the standard criteria established by World Health Organization in its practical manual "Guide to Good prescribing". The collected data were processed and statistically analyzed by using SSPSS to calculate the percentage of missing information. Eleven percent (11.0%) of the prescriptions had no address or name of the prescriber on them while 58.0% had no date written on them and in 21.0% the prescriber did not sign the prescription. The age of the patient was only written on 38.0% of the prescriptions. The name of the medication was not clearly written in 18.0% of the prescriptions, while the dosage form of the medication was not written at all in 18.0% and not clearly written in 20.0% of the prescriptions. The total amount of the prescribed drug was not written in 30.0% of the prescriptions. It is to conclude that prescribers included in this study wrote prescriptions with a lot of missing and unclear information as per WHO guidelines for a good prescribing. This shows the weak attitude of Libyan prescribers toward the different aspects of “Good Prescribing”.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
Although, antibiotics play a fundamental role in control of infectious diseases still the injudicious prescription of antibacterial agents and antibiotic resistance are a global problem. This study aims to assess prescribing pattern of antibiotics and to provide a baseline data about behaviors of physicians prescribing antibiotics during pediatric consultations. In this study, a total of 316 pediatric patients of both genders were receiving different antimicrobial therapy were evaluated during 2021 in pediatric health care services in Bayda, Libya. Data revealed that the average of drugs prescribed was 4.10 per patient while the average of antimicrobials was 2.30 per prescription. Most of the antibiotics were prescribed for the respiratory tract infections (34.0%) and followed by the urinary tract infections (29.0%). Cephalosporins and penicillins were the most common antibiotics prescribed in this study. In conclusion, these findings show the presence of polypharmacy and inappropriate prescribing pattern. To improve and minimize the unnecessary prescribing of antimicrobial agents, a continuous training program for physicians, as well as engaged pharmacists in health care services are needed.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
The prevalence rate of vitamin D deficiency over the last decades has grown up rapidly worldwide among young adults. Therefore, the aim of this study is to explore knowledge, attitude and practice of Libyan medical students of Sebha University regarding vitamin D deficiency. Out of a total of 200 questionnaires, 148 completed questionnaires were returned (74.0% response rate). The majority of respondents did not measure their vitamin D levels (62.1%). Participants who indicated they exposing to sunlight for less than 15 min were 47.2% while 74.9% exposing to less than 30 min with highly significant difference in gender (p < 0.001). All the males did not use sunscreen creams compared with females (43.5%). Nearly two-thirds of the participants (61.4%) denied drink milk almost daily with significant differences based on the gender (p < 0.005) while 56.0 % of the participants reported eat fish, 60.8% of the students denied eating fast food and 74.3% eating eggs daily or weekly. However, 49.3% of the students are usually drinking of tea and coffee after meals, and do not usually practice exercise (53.3%), however, disagreed that their food has a low amount of calcium (30.4%). Most of the students agreed with the benefits of vitamin D (72.0%). Based on the assessment of awareness of the participants about vitamin D information, the average of correct answers percentage of the respondents was 47.1%. The most frequent sources of vitamin D information were the internet which accounted for 49.3%, followed by relatives and friends (31.7%). Some of the respondents (58.7%) reported that unawareness is the main cause of vitamin D deficiency. This study highlights the lack of awareness about the importance of vitamin D among medical students. This finding provides the institutions of medical education in Libya with an evidence base for a deficit knowledge regarding young health which could be utilized it to draw a strategy to correct health behaviors of students and community through medical education programs.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
One must accept the complexity of modern society as a multifaceted influence which will direct the future of all social organizations. Technology has brought the people of the world into almost instant communication. Biomedical science has conquered most infectious, acute diseases and has provided several medicines for a successful maintenance therapy of chronic diseases. The life style of some people as smoking and drug addiction remain a strong factor to their achievement of health goals of the good life. Universally, economic inflation and international business have created an economic interdependence among nations and dealing of the economic problems of one country must take into account this interdependence. When one views the future within this technologic-social-economic framework, he has difficulty sorting out certain directing influences that may shape the future of pharmacy practice in Libya. Currently, the duties, functions and roles undertaken by pharmacists in Libya range from those limited to traditional dispensing duties to highly clinically oriented roles [1]. In this regard, the Libyan health service providers request for the expanded roles of pharmacists in the society. Many of them ask for a number of clinical and patient-oriented functions as oncology, patient counseling, chronic care, hypertension, pediatric, diabetes, psychiatric, cardiology and others. They also question for protocols, standing orders and procedures for pharmacist management of drug therapy and provide information to use as a basis for initiation of clinically oriented services. The treatment of chronic diseases will be refined and drug therapy in many instances will be improved through the application of pharmacokinetic principles and improved methods of monitoring. There is no doubt that pharmacy practice has made clear steps in its own professionalization in hospitals during the past years. With an increase in the number of pharmacists practicing in hospitals and drug stores has come other changes in pharmacy manpower. Technicians and assistant pharmacists now perform many of the routine tasks in drug distribution under pharmacist's supervision. The latter, therefore, is available to participate in clinical programs in inpatient areas and in outpatient clinics. The practice of technicians and assistant pharmacists both in and out of hospitals remains a controversial issue in Libya (absence of a clear national medical policy). Many pharmacists in Libya who provide services hold Bachelor degree in Pharmacy or Pharmaceutical Sciences or Doctor of Pharmacy (Pharm D) or have completed a short or long term diploma training in teaching hospitals or postgraduate academics. Some hold appointments in other health professions institutions. Libyan Association for Pharmacists (LAP) and Libyan Medical Board are currently planning for a program in clinical pharmacy in different clinical branches. Nevertheless, professional pharmacy personnel must be upgraded in the future in both educational background and competence if continued professionalization is to be achieved [2]. The future will see continued stratification of professional personnel according to specialized functions in management and clinical and other professional; services particularly in large hospitals. The scope of the educational function of pharmacy will expand and become an increasingly important activity in the future in Libya. Some hospitals will maintain health education facilities as part of their physical plant. Others will participate in the program of area health education centers. Pharmacy's responsibility in this effort will require not only an increased commitment, but likewise, increased capability and capacity to provide educational services.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence self-reported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1–6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.