CLINICAL AND BIOCHEMICAL CHARACTERISTICS IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME IN THE REGION OF POLLOG, REPUBLIC OF MACEDONIA

Polycystic ovary syndrome (PCOS) is a common endocrine disorderand is a major cause of an ovulatory infertility. The main objective is toestimate the prevalence of PCOS in the region of Pollog, Republic ofMacedonia and to assess some clinical and biochemical parameters inpatients with PCOS in comparison with normal women as control.Rotterdam criteria is used to evaluate 70 women diagnosed with PCOS,compared to 30 age matched controls to assess the clinical and biochemicalabnormalities that occur in PCOS patients. All statistical analysis is doneusing SPSS (version 19.0). A P-value < 0.05 is considered statisticallysignificant. Mean age in PCOS group is 25.11 ± 3.32, and 25.10 ± 3.91 in thecontrol group. BMI of the women with PCOS is significantly higher than inthe control group. Menstrual cycle abnormalities are observed in 71.4% ofPCOS patients, and ultrasonographic appearance of polycystic ovaries isreported for all PCOS cases. Hirsutism (FG 8-9) is present in 42.9 %,hirsutism (FG 10-14) in 50% and 7.1% showed hirsutism (FG>15). Werecorded significantly higher serum levels of luteinizing hormone (LH), totaltestosterone (TT), and insulin, while the serum levels of sex hormonebinding globuline (SHBG) and follicular stimulating hormone (FSH) aresignificantly lower than in the control group. By analyzing the clinical andbiochemical characteristics of our studied population of patients with PCOS,we can conclude that the majority of our patients expressed all threediagnostic features of PCOS (hyperandrogenism, menstrual abnormalities,and ultrasound findings of polycystic ovaries)

OVERVIEW ON GENERICS POLICIES AND PHARMACEUTICAL PRICING IN THE EUROPEAN COUNTRIES AND THE REPUBLIC OF MACEDONIA

Continued growth of spending on drugs in Health care, especially in the public sector encouraged initiatives for reforms in the system of determining the prices of medicines. These initiatives that were undertaken, were primarily aimed at reducing the cost of drugs but parallel to become a generic medications simultaneously promoting an adjustment of reimbursement procedures in the pharmaceutical sector. The policies for the regulation of the pharmaceutical market come as a response to health care classical market failures. This article will focus on the features, implementation and impact of these policies in some EU member states. Most EU countries, apply the external reference system of prices, whereupon the price of a certain medication is determined based on the price of the same product in other countries. On the other hand, in twenty other EU member states, prices are determined by comparing the prices of the same products according to chemical, pharmacological or therapeutic grouping. The reference pricing system has been adopted by governments as a mechanism to reduce the costs in the public health care system. By setting a price limit, competition among producers has been stimulated

Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste

The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people's health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection

Overview of the Regulatory Framework for Radiopharmaceuticals

Radiopharmaceuticals are products that have the particularity of combining two very restrictive regulatory requirements depending on two different authorities: that of the drug in the pharmaceutical sense and that of a radioactive source linked to a specific authorization system. Radiopharmaceuticals are a new reality in the pharmaceutical industry and are considered to be an indicator of modern medicine and the technological industry. The exponential increase in their use is attributed to their dual use as diagnostic and therapeutic agents. They represent a group of pharmaceutical preparations, which contain radionuclides with short half-lives and are mainly administered intravenously. Maximum care should be taken during their production, distribution, storage, and disposal because their radiant nature is a concern for both patients and medical staff. All stages of production must be done by the requirements of Good Manufacturing Practice. Therefore, radiopharmaceuticals must meet the requirements of the pharmaceutical regulator, the same as those of the nuclear regulator. The largest number of regulatory bodies in the world have different perspectives in terms of their production, distribution, transportation, storage, and disposal. However, in developed countries, the regulator of radiopharmaceuticals is in its infancy. In this article, we will shed light on the various regulatorylimitationsimposedbythesestatutes, emphasizing that these regulations are therefore likely to evolve in the years to come and to demonstrate the importance of their development, proper use, and perspective

Evaluation a renal function of patients with Medication-overuse headache (MOH)

Excessive drug use causes Medication-overuse headache (MOH) which can be manifested of chronic daily headaches, occurring monthly 15 or more days, when the medicament is used redundantly for more than three months. Recent studies concerning the epidemiology of drug-induced disorders suggest that increased risk of nephrotoxicity appears in a group of patients who abuse NSAIDs. The aim is to confirm the early phase of nephrotoxicity in patients with (MOH),were treated with NSAIDs in combination with other drugs (analgesics, triptans and antidepressants) and compared patients treated only with Diclofenac, Piroxicam, Ketoprofen, Paracetamol, Ibuprofen and Celecoxib, Besides conventional markers of renal functioning (serum/urine creatinine determined by Jaffe methods, enzymatic assay for urea serum). Imunoturbodimetric assay for determination of urinary albumin, microalbuminuria and β2-microglobulin will be used. Significant glomerular and tubular damage has been reported, and patients on combination therapy with NSAIDs and other drugs (analgesics, triptans, and antidepressants) have seen more glomerular changes than patients treated with NSAID monotherapy. Keywords: Medication-overuse headache, Nephrotoxicity, Nonsteroidalantiinflammatory drugs

Migraine and the effects of NSAIDS on renal function

Trigeminovascular system (TGV) activation is a basic mechanism for generating pain during a migraine attack. Many experimental results highlight the importance of the cyclooxygenase system in the peripheral arm of TGV and suggest that NSAIDs may be effective in migraine therapy through the action of these peripheral nociceptors. Inhibition of NSAID-mediated prostaglandin synthesis prevents neurogenically mediated inflammation of the trigeminal system and reduces pain, but at the same time inhibition of prostaglandin in the kidney may reduce renal blood flow,speed glomerular filtration retention. and water. The purpose of the study is to follow the renal function, in patients with cefaleamigraine that has been treated for a long period, treated with Diclofenac and Paracetamol.We used Jaffe’s method for the determination of serum/urine creatinine and еnzymatic assays for urea and uric acid in serum and ᵧ glutamyl transferase (ᵧ-GT) in serum and jon selective electrode (ISE) are used for determination of electrolite in serum. We used nephelometry by β2 microglobulin (β2M) and photoelectric colorimetry for microalbuminuria in urine, to monitor glomerular and tubular functioning. Any history of kidney diseases was exclusion criteria to enter the study. In chronic treatment of patients with headache with Diclofenac and Paracetamol in symptomatic headaches, they have been confirmed as renoprotective in their use. Keywords: non-steroidal anti-inflammatory drugs, migraine, renal function, trigeminovascular syste

Comparison of the sensitivity of several biomarkers in patients with medication overuse headache (MOH)

Migraine is a common headache disorder that causes significant disabilities. Headache developed or significantly worsened during medication overuse (for simple analgesics and combination acute medications, intake must be 15 days or more per month for triptans, ergotamines, opioids, and combination analgesics; 10 days per month sufficient to get a diagnosis of Medication-overuse headache-MOH). A recent epidemiologic study on drug-induced disorders demonstrated that excessive drug use can lead to nephrotoxicity. Microalbuminuria was common in patients under the influence of nephrotoxic drugs. Subclinical renal damage cannot be identified by routine tests (serum creatinine), and microalbuminuria is a more sensitive indicator of renal dysfunction. The aim is to confirm the sensitivity of certain biomarkers when comparing patients treated with NSAIDs in combination with other drugs (analgesics, triptans and antidepressants) with patients treated with monotherapy by NSAIDs Besides conventional markers of renal functioning (serum/urine creatinine determined by Jaffe methods), enzymatic assay for urea serum and Jon selective electrode (ISE) are used for determination of electrolyte in serum. Imunoturbodimetric assay for determination of urinary albumin, microalbuminuria and β2-microglobulin will be used. In the case of combined therapy with NSAIDs and other medications (analgesics, triptans and antidepressants), a significant effect on the increase of microalbuminuria has been demonstrated, which signals us for a more sensitive indicator in compared to β2M which as specific bioindicator did not show a measured sensitivity for the detection of early changes in the tubular level. Significant glomerular damage has been reported in patients with combination therapy than patients treated with NSAID monotherapy. Following the levels of specific biomarkers, we can use them as signals for early detection of nephrotoxicity, especially in patients treated with combination therapy requiring special attention when administering them