Perception of community pharmacy personnel towards patient counseling and continuing pharmacy education programs in Aden, Yemen

© 2018, Journal of Clinical and Diagnostic Research. All rights reserved. Introduction: Patient counseling is a major component of pharmaceutical care, especially in community pharmacy settings. However, most community pharmacists still do not offer patient-oriented services. Despite the beneficial role of community pharmacists, research examining their roles and responsibilities in developing countries like Yemen is lacking. Aim: To assess the community pharmacy personnel’s perceptions towards patient counseling and to recognise the major barriers to successful counseling; and to assess their perception towards continuing pharmacy education programs in Aden. Materials and Methods: A descriptive, cross-sectional study was conducted among 200 community pharmacy personnel in Aden using a self-administered, structured questionnaire. Data were collected regarding community pharmacy personnel’s knowledge, attitude, and their perception about patients’ attitude concerning patient counseling and respondents’ attitude toward the continuing pharmacy education. Results: The majority of the respondents had a positive attitude towards patient counseling (85%) and continuing pharmacy education (94.0%); dose and frequency (43.0%), duration (34.0%) and indication (11.5%) were the major information mentioned while counseling their patients. Lack of patient interest (47.0%), lack of knowledge (20.0%) and lack of time (15.5%) were the major barriers towards counseling. Conclusion: The present study showed that most community pharmacy personnel in Aden, Yemen had a positive perception towords patient counseling and continuing pharmacy education program

Traditional African Medicine

African traditional medicine is defined as one of the holistic health care system comprised of three levels of specializations namely divination, spiritualism, and herbalism. The traditional healer provides healing services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Hence the current chapter focuses on the different types of african healing system, traditional healers, traditional practices and modern herbalism and also describes the phytochemical and pharmacological evidences of the traditional african herbs like Acanthus montanus (Acanthaceae), Amaranthus spinosus (Amaranthaceae), Bridelia ferruginea (Euphorbiaceae) etc

The Interplay of Dysregulated pH and Electrolyte Imbalance in Cancer.

Cancer cells and tissues have an aberrant regulation of hydrogen ion dynamics driven by a combination of poor vascular perfusion, regional hypoxia, and increased the flux of carbons through fermentative glycolysis. This leads to extracellular acidosis and intracellular alkalinization. Dysregulated pH dynamics influence cancer cell biology, from cell transformation and tumorigenesis to proliferation, local growth, invasion, and metastasis. Moreover, this dysregulated intracellular pH (pHi) drives a metabolic shift to increased aerobic glycolysis and reduced mitochondrial oxidative phosphorylation, referred to as the Warburg effect, or Warburg metabolism, which is a selective feature of cancer. This metabolic reprogramming confers a thermodynamic advantage on cancer cells and tissues by protecting them against oxidative stress, enhancing their resistance to hypoxia, and allowing a rapid conversion of nutrients into biomass to enable cell proliferation. Indeed, most cancers have increased glucose uptake and lactic acid production. Furthermore, cancer cells have very dysregulated electrolyte balances, and in the interaction of the pH dynamics with electrolyte, dynamics is less well known. In this review, we highlight the interconnected roles of dysregulated pH dynamics and electrolytes imbalance in cancer initiation, progression, adaptation, and in determining the programming and reprogramming of tumor cell metabolism

The Pentose Phosphate Pathway Dynamics in Cancer and Its Dependency on Intracellular pH

The Pentose Phosphate Pathway (PPP) is one of the key metabolic pathways occurring in living cells to produce energy and maintain cellular homeostasis. Cancer cells have higher cytoplasmic utilization of glucose (glycolysis), even in the presence of oxygen; this is known as the “Warburg Effect”. However, cytoplasmic glucose utilization can also occur in cancer through the PPP. This pathway contributes to cancer cells by operating in many different ways: (i) as a defense mechanism via the reduced form of nicotinamide adenine dinucleotide phosphate (NADPH) to prevent apoptosis, (ii) as a provision for the maintenance of energy by intermediate glycolysis, (iii) by increasing genomic material to the cellular pool of nucleic acid bases, (iv) by promoting survival through increasing glycolysis, and so increasing acid production, and (v) by inducing cellular proliferation by the synthesis of nucleic acid, fatty acid, and amino acid. Each step of the PPP can be upregulated in some types of cancer but not in others. An interesting aspect of this metabolic pathway is the shared regulation of the glycolytic and PPP pathways by intracellular pH (pHi). Indeed, as with glycolysis, the optimum activity of the enzymes driving the PPP occurs at an alkaline pHi, which is compatible with the cytoplasmic pH of cancer cells. Here, we outline each step of the PPP and discuss its possible correlation with cancer

Antioxidant assessment on promethazinr HCl decomposition using RP-HPLC assay method

The objective of this study was to investigate the effect of different sodium metabisulfite (SMBS) concentrations under a variety of ICH recommended test conditions. An attempt was made to test the feasibility of increasing shelf life when stored under different conditions. The promethazine hydrochloride (HCL) sample solutions used according to USP 24 and BP 1999 were prepared using different concentration of sodium metabisulfite as antioxidant. Standard solution was prepared using reference promethazine and analyses were done by employing reversed-phase high-performance liquid chromatography (RP-HPLC). The method used is efficient in acceptable resolution. The effect of different concentrations of SMBS on promethazine was investigated in promethazine HCL degradation. Chemical and physical stability was conducted in different conditions. The result shows that the drug was liable to degradation in basic pH medium condition, though the extent of degradation varied. Separation of the drug and the degradation products under various conditions was successfully achieved. The method was validated and the response was linear (r=0.9998) in the drug concentration range of 5 to 50 μg. The mean values (±RSD) of slope and intercept were 46376 (±0.006975) and 200049 (±0.4009), respectively. The recovery of the drug ranged between 98.3 and 101.16% from the mixture of degradation products. SMBS concentration influences the degradation process. Increase in concentration resulted in decrease of promethazine degradation. The developed method is simple and accurate in use for analysis of the drug and its degradation products. Antioxidant (SMBS) has important role in preventing promethazine degradation beside other factors.Keywords: Degradation, reversed-phase high-performance liquid chromatography (RP-HPLC), promethazine hydrochloride, sodium metabisulfit

Attitudes and practices of community pharmacists and barriers to their participation in public health activities in Yemen: mind the gap

Abstract Background Patients in Yemen commonly visit community pharmacies to obtain consultation or treatment for common ailments. Community pharmacists have an opportunity to optimize medication use and improve patient outcomes. This study aimed to evaluate the attitudes and practices of community pharmacists regarding their participation in public health activities and barriers to their participation in these activities. Methods This cross-sectional study was carried out among community pharmacists working in pharmacies located in urban areas of the Aden governorate of Yemen from March to June 2017 using a self-administered questionnaire. We selected pharmacies from a line list using proportional sampling according to the number of pharmacies in the urban areas of each district. The questionnaire contained four sections: demographic characteristics, attitudes, practices, and barriers encountered. Data were analyzed descriptively, and the Chi-square test was used for analyzing the association of variables (alpha = 0.05). Results The questionnaire was distributed to 200 community pharmacists working in community pharmacies. Of the 200 respondents, 62% (n = 124) were male. Overall, the mean age (sd) was 30.0 years (8.6) with the number of years of work experience between 2 and 9.9 years (n = 158, 79%). On average, 62.3% of the pharmacists had a positive attitude toward participation in public health activities. Providing education to stop tobacco chewing, smoking, alcohol drinking and improve oral hygiene was an important activity of the community pharmacists. Blood pressure measurements (86%, n = 172) and glucose tests (45%, n = 90) were commonly conducted for clients. Lack of time (71%, n = 142) and lack of teamwork (70%, n = 140) were mentioned as common barriers to participation in public health activities. Conclusions Community pharmacists had a positive attitude toward public health activities. Health education and routine health tests were important practices of the community pharmacists. Barriers need to be overcome to enable more active participation by community pharmacists in public health activities by consulting with all stakeholders, assessing the situation, considering alternatives and taking action

Preliminary investigation of novel tetra-tailed macrocycle amphiphile based nano-vesicles for amphotericin B improved oral pharmacokinetics

Supramolecular macrocycles-based drug delivery systems are receiving wider recognition due to their self-assembly into nanostructures with unique characteristics. This study reports synthesis of resorcinarene-based novel and biocompatible amphiphilic supramolecular macrocycle that self-assembles into nano-vesicular system for Amphotericin B (Am-B) delivery, a model hydrophobic drug. The macrocycle was synthesized through a two-step reaction and was characterized with 1H NMR and mass spectrometric techniques. Its biocompatibility was assessed in cancer cell lines, blood and animals. Its critical micelle concentration (CMC) was determined using UV spectrophotometer. Am-B loaded in novel macrocycle-based vesicles were examined according to their shape, size, surface charge, drug entrapment efficiency and excepients compatibility using atomic force microscope (AFM), Zetasizer, HPLC and FT-IR spectroscopy. Drug-loaded vesicles were also investigated for their in-vitro release, stability and in-vivo oral bioavailability in rabbits. The macrocycle was found to be nontoxic against cancer cells, haemo-compatible and safe in mice and revealed lower CMC. It formed mono-dispersed spherical shape vesicles of 174.4 +/- 3.78nm in mean size. Vesicles entrapped 92.05 +/- 4.39% drug and were stable upon storage with gastric-simulated fluid and increased the drug oral bioavailability in rabbits. Results confirmed novel macrocycle as biocompatible vesicular nanocarrier for enhancing the oral bioavailability of lipophilic drugs

Of mitochondrion and COVID-19

COVID-19, a pandemic disease caused by a viral infection, is associated with a high mortality rate. Most of the signs and symptoms, e.g. cytokine storm, electrolytes imbalances, thromboembolism, etc., are related to mitochondrial dysfunction. Therefore, targeting mitochondrion will represent a more rational treatment of COVID-19. The current work outlines how COVID-19’s signs and symptoms are related to the mitochondrion. Proper understanding of the underlying causes might enhance the opportunity to treat COVID-19

The Interplay of Dysregulated pH and Electrolyte Imbalance in Cancer

Cancer cells and tissues have an aberrant regulation of hydrogen ion dynamics driven by a combination of poor vascular perfusion, regional hypoxia, and increased the flux of carbons through fermentative glycolysis. This leads to extracellular acidosis and intracellular alkalinization. Dysregulated pH dynamics influence cancer cell biology, from cell transformation and tumorigenesis to proliferation, local growth, invasion, and metastasis. Moreover, this dysregulated intracellular pH (pHi) drives a metabolic shift to increased aerobic glycolysis and reduced mitochondrial oxidative phosphorylation, referred to as the Warburg effect, or Warburg metabolism, which is a selective feature of cancer. This metabolic reprogramming confers a thermodynamic advantage on cancer cells and tissues by protecting them against oxidative stress, enhancing their resistance to hypoxia, and allowing a rapid conversion of nutrients into biomass to enable cell proliferation. Indeed, most cancers have increased glucose uptake and lactic acid production. Furthermore, cancer cells have very dysregulated electrolyte balances, and in the interaction of the pH dynamics with electrolyte, dynamics is less well known. In this review, we highlight the interconnected roles of dysregulated pH dynamics and electrolytes imbalance in cancer initiation, progression, adaptation, and in determining the programming and reprogramming of tumor cell metabolism