Antibiotics dispensing for URTIs by community pharmacists and general medical practitioners in Penang, Malaysia: A comparative study using simulated patients

Background: In Malaysia, doctors in private clinics (often called dispensing doctors) are permitted to dispense medicines. This potentially may compromise rational dispensing of medicines in general and antibiotics in particular. Aim: This study explored, assessed and compared dispensing of antibiotics between Community Pharmacist (CP) and General Practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, adherence to therapeutic doses and promotion of generic antibiotics. Method: The study used trained Simulated Patients (SPs), who used a scenario of common cold symptoms at GP private clinics and community pharmacies to observe and explore the practice of antibiotics dispensing. The study was conducted within the period of May to September 2011 in Penang, Malaysia. The data was analysed using descriptive statistics, Chi-square and Fisher’s Exact Tests at alpha level of 0.05. Results: GPs dispensed more antibiotics than CPs (p= 0.001) for common cold symptoms. They dispensed more Amoxicillin (n = 14, 35%) than CPs (n = 11, 11%) (p < 0.001) and more Tetracycline (n = 3, 7.5%) while no CP dispensed this category (p = 0.022). On the other hand, CPs (n = 11, 11%) suggested brand antibiotics where as GPs dispensed only generic antibiotics (p < 0.001). Generally GPs comply better with the symptomatic diagnosis standard e.g. when asking SPs about the symptoms they had, all GPs (n = 40, 100%) complied better with this standard. Despite that, they dispensed more antibiotics (n = 26, 65%) than CPs (n = 29, 29%) (p = 0.001). GPs (n = 22, 55%) also are better than CPs (n = 16, 16%) in adherence to therapeutic doses (p< 0.001). Conclusion: Findings showed poor adherence to rational dispensing of antibiotics by both providers. Although, GPs adhere better to symptomatic diagnosis and therapeutic dosing of antibiotics than CPs, they unnecessarily prescribe and dispense more antibiotics for Upper respiratory tract infection (URTI) symptoms. Establishing prescription guidance and regulatory actions, especially for URTIs treatment, and separating of medication dispensing are seemed to be crucial steps for the reform.Scopu

THE FUNCTIONAL PROFILES OF CHICKEN EGGS INCUBATED UNDER MONOCHROMATIC LIGHTING

Poultry production remains susceptible to significant infectious disease threats such as Avian Flu, and Newcastle Disease Virus (NDV), which threaten the supply of poultry production. My dissertation research addresses this challenge by leveraging avian circadian biology to improve responses to vaccines to enhance poultry performance. The central hypothesis is that specific visible light wavelengths would enhance circadian rhythm development in ovo, leading to improved immune responses. I addressed an essential question regarding the effect of providing photoperiods with different wavelengths (Blue, Green, and White) on circadian rhythm development and its interplay with the immune response following the NDV challenge in chick embryos using the RNAseq technology. Our results showed that incubating chicken embryos under blue light 450nm was most efficient in entraining the circadian rhythm in lung tissue, compared to white light or dark treatment. Blue light showed a specific impact on skeletal muscle, regulation of striated muscle contraction, Glycerolipid metabolism, and development of neurons. The white light incubation led to a photo-acceleration stimulant effect on epidermal growth factor receptor signaling pathway, ErbB signaling pathway, MAPK signaling pathway, and Insulin signaling pathway were upregulated in white light non-challenged treatment. The response to NDV challenging showed a distinct transcriptome profile between blue and white light. The blue light showed a potent innate immune response, targeting viral replication, clearly pointing to antiviral response. The white light showed less immune response, but more pronounced cell proliferation and metabolic state, suggesting photo-acceleration as the primary process, particularly T cell development, T cell homeostasis, and T lymphocytes' quantity, suggests a rapid or ongoing transition between innate and adaptive immunity. This observation paves the way to photo-accelerated effect of providing white light during chicken egg incubation on organismal development and immune response. It is noteworthy that unvaccinated white light incubated chicks hatched 6-8 h earlier than other blue or dark incubation at the organism level. In conclusion, this study is the first to generated high-resolution RNASeq evidence demonstrating the effect of lighting color background on the circadian rhythm development and modulation of the innate immune response of chicks’ embryos challenged with NDV

Crucial File Selection Strategy (CFSS) for Enhanced Download Response Time in Cloud Replication Environments

الحوسبة السحابية هي عبارة عن منصة ضخمة لتقديم بيانات كبيرة الحجم من أجهزة متعددة وتقنيات مختلفه. هناك طلب كبير من قبل مستأجري السحابة للوصول إلى بياناتهم بشكل أسرع دون أي انقطاع. يبدل مقدمو الخدمات السحابية كل جهدهم لضمان تأمين كل البيانات الفردية وإمكانية الوصول إليها دائمًا. ومن الملاحظ بإن استراتيجية النسخ المتماثل المناسبة القادرة على اختيار البيانات الأساسية مطلوبة في بيئات النسخ السحابي كأحد الحلول. اقترحت هذه الورقة استراتيجية اختيار الملفات الحاسمة (CFSS) لمعالجة وقت الاستجابة الضعيف في بيئة النسخ المتماثل السحابي. يتم استخدام محاكي سحابة يسمى CloudSim لإجراء التجارب اللازمة ، ويتم تقديم النتائج لإثبات التحسن في أداء النسخ المتماثل. تمت مناقشة الرسوم البيانية التحليلية التي تم الحصول عليها بدقة ، وأظهرت النتائج تفوق خوارزمية CFSS المقترحة على خوارزمية أخرى موجودة مع تحسن بنسبة 10.47 ٪ في متوسط ​​وقت الاستجابة لوظائف متعددة في كل جولة.Cloud Computing is a mass platform to serve high volume data from multi-devices and numerous technologies. Cloud tenants have a high demand to access their data faster without any disruptions. Therefore, cloud providers are struggling to ensure every individual data is secured and always accessible. Hence, an appropriate replication strategy capable of selecting essential data is required in cloud replication environments as the solution. This paper proposed a Crucial File Selection Strategy (CFSS) to address poor response time in a cloud replication environment. A cloud simulator called CloudSim is used to conduct the necessary experiments, and results are presented to evidence the enhancement on replication performance. The obtained analytical graphs are discussed thoroughly, and apparently, the proposed CFSS algorithm outperformed another existing algorithm with a 10.47% improvement in average response time for multiple jobs per round

Scale development on consumer behavior toward counterfeit drugs in a developing country: A quantitative study exploiting the tools of an evolving paradigm

Background: Although desperate need and drug counterfeiting are linked in developing countries, little research has been carried out to address this link, and there is a lack of proper tools and methodology. This study addresses the need for a new methodological approach by developing a scale to aid in understanding the demand side of drug counterfeiting in a developing country. Methods. The study presents a quantitative, non-representative survey conducted in Sudan. A face-to-face structured interview survey methodology was employed to collect the data from the general population (people in the street) in two phases: pilot (n = 100) and final survey (n = 1003). Data were analyzed by examining means, variances, squared multiple correlations, item-to-total correlations, and the results of an exploratory factor analysis and a confirmatory factor analysis. Results: As an approach to scale purification, internal consistency was examined and improved. The scale was reduced from 44 to 41 items and Cronbach's alpha improved from 0.818 to 0.862. Finally, scale items were assessed. The result was an eleven-factor solution. Convergent and discriminant validity were demonstrated. Conclusion: The results of this study indicate that the "Consumer Behavior Toward Counterfeit Drugs Scale" is a valid, reliable measure with a solid theoretical base. Ultimately, the study offers public health policymakers a valid measurement tool and, consequently, a new methodological approach with which to build a better understanding of the demand side of counterfeit drugs and to develop more effective strategies to combat the problem.This work was supported by the Federal Ministry of Health Sudan.Scopu

Stages of change and health-related quality of life among employees of an institution

Background Transtheoretical Model of change has been used successfully in promoting behaviour change. Objective To examine the relationships between health-related quality of life (HRQoL) scores with the stages of change of adequate physical activity and fruit and vegetables intake. Design This was a cross-sectional study conducted among employees of the main campus and Engineering campus of Universiti Sains Malaysia (USM) during October 2009 and March 2010. Main variables studied: Data on physical activity and fruit and vegetable intake was collected using the WHO STEPS instrument for chronic disease risk factors surveillance. The Short Form-12 health survey (SF-12) was used to gather information on participants' HRQoL. The current stages of change are measured using the measures developed by the Pro-Change Behaviour Systems Incorporation. Statistical analysis: One way ANOVA and its non-parametric equivalent Kruskal-Wallis were used to compare the differences between SF-12 scores with the stages of change. Results A total of 144 employees were included in this analysis. A large proportion of the participants reported inadequate fruits and vegetable intake (92.3%) and physical activity (84.6%). Mean physical and mental component scores of SF-12 were 50.39 (SD = 7.69) and 49.73 (SD = 8.64) respectively. Overall, there was no statistical significant difference in the SF-12 domains scores with regards to the stages of change for both the risk factors. Conclusions There were some evidence of positive relationship between stages of change of physical activity and fruit and vegetable intake with SF-12 scores. Further studies need to be conducted to confirm this association.Scopu

Mothers beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal

Background: In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers beliefs and barriers about diarrhea and its management. Methods. Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis. Results: Twenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers. Conclusions: There were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea.Scopu

Histological and ultrastructural studies on the effect of Cassia alata methanolic leaf extracts against chemically induced lung adenocarcinoma in rats

ABSTRACT The present work aims to evaluate anticancer performance of Cassia alata methanolic leaf extracts (CMLE) in ethyl carbamate-stimulated lung adenocarcinoma (LAD) in differentiation to the function of Cisplatin (CIPL). Rats were divided into four groups: (1) control (CONT), (2) lung-adenocarcinoma (LAD) injected intra-peritoneally with 1g/kg ethyl carbamate once weekly for a month, (3) LAD+CMLE administered 500 mg/kg CMLE orally for the last two months of the experiment, and (4) LAD+CIPL treated group, injected 2.5 mg/kg Cisplatin intraperitoneally once weekly for the last two months of the experiment. Light and electron microscopic examinations revealed adenocarcinoma development in terminal bronchiole besides some histopathological changes in the LAD group such as atypical, exaggerated collagen fibers, increment of mucinous content, and increasing of PCNA positive immunoreactivity whereas electron microscopy investigation exposed that papillary adenocarcinoma originated from Clara cells in the LAD group. The LAD+CMLE treated group showed no tumor masses and nearly all with normal lung histology. It also recovered the normal ultrastructure of bronchiolar Clara cells. CMLE treatment offers a new alternative cure with less toxicity than Cisplatin for lung cancer therapy. Hence, CMLE would be employed as a novel supply of anti-cancer compounds combating lung cancer