The Approach of Pharmacy Students Towards Communication of Medication Errors in Karachi, Pakistan

Purpose: To assess pharmacy students’ knowledge of communicating medication errors in Karachi, Pakistan.Methods: The study design was cross-sectional and conducted from February to May 2014. A previously validated questionnaire was adopted, modified and distributed to final year pharmacy students in four universities of Karachi. Descriptive statistics were used to present students’ demographic information and their response to the questionnaire items. Pearson chi square test and Logistic regression model were executed to evaluate the association of gender and institution of students with their response.Results: Out of 600 survey questionnaires distributed, only 464 were returned in useable form, giving a response rate of 77.33 %. A majority of the students showed moderately positive attitude towards general communication and training in communicating medication errors. More than 40 % of the respondents were not satisfied with the training they received in communicating and reporting incidence of medication errors. Incorrect drug (14.65 %), incorrect dose (8.40 %) and improper storage of medicines (7.97 %) were the most common errors observed by the students during clerkship.Conclusion: The findings indicate the need for a more standardized approach to improving knowledge of medication errors as well as training in the communication of occurrence of medication errors.Keywords: Communication, Medication error, Pharmacy students, Standardized trainin

Preparation of NLCs-Based Topical Erythromycin Gel: In Vitro Characterization and Antibacterial Assessment

In the present study, erythromycin (EM)-loaded nanostructured lipid carriers (NLCs) were prepared by the emulsification and ultra-sonication method. EM-NLCs were optimized by central composite design using the lipid (A), pluronic F127 (B) and sonication time (C) as independent variables. Their effects were evaluated on particle size (Y1) and entrapment efficiency (Y2). The optimized formulation (EM-NLCs-opt) showed a particle size of 169.6 ± 4.8 nm and entrapment efficiency of 81.7 ± 1.4%. EM-NLCs-opt further transformed into an in-situ gel system by using the carbopol 940 and chitosan blend as a gelling agent. The optimized EM-NLCs in situ gel (EM-NLCs-opt-IG4) showed quick gelation and were found to be stable for more than 24 h. EM-NLCs-opt-IG4 showed prolonged drug release compared to EM in situ gel. It also revealed significant high permeation (56.72%) and flux (1.51-fold) than EM in situ gel. The irritation and hydration study results depicted no damage to the goat cornea. HET-CAM results also confirmed its non-irritant potential (zero score). EM-NLCs-opt-IG4 was found to be isotonic and also showed significantly (p < 0.05) higher antimicrobial activity than EM in situ gel. The findings of the study concluded that NLCs laden in situ gel is an alternative delivery of erythromycin for the treatment of bacterial conjunctivitis

Exome sequencing efficacy and phenotypic expansions involving esophageal atresia/tracheoesophageal fistula plus

Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a life-threatening birth defect that often occurs with other major birth defects (EA/TEF+). Despite advances in genetic testing, a molecular diagnosis can only be made in a minority of EA/TEF+ cases. Here, we analyzed clinical exome sequencing data and data from the DECIPHER database to determine the efficacy of exome sequencing in cases of EA/TEF+ and to identify phenotypic expansions involving EA/TEF. Among 67 individuals with EA/TEF+ referred for clinical exome sequencing, a definitive or probable diagnosis was made in 11 cases for an efficacy rate of 16% (11/67). This efficacy rate is significantly lower than that reported for other major birth defects, suggesting that polygenic, multifactorial, epigenetic, and/or environmental factors may play a particularly important role in EA/TEF pathogenesis. Our cohort included individuals with pathogenic or likely pathogenic variants that affect TCF4 and its downstream target NRXN1, and FANCA, FANCB, and FANCC, which are associated with Fanconi anemia. These cases, previously published case reports, and comparisons to other EA/TEF genes made using a machine learning algorithm, provide evidence in support of a potential pathogenic role for these genes in the development of EA/TEF