The Effect of Elaeagnus angustifolia L. Cream on Radiation-Induced Skin Reactions in Women with Breast Cancer; A Preliminary Clinical Trial: Running title?????

Radiotherapy, a highly effective way to destroy breast cancer, causes skin adverse effects. A considerable amount of studies have been conducted to find a way to alleviate or relieve dermal adverse effects of radiation. The aim of this study was to observe the clinical effect of Elaeagnus angustifolia L. cream to treat radiotherapy-induced skin destruction in breast cancer patients.Thirty two patients suffering from different stages of radiotherapy-induced skin reactions were evaluated in a double-blind randomized study; 16 patients in the treatment group received Elaeagnus angustifolia cream, while the other 16 patients, served as control group.Two weeks after the treatment, patients in Elaeagnus angustifolia group showed significantly lower skin reaction grade compared with placebo group. The attitude of the patients of Elaeagnus angustifolia group about dryness, itching, pain, burning, blisters and sores was significantly improved after two weeks of treatment.Elaeagnus angustifolia cream may effectively reduce the radiotherapy-induced dermal injury

Asthma: Achievements and Questions in Front: Asthma: achievements and questions in front

Asthma, which is mainly distinguished by airway inflammation and bronchial hyper-responsiveness, is known as one of the most common chronic diseasesworldwide. It also is the most frequent chronic respiratory disorder amongst all age groups. On one side of the asthma story, there are massive investment of time, effort and money, a large number of pharmaceutical and academic research studies, health service modifications and revised guidelines. On the other side, there are unacceptably high, but mostly preventable, morbidity and mortality rates, socio-economic burdens and psychological problems due to asthma. A considerable proportion of doctor’s workload, hospital resources, health utilization costs, days off from school and work are caused by asthma. Our knowledge about this disorder and its complications is still on demand. There are significant questions regarding asthma and its pathophysiology which should be answered. National, regional and local initiatives are needed to be established to help health systems to overcome socio-economic burdens dueto this disease. These could only be done if a clear picture of this respiratory disorder and its management achievements are available. This review article is anapproach to present an image about asthma and its management based on the current understandings of the nature of this disorder

Clinical Pharmacy in Iran: Evolution and Up-to-Date Developmental

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Prioritizing the Factors Affecting the Abuse of Pharmaceutical Opioids by Applying Topsis: Factors Affecting the Abuse of Pharmaceutical Opioids

Human societies have witnessed the phenomenon of ever-increasing use of pharmaceutical opioids for a long time. Moreover, cultural, social, and economic aspects in any community have undergone the negative effects of the growing tendency toward opioids addiction. Since abusing pharmaceutical opioids is a serious problem, it is important to recognize and prioritize the factors influencing this abuse. This paper concentrates on assessing the priorities of variables which have effects on the abuse of pharmaceutical opioids in order to help the policy makers to make correct decisions to reduce the abuse of opioids.Topsis is applied as a method for Multi-Attribute decision making, which prioritizes alternatives in a simple but efficient way. Topsis method identifies the closeness of each alternative to the ideal solution. In this method, each alternative should have the shortest distance from the best solution and the farthest distance from the worst solution. According to the findings, ―family role‖ and ―extra prescription‖ are the most important factors in variables

Hemorrhagic Events in Patients Receiving Heparin or Enoxaparin in Combination With Oral Antithrombotics, NSAIDs, and Antiplatelet Medications: A Multi-Center Case-Series Study

Background: Hemorrhagic events are amongst the significant adverse effects of injectable anticoagulants such as heparin and enoxaparin. This undesirable effect needs close monitoring of their use for clinically relevant drug-drug interactions.Objectives: To study the rate of hemorrhagic events, the anatomical site, and the severity of the bleeding in patients receiving heparin or enoxaparin in combination with clopidogrel, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and warfarin.Methods: We designed a prospective, multi-center, case-series study. Patients admitted to two teaching hospitals who received either an NSAID, or warfarin, or clopidogrel were evaluated. Any hemorrhagic event was recorded by Yellow Card Scheme. Also, the Naranjo scale was utilized for causality assessment.Results: A total of 123 patients were eligible for inclusion. They were admitted between November 2014 and April 2015. Sixty-five patients (52.5%) received heparin and 58 patients (47.2%) received enoxaparin. Of 123 patients, 115 patients (93.5%) received aspirin, 69 (56.1%) warfarin, 34 (27.6%) an antiplatelet medication, and 121 (98.4%) NSAIDs in combination with heparin or enoxaparin. Overall, 26 cases (21.1%) of the hemorrhagic incident were reported, of whom six cases (4.9%) were categorized as major bleeding. Patients receiving heparin constituted the largest proportion among all 26 hemorrhagic incidents (57.7%). All patients with the hemorrhagic incident had aspirin in their medication regimen, while 19 patients (73.0%) were concomitantly receiving warfarin as well. Hematuria (46.2%), hematoma in the injection site (38.5%), and hematoma (34.6%) were the top three types of hemorrhagic events. In Naranjo scale analysis, 19 patients scored more than 9 points, indicating a definite Adverse Drug Reaction (ADR) causality. Moreover, seven patients scored 5 to 8, affirming a possible association with ADR.Conclusion: The risk of hemorrhagic can be influenced by undesirable drug-drug interactions. Close monitoring of high-risk patients is advised to prevent adverse hemorrhagic reactions. Further studies to detect the explanatory factors associated with the hemorrhagic events are recommended

Study of the Neuroprotective Effects of Memantine in Patients with Mild to Moderate Ischemic Stroke

Abstract Ischemic stroke is amongst the top four causes of mortality and the leading cause of disability in the world. The aim of this study was to evaluate the efficacy of a high dose memantine on neurological function of patients with ischemic stroke. In a randomized, 2 armed, open-label study, patients with mild to moderate cerebral thromboembolic event (CTEE) who admitted to Imam Hossein Hospital, Tehran, Iran, during preceding 24 hours, entered the study. Patients allocated in two study groups of memantine (as add-on therapy) and control. All patients were managed based on the American Heart Association and American Stroke Association (AHA/ASA) guidelines. Patients in memantine group received conventional treatment plus memantine 20 mg TID. The National Institute of Health Stroke Scale (NIHSS) was determined and recorded daily. The primary objective was comparison of the changes in NIHSS in the study groups at day 1 and day 5 of intervention. Significance level of p<0.05 was considered for statistical analysis. Patients were randomly allocated in control (15 women and 14 men, age 70.78 ± 10.92 years) and memantine (16 women and 8 men, age 73.33 ± 9.35 years) groups. There were no significant differences in age and sex distribution of two study groups as well as in comorbidities and concurrent drugs. NIHSS changes were significantly different between control (1.24 ± 0.96) and memantine group (2.96 ± 0.1), (p < 0.0001). Our results reveal that memantine added to standard treatment of CTEE could result in a remarkable decrease in the NIHSS confirming improvement of the neurological function of the patients

Medication Errors in Administration of Chemotherapeutic Agents: an Observational Study: Medication Errors in Administration of Chemotherapeutic Agents

Chemotherapy medication errors may lead to potentially harmful consequences while most of them could be preventable. This study aims to determine the incidence and type of drug handling and administration errors among the nurses and to identify possible contributing factors. Setting of the study was a teaching hospital affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. To attain the study objectives, an observational, cross-sectional study was performed in the haematology and oncology wards of the hospital. A checklist consisting of appropriate process of handling, preparation and administration of injectable chemotherapy agents was developed and used by a trained pharmacist. In addition, socio-demographic characteristics of nurses were recorded. The primary outcome was the number and type of medication errors in chemotherapy administration according to the prepared check lists. Overall, administration processes of 544 chemotherapy medications, consisting of 8322 error opportunities, were observed of which 2705 (32.5%) errors were detected. 52.8% (2926/5532), 15.5% (254/1635) and 26.5% (306/1155) of the errors were in the handling, preparation and injection stages, respectively. The top 5 drugs with the highest risk of errors were metotraxate 45.4% (20/44), fluorouracil 38.5% (439/1139), cyclophosphamide 37.1% (267/719), vincristine 34.8% (240/689) and etoposide 33.5% (125/373). Our results revealed a substantial occurrence rate of medication errors during preparation and administration of injectable chemotherapy agents, which are often made by nurses who fail to follow relevant nursing standards. This confirms that educational programs and advanced pharmaceutical care services are required for safe preparation and administration of intravenous chemotherapy agents

Oxidative stress in kidney transplantation: causes, consequences, and potential treatment.

Oxidative stress is a major mediator of adverse outcomes throughout the course of transplantation. Transplanted kidneys are prone to oxidative stress-mediated injury by pre-transplant and post-transplant conditions that cause reperfusion injury or imbalance between oxidants and antioxidants. Besides adversely affecting the allograft, oxidative stress and its constant companion, inflammation, cause cardiovascular disease, cancer, metabolic syndrome, and other disorders in transplant recipients. Presence and severity of oxidative stress can be assessed by various biomarkers produced from interaction of reactive oxygen species with lipids, proteins, nucleic acids, nitric oxide, glutathione, etc. In addition, expression and activities of redox-sensitive molecules such as antioxidant enzymes can serve as biomarkers of oxidative stress. Via activation of nuclear factor kappa B, oxidative stress promotes inflammation which, in turn, amplifies oxidative stress through reactive oxygen species generation by activated immune cells. Therefore, inflammation markers are indirect indicators of oxidative stress. Many treatment options have been evaluated in studies conducted at different stages of transplantation in humans and animals. These studies have provided useful strategies for use in donors or in organ preservation solutions. However, strategies tested for use in post-transplant phase have been largely inconclusive and controversial. A number of therapeutic options have been exclusively examined in animal models and only a few have been tested in humans. Most of the clinical investigations have been of short duration and have provided no insight into their impact on the long-term survival of transplant patients. Effective treatment of oxidative stress in transplant population remains elusive and awaits future explorations

Oxidative stress in kidney transplantation: causes, consequences, and potential treatment.

Oxidative stress is a major mediator of adverse outcomes throughout the course of transplantation. Transplanted kidneys are prone to oxidative stress-mediated injury by pre-transplant and post-transplant conditions that cause reperfusion injury or imbalance between oxidants and antioxidants. Besides adversely affecting the allograft, oxidative stress and its constant companion, inflammation, cause cardiovascular disease, cancer, metabolic syndrome, and other disorders in transplant recipients. Presence and severity of oxidative stress can be assessed by various biomarkers produced from interaction of reactive oxygen species with lipids, proteins, nucleic acids, nitric oxide, glutathione, etc. In addition, expression and activities of redox-sensitive molecules such as antioxidant enzymes can serve as biomarkers of oxidative stress. Via activation of nuclear factor kappa B, oxidative stress promotes inflammation which, in turn, amplifies oxidative stress through reactive oxygen species generation by activated immune cells. Therefore, inflammation markers are indirect indicators of oxidative stress. Many treatment options have been evaluated in studies conducted at different stages of transplantation in humans and animals. These studies have provided useful strategies for use in donors or in organ preservation solutions. However, strategies tested for use in post-transplant phase have been largely inconclusive and controversial. A number of therapeutic options have been exclusively examined in animal models and only a few have been tested in humans. Most of the clinical investigations have been of short duration and have provided no insight into their impact on the long-term survival of transplant patients. Effective treatment of oxidative stress in transplant population remains elusive and awaits future explorations

Impact of Corporate Reputation on Brand Segmentation Strategy: An Empirical Study from Iranian Pharmaceutical Companies: Impact of Reputation on Pharmaceutical Brand Segmentation

The impact of corporate reputation uses, including value creation, corporate communication, and strategic resources on branding strategies such as segmentation and producing intangible assets for different industries is investigated in western countries in the past few years, but there is a gap for the generalizability of findings to countries out of the United States and Europe. To establish the western researcher‟s external validity of theories in other countries and to obtain a better understanding of the influences of branding and corporate reputation in pharmaceutical business markets, the researchers applied this study for Iran, as a country in the Middle East. The obtained results using SEM (by P.L.S. 2.0 software) showed a weak relation between value creation and brand segmentation (β = 3.007 and t-value = 1.806) and no significant relation between corporate communication and strategic resources with brand segmentation (β = 0.199 and t-value = 1.301) and (β = 3.046 and t-value = 1.465). Based on these findings; and previous researches in this field, it seems that pharmaceutical managers and marketers need to change their thoughts and practices regarding segmentation and reputation.This study is a pioneering attempt in Iran to evaluate the impact of corporate reputation on brand segmentation strategy