Current Pharmaceutical Situation (Services) in Yemen and Future Challenges

This article deals with Yemen’s current pharmaceutical scenario and possible future challenges that it may face. The manuscript provides an overview of health services particularly pharmaceutical services and the critical health challenges facing the people of the country. Details included are statistical data with regard to the health of the Yemeni population and their demographic backgrounds following administrative issues, policy for the medicinal trade and production, the regulation and financing. The manuscript also deals with the government’s action about medicines, their procurement, and distribution in the public sector, and the public perception of medicines. Rational use of medicines is determined by the knowledge and attitude of the consumers. Future challenges are also anticipated. World health systems have been facing an incredible transformation to address new challenges with regard to the demographics, disease trends, the emergence and the re-emergence of diseases along with higher costs of health care delivery. This has led to a comprehensive review of health systems and how they function to serve the masses. Some health systems do not seem to adequately provide services that really matter to the people and some deteriorate, following governments’ lack of efficiency in supporting and extending the services. Other issues can also affect the ability of the health systems to deliver including health administration, healthcare financing, the lack of balance of the human resources, inaccessible and poor quality services and the impact of modifications and reform prevalent in other economic areas

An educational intervention’s effect on healthcare professionals’ attitudes towards pharmacovigilance

BackgroundPharmacovigilance concerns the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. Consumer pharmacovigilance is the involvement of consumers in adverse drug reaction (ADR) reporting. Assessing healthcare professionals’ (HCPs) knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance is integral to strengthening adverse drug reaction reporting systems. AimsTo study knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance among HCPs from KIST Medical College, Lalitpur, Nepal, and to plan an appropriate educational intervention to address deficiencies noted.Methods The study was conducted from February 2013 to December 2013 at KIST Medical College using a self-administered, pretested, structured questionnaire. The maximum possible scores for knowledge, attitude, and total were 100, 95, and 195, respectively. Baseline knowledge and attitude were studied. Two months after the questionnaire, an intervention that used a combination of methods about pharmacovigilance and consumer pharmacovigilance was undertaken. Knowledge and attitudes were studied immediately after the intervention. Scores before and after the intervention were compared using Wilcoxon signed-rank test.Results A total of 105 HCPs participated. The median (interquartile range) knowledge, attitude, and total scores before the intervention were 56 (7), 72 (9), and 127 (16), respectively. After the intervention the scores increased significantly to 72 (8), 75 (11.5), and 146 (16.5) (

Problems and challenges faced in consumer reporting of adverse drug reactions in developing countries – A case study of Yemen, Nepal and Malaysia

Background: Pharmacovigilance is the “science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems”. The most commonly used adverse drug reaction (ADR) reporting system worldwide is spontaneous and voluntary reporting, which forms the backbone of reporting systems. Aims: To explore the current status of consumer involvement in the pharmacovigilance program in three developing countries, Yemen, Nepal and Malaysia. Method: An analysis was carried out for these three countries based on the current status of pharmacovigilance and involvement of consumers in their pharmacovigilance programs. Results: Malaysia has a good system for involving consumers in their national pharmacovigilance system, whereas Yemen still lacks the well-formed national drug policy. Lack of legislation and regulation which govern the import and distribution of drugs in Yemen is a limiting factor for development of consumer pharmacovigilance. Despite establishment of a pharmacovigilance centre, no reports have been released by the centre. The status of pharmacovigilance in Nepal is still in infancy. The regulatory body is assigned to be a national pharmacovigilance center, and coordinates with seven regional centers for pharmacovigilance activities. Nepal also lacks the involvement of consumers in the national pharmacovigilance program. Conclusion: Consumer reporting may be important for developing countries to implement a proper and effective pharmacovigilance program that can reduce morbidity and mortality rates, as well as reducing the economic burden of ADRs

What do we know about chronic kidney disease in India: first report of the Indian CKD registry

<p>Abstract</p> <p>Background</p> <p>There are no national data on the magnitude and pattern of chronic kidney disease (CKD) in India. The Indian CKD Registry documents the demographics, etiological spectrum, practice patterns, variations and special characteristics.</p> <p>Methods</p> <p>Data was collected for this cross-sectional study in a standardized format according to predetermined criteria. Of the 52,273 adult patients, 35.5%, 27.9%, 25.6% and 11% patients came from South, North, West and East zones respectively.</p> <p>Results</p> <p>The mean age was 50.1 ± 14.6 years, with M:F ratio of 70:30. Patients from North Zone were younger and those from the East Zone older. Diabetic nephropathy was the commonest cause (31%), followed by CKD of undetermined etiology (16%), chronic glomerulonephritis (14%) and hypertensive nephrosclerosis (13%). About 48% cases presented in Stage V; they were younger than those in Stages III-IV. Diabetic nephropathy patients were older, more likely to present in earlier stages of CKD and had a higher frequency of males; whereas those with CKD of unexplained etiology were younger, had more females and more frequently presented in Stage V. Patients in lower income groups had more advanced CKD at presentation. Patients presenting to public sector hospitals were poorer, younger, and more frequently had CKD of unknown etiology.</p> <p>Conclusions</p> <p>This report confirms the emergence of diabetic nephropathy as the pre-eminent cause in India. Patients with CKD of unknown etiology are younger, poorer and more likely to present with advanced CKD. There were some geographic variations.</p

Employing machine learning for reliable miRNA target identification in plants

<p>Abstract</p> <p>Background</p> <p>miRNAs are ~21 nucleotide long small noncoding RNA molecules, formed endogenously in most of the eukaryotes, which mainly control their target genes post transcriptionally by interacting and silencing them. While a lot of tools has been developed for animal miRNA target system, plant miRNA target identification system has witnessed limited development. Most of them have been centered around exact complementarity match. Very few of them considered other factors like multiple target sites and role of flanking regions.</p> <p>Result</p> <p>In the present work, a Support Vector Regression (SVR) approach has been implemented for plant miRNA target identification, utilizing position specific dinucleotide density variation information around the target sites, to yield highly reliable result. It has been named as p-TAREF (plant-Target Refiner). Performance comparison for p-TAREF was done with other prediction tools for plants with utmost rigor and where p-TAREF was found better performing in several aspects. Further, p-TAREF was run over the experimentally validated miRNA targets from species like <it>Arabidopsis</it>, <it>Medicago</it>, Rice and Tomato, and detected them accurately, suggesting gross usability of p-TAREF for plant species. Using p-TAREF, target identification was done for the complete Rice transcriptome, supported by expression and degradome based data. miR156 was found as an important component of the Rice regulatory system, where control of genes associated with growth and transcription looked predominant. The entire methodology has been implemented in a multi-threaded parallel architecture in Java, to enable fast processing for web-server version as well as standalone version. This also makes it to run even on a simple desktop computer in concurrent mode. It also provides a facility to gather experimental support for predictions made, through on the spot expression data analysis, in its web-server version.</p> <p>Conclusion</p> <p>A machine learning multivariate feature tool has been implemented in parallel and locally installable form, for plant miRNA target identification. The performance was assessed and compared through comprehensive testing and benchmarking, suggesting a reliable performance and gross usability for transcriptome wide plant miRNA target identification.</p

Shock Cooling and Possible Precursor Emission in the Early Light Curve of the Type II SN 2023ixf

We present the densely sampled early light curve of the Type II supernova (SN) 2023ixf, first observed within hours of explosion in the nearby Pinwheel Galaxy (Messier 101; 6.7 Mpc). Comparing these data to recently updated models of shock cooling emission, we find that the progenitor likely had a radius of $410 \pm 10\ R_\odot$ (statistical uncertainty only), consistent with a red supergiant. These models provide a good fit to the data starting about 1 day after the explosion, despite the fact that the classification spectrum shows signatures of circumstellar material around SN 2023ixf during that time. Photometry during the first day after the explosion, provided almost entirely by amateur astronomers, does not agree with the shock cooling models or a simple power-law rise fit to data after 1 day. We consider the possible causes of this discrepancy, including precursor activity from the progenitor star, circumstellar interaction, and emission from the shock before or after it breaks out of the stellar surface. The very low luminosity ($-11\mathrm{\ mag} > M > -14\mathrm{\ mag}$) and short duration of the initial excess leads us to prefer a scenario related to prolonged emission from the SN shock traveling through the progenitor system.Comment: submitted to ApJ

Early Spectroscopy and Dense Circumstellar Medium Interaction in SN~2023ixf

We present the optical spectroscopic evolution of SN~2023ixf seen in sub-night cadence spectra from 1.18 to 14 days after explosion. We identify high-ionization emission features, signatures of interaction with material surrounding the progenitor star, that fade over the first 7 days, with rapid evolution between spectra observed within the same night. We compare the emission lines present and their relative strength to those of other supernovae with early interaction, finding a close match to SN~2020pni and SN~2017ahn in the first spectrum and SN~2014G at later epochs. To physically interpret our observations we compare them to CMFGEN models with confined, dense circumstellar material around a red supergiant progenitor from the literature. We find that very few models reproduce the blended \NC{} emission lines observed in the first few spectra and their rapid disappearance thereafter, making this a unique diagnostic. From the best models, we find a mass-loss rate of $10^{-3}-10^{-2}$ \mlunit{}, which far exceeds the mass-loss rate for any steady wind, especially for a red supergiant in the initial mass range of the detected progenitor. These mass-loss rates are, however, similar to rates inferred for other supernovae with early circumstellar interaction. Using the phase when the narrow emission features disappear, we calculate an outer dense radius of circumstellar material $R_\mathrm{CSM, out}\sim5\times10^{14}~\mathrm{cm}$ and a mean circumstellar material density of $\rho=5.6\times10^{-14}~\mathrm{g\,cm^{-3}}$. This is consistent with the lower limit on the outer radius of the circumstellar material we calculate from the peak \Halpha{} emission flux, $R_\text{CSM, out}\gtrsim9\times10^{13}~\mathrm{cm}$.Comment: Submitted to ApJ