Exploring community pharmacists perception towards responsible provision of patient care services: A quantitative assessment

Purpose: To investigate the perception of community pharmacists with regard to pharmaceutical care services in Khyber Pakhtunkhwa (KPK), Pakistan.Methods: This was a cross-sectional survey carried out among the community pharmacists in seven divisions of KPK, namely, Bannu, Dera Ismail Khan, Hazara, Kohat, Malakand, Mardan, and Peshawar. The survey was conducted between July and September 2014. A total of 22 community  pharmacists were identified and approached.Results: Eighteen community pharmacists returned the filled questionnaire showing a response rate of 81.8 %. All participants (n = 18, 100 %) were male. The majority of the participants 55.6 % (n = 10) made it clear that they had never interacted with doctors, while only 33.3 % (n = 6) reported weekly interaction. The major reasons for interaction were to discuss drug alternatives (38.9 %, n = 7) and the availability of prescribed drugs (33.3 %, n = 6). Meanwhile, about 83.3 % (n = 15) of community pharmacists were involved in educating patients, while only 38.9 % (n = 7) spend enough time on each patient. Further, a large proportion of respondents had never documented patients’ medical, allergy and family histories (83.3 %, n = 15). Only 44.4 % (n = 8) of community pharmacists sometimes checked and signed the prescription.Conclusion: Community pharmacists are few in number in the studied area. They are involved in patient counseling but face difficulties in  counseling due to lack of time and insufficient pharmacy staff. Therefore, there is a need to significantly enhance the interaction between  pharmacists and other healthcare professionals to facilitate inter-professional collaboration. Keywords: Community pharmacy, Pharmaceutical care, Perception, Inter-professional collaboratio

Targeting of protein expression in renal disease using siRNA – A review

The kidneys have rarely been used as a target in the systemic delivery of siRNA when compared to other tissues or organs in the body. This review article deals with various modalities adopted to deliver siRNA to the renal system under different normal and pathophysiological states. In this article, the authors have reviewed extensive clinical data that describe the use of siRNA for the treatment of renal diseases. Conventional and 3D modeling utilizes the existing genome-based RNA libraries, which facilitated the identification of molecular pathways involved in renal diseases. Keywords: siRNA, kidney disease, targeting proteins, signal pathway

Current views of community and hospital pharmacists on pharmaceutical care services in the United Arab Emirates: A mixed methodological study [version 2; peer review: 2 approved]

Background: The profession of pharmacy has evolved significantly in recent years in terms of professional service delivery. The aim of this study was to explore the current views of pharmacists in the United Arab Emirates (UAE) on pharmaceutical care services and the nature of barriers encountered in practice using qualitative and quantitative assessment methods. Methods: A cross-sectional study was conducted among hospital and community pharmacists (n = 305) between March and May 2021, using qualitative and quantitative assessment methods. In the qualitative phase, 15 interviews were conducted to explore five main criteria: patient information, inadequate patient counseling, prescribing errors prevention and identifying drug-related problems, lack of participation in health awareness programs, and barriers to pharmaceutical care implementation. In the quantitative phase, 305 consenting pharmacists completed a questionnaire on seven criteria: demographic profile, pharmacist-physician interaction, patient counseling assessment, patient reports of adverse drug events, pharmacist participation in health awareness programs, perceptions of reducing prescribing errors and identifying drug-related problems, and barriers to appropriate pharmaceutical care implementation. Results: The results of both the qualitative and quantitative phases of the study revealed that pharmacists' influence on practice in the UAE is limited due to many factors, mainly lack of time and patients' ignorance of the pharmacist's role in the medical field. The mean responses regarding pharmacists' approach to patient counseling and patients' knowledge of pharmacists' role in managing adverse drug reactions were 77.1% and 59.7%, respectively. Active participation in health awareness programs was 64.8%. The mean positive response of participants in reducing prescribing errors and recognizing drug-related problems was 9.2%. Pharmacists' age and number of years in practice were the most important factors influencing the pharmaceutical care services implementation. Conclusion: The study has shown the need to shed light on the proper implementation of pharmaceutical care while maintaining a trusting relationship with physicians

Emerging Prospects for Nanoparticle-Enabled Cancer Immunotherapy

One of the standards for cancer treatment is cancer immunotherapy which treats both primary and metastasized tumors. Although cancer immunotherapeutics show better outcomes as compared with conventional approaches of cancer treatment, the currently used cancer immunotherapeutics have limited application in delivering cancer antigens to immune cells. Conversely, in solid tumors, tumor microenvironment suppresses the immune system leading to the evasion of anticancer immunity. Some promising attempts have been made to overcome these drawbacks by using different approaches, for instance, the use of biomaterial-based nanoparticles. Accordingly, various studies involving the application of nanoparticles in cancer immunotherapy have been discussed in this review article. This review not only describes the modes of cancer immunotherapy to reveal the importance of nanoparticles in this modality but also narrates nanoparticle-mediated delivery of cancer antigens and therapeutic supplements. Moreover, the impact of nanoparticles on the immunosuppressive behavior of tumor environment has been discussed. The last part of this review deals with cancer immunotherapy using a combination of traditional interventional oncology approach and image-guided local immunotherapy against cancer. According to recent studies, cancer therapy can potentially be improved through nanoparticle-based immunotherapy. In addition, drawbacks associated with the currently used cancer immunotherapeutics can be fixed by using nanoparticles

Therapeutic Implications of a Polymethoxylated Flavone, Tangeretin, in the Management of Cancer via Modulation of Different Molecular Pathways

Chemotherapeutics can induce oxidative stress, inflammation, apoptosis, mitochondrial dysfunction, and abnormalities in neurotransmitter metabolism leading to toxicity. Because there have been no therapeutic strategies developed to target inflammation and oxidative stress, there is a continuing need for new and improved therapy. As a result, there has been increasing interest in complementary and alternative medicine with anticancer potential. Studies have shown that the antioxidant activities and anti-inflammatory effects of citrus fruits are promising natural phytochemicals in the development of new anticancer agents. Tangeretin is a naturally polymethoxylated flavone compound extracted from the citrus peel that has shown significant intestinal absorption and adequate bioavailability, with the added benefit of promoting longevity. In addition, tangeretin is known to exhibit considerable selective toxicity to many types of cancer cell proliferation such as ovarian, brain, blood, and skin cancer. Evidence indicates that tangeretin acts through several mechanisms including growth inhibition, induction of apoptosis, autophagy, antiangiogenesis, and estrogenic-like effects. Furthermore, tangeretin works through mitigating levels of inflammatory mediators in the immune system. Using tangeretin in combination with clinically applied anticancer drugs could be a good strategy for increasing the efficiency of these agents and protecting noncancerous cells from damage caused by chemotherapy. The purpose of this review is to highlight the protective effects of a novel natural product, tangeretin against chemotherapeutic-induced toxicity. The development of chemoprevention strategies can lead to significant health care improvement in cancer survivors. Thus, study outcomes may attract more investigators to conduct tangeretin-related research and find out potentially significant impacts on health care of cancer patients and decreased health problems associated with chemotherapeutics-induced toxicity

Ficus carica and Sizigium cumini Regulate Glucose and Lipid Parameters in High-Fat Diet and Streptozocin-Induced Rats

Obesity linked diabetes, popularly known as diabesity, has been viewed as a direct product of the modern lifestyle in both developed and developing countries, and its increased prevalence is seen as a major threat to public health globally. Ficus carica (FC) and Syzigium cumini (SC) are part of indigenous flora with traditional medicinal properties. Fresh seeds of SC fruit and fruit of FC were collected and macerated to obtain the final extract. Wistar rats were divided into seven groups fed either on a normal diet or high-fat diet (HFD) along with streptozocin (STZ) to induce diabesity. The crude extract of FC (FC.Cr.) and SC (SC.Cr.) were administered at 250 mg/kg/day and 500 mg/kg/day in induced diabesity state. Body weights, blood glucose level, complete blood count (CBC), cholesterol, triglycerides (TG), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) were recorded to analyze their effects on glucose and lipid metabolism. Further, superoxide dismutase (SOD) and malondialdehyde (MDA) were measured to examine their effects on lipid peroxidation and ant oxidative enzyme. Results showed that both FC.Cr. and SC.Cr. have the potential to control obesity-linked type 2 diabetes mellitus (T2DM) by lowering the body weights, serum glucose, cholesterol, TG, LDL, and VLDL, while increasing the protective effects of HDL dose-dependently. The crude extract of both plants showed significant activity to raise SOD and curb MDA under diabetic states. It was concluded that both FC.Cr. and SC.Cr. exhibited remarkable therapeutics potential in HFD-STZ-induced diabetic rats. However, we found that the effects of SC.Cr. are relatively more pronounced as compared to FC.Cr. in almost all parameters

In Silico Prediction of the Mode of Action of Viola odorata in Diabetes

Background. The metabolic syndrome increases the risk of different diseases such as type 2 diabetes. The prevalence of metabolic syndrome has rapidly grown and affected more than 230 million people worldwide. Viola odorata is a traditionally used plant for the treatment of diabetes; however, its mechanism to manage diabetes is still unknown. Purpose. This study was designed to systematically assess the mechanism of action of Viola odorata in diabetes. Methods. An extensive literature search was made to establish an ingredient-target database of Viola odorata. Of these, targets related to diabetes were identified and used to develop a protein-protein interaction network (PPIN) by utilizing the STITCH database. The obtained PPIN was assessed through Gene Ontology (GO) enrichment analysis based on ClueGO plugin. Results. According to the acquired data, there were about 143 chemical constituents present in Viola odorata having 119 protein targets. Of these, 31 targets were established to give the pharmacological effect against diabetes. The UniProt database was used for screening of 31 targets, out of which Homo sapiens contained 22 targets. Ultimately, 207 GO terms, grouped into 41 clusters, were found by gene analysis, and most of them were found to be linked with diabetes. According to findings, several proteins including TP53, BCL2, CDKN1A, 1L6, CCND1, CDKN2A, and RB1 have a significant role in the treatment of diabetes by Viola odorata. Conclusion. The possible activity of Viola odorata in the management of diabetes may be mediated by several molecular mechanisms, including the glutamine metabolic process, IRE1-mediated unfolded protein response, and pentose metabolic process

Zinc's protective role against hydroxychloroquine-induced cardiac effects in adult male albino rats

Background: Long exposure to Hydroxychloroquine (HCQ) has been complicated by some dangerous though infrequent cardiotoxicity. Methods: A total of 40 normal adult male albino rats dispersed into 4 groups were used. Group 1 (Control group), Group II (HCQ treated group), Group III (zinc [Zn]-treated group), and Group IV (HCQ and Zn treated group). Once the experimentation ended, rats were sacrificed and cardiac soft tissue sections were processed twenty-four hours at the end of the experiment for histological study. Results: Cardiac-stained sections revealed that HCQ induced widespread necrosis, dilatation, and vacuolar degeneration. However, the combination of HCQ with Zn ameliorated these damaging effects. Cardiac enzyme parameters were also studied in the 4 groups and revealed CK-MB and troponin were considerably elevated in groups II associated to the control group. Conclusion: It was concluded that Zn revealed a protective role against HCQ cardiomyopathy in adult male albino rats. This might signify an appreciated means for Zn-based treatment in the upcoming subsequent clinical records to adjust doses and guarantee patient safeguard

Synthesis of cross-linked carboxymethyl cellulose and poly (2-acrylamido-2-methylpropane sulfonic acid) hydrogel for sustained drug release optimized by Box-Behnken Design

This research aims to fabricate and characterize chemically crosslinked CMC/PVP-co-poly (AMPS) based hydrogel for the sustained release of model drug metoprolol tartrate through the free radical polymerization technique. Box-Behnken Design was used to optimize CMC/PVP-co-poly (AMPS) hydrogel by varying the content of reactants such as; polymers (CMC and PVP), monomer (AMPS), and crosslinker (EGDMA). Carboxymethyl cellulose (CMC) was crosslinked chemically with AMPS with a constant ratio of PVP by the ethylene glycol dimethacrylate as the crosslinker in the presence of sodium hydrogen sulfite (SHS)/ammonium peroxodisulfate (APS) as initiators. After developing CMC-based hydrogels using different polymers, monomer, and crosslinker concentrations, this study encompassed dynamic swelling, sol–gel fraction, drug release and chemical characterizations such as FTIR, XRD, TGA, DSC, and SEM. In vitro drug release and swelling were performed at 1.2 and 6.8 pH to determine the sustained release pattern and pH-responsive behavior. These parameters depended on the crosslinker, polymer, and monomer ratios used in the formulation development. XRD, SEM, and FTIR showed the successful grafting of constituents resulting in the formation of a stable hydrogel. DSC and TGA confirmed the thermodynamic stability of the hydrogel. Hydrogel swelling was increased with an increase in the ratio of monomer; however, an increase in the ratio of polymer and crosslinker decreased the hydrogel swelling. In vitro gel fraction and drug release also depended on polymer, monomer, and crosslinker ratios. The fabricated CMC/PVP-co-poly (AMPS) hydrogels constituted a potential system for sustained drug delivery