Knowledge, Perception and Attitude of Community Pharmacists towards Generic Medicines in Karachi, Pakistan: A Qualitative Insight

Purpose: In an era of escalating healthcare costs and ageing population, there is a need for costeffective measures. This study was aimed to investigate the knowledge, perception and attitude of community pharmacists towards generic medicines. Methods: A  qualitative methodology was adopted. Snowball sampling technique was used to identify eight community pharmacists. Semi-structured interviews were conducted with the pharmacists until the point of saturation was obtained. The interviews, which were audio-taped and transcribed verbatim, were evaluated by thematic content analysis and further verified by other authors’ analyses. Results: Thematic content analysis identified three major themes: knowledge of generic medicines,perception towards generic medicines, and attitude towards generic medicines. All the pharmacist  showed good understanding and positive perception towards generic medicines. Mixed responses were observed regarding dispensing of locally manufactured medicines. Low cost was cited as the major determinant in dispensing locally manufactured generics. Conclusion: The current study showed good knowledge and perception towards generic medicines among community pharmacists in Karachi, Pakistan. It also highlighted mixed attitudes towards generic medicine dispensing. A 24-hour mandatory presence of professionally qualified pharmacists in community pharmacies can boost the confidence of doctors in pharmacists and enhance generic substitution.Keywords:   Community pharmacist, Generic Medicine, Pakistan, Qualitative methodolog

A novel track-drive mobile robotic framework for conducting projects on robotics and control systems

This paper presents a novel robotic framework to help students to practically grasp the concepts of Robotics and Control Systems in a laboratory environment. The framework is centered on a robotic rover having two tank-like tracks which permit locomotion on uneven terrains. The sensory system consists of encoders for position feedback while the actuation system comprises of six precise DC motors. To enhance the learning outcomes of students and to permit readily realizaion of applications, developed software library supports three different command levels. The efficacy of the framework has been demonstrated by presenting a list of projects conducted on the framework. In particular, as a case-study, a project titled tether tracking and control of robotic rover has been detailed in the paper with presentation of experimental results. The pilot study indicated that incorporating the framework in robotics laboratory resulted in an efficient methodology of imparting interdisciplinary knowledge to engineering students. Additionally, the framework finds its potential in research of advanced robotic and control algorithms

Evaluation Of Antibody Response To Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination In Patients With Lymphoid And Solid Organ Malignancies

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the current COVID-19 pandemic. There is emerging evidence regarding suboptimal response to vaccination against COVID-19 in patients with hematologic and solid organ malignancies. We conducted a single-center prospective study assessing seroconversion in response to vaccination against COVID-19 in 53 patients with chronic lymphocytic leukemia (CLL), non-Hodgkin’s lymphoma (NHL), multiple myeloma (MM), and solid organ malignancies. A quantitative immunoassay of IgG antibodies to SARS-CoV-2 Spike (S) protein was measured prior to vaccination and at 2 weeks after completion of two-dose vaccination series. A fourfold increase in antibody titers was considered positive seroconversion. Through a predesigned survey, patients also self-reported side effects from each dose of vaccination. Seroconversion on vaccination was seen in 6/12 (50%) patients with CLL, 7/11 (63.6%) patients with NHL, 9/10 (90%) patients with MM, and 17/20 (85%) patients with solid organ malignancy. Only 6 of the 14 (42.8%) patients currently on or with previous history of rituximab use seroconverted. Injection site soreness was the most reported side effect. The only severe side effect occurred in a patient with solid organ malignancy who developed Parsonage-Turner syndrome. Patients with CLL and NHL appear less likely to respond to vaccination against COVID-19 in contrast to patients with MM or solid organ malignancies. Previous treatment with rituximab is a possible risk factor for suboptimal response to vaccination. These data highlight the importance of continuing risk mitigation strategies against COVID-19 in individuals with hematologic malignancy, particularly those with CLL or on treatment with rituximab

Patterns of cancer cell sphere formation in primary cultures of human oral tongue squamous cell carcinoma and neck nodes

YesRecently a sub-population of cells with stem cell characteristics, reported to be associated with initiation, growth, spread and recurrence, has been identified in several solid tumors including oral tongue squamous cell carcinoma (OTSCC). The aim of our pilot study was to isolate CD44+ cancer stem cells from primary cultures of OTSCC and neck node Level I (node-I) biopsies, grow cell spheres and observe their characteristics in primary cultures. Parallel cultures of hyperplastic lesions of tongue (non-cancer) were set up as a control. Immunohistochemistry was used to detect CD44/CD24 expression and magnetic activated cell sorting to isolate CD44+ cell populations followed by primary cell culturing. Both OTSCC and node-I biopsies produced floating spheres in suspension, however those grown in hyperplastic and node-I primary cultures did not exhibit self-renewal properties. Lymph node metastatic OTSCC, express higher CD44/CD24 levels, produce cancer cell spheres in larger number and rapidly (24 hours) compared to node negative OTSCC (1 week) and non-cancer specimens (3 weeks). In addition, metastatic OTSCC have the capacity for proliferation for up to three generations in primary culture. This in vitro system will be used to study cancer stem cell behavior, therapeutic drug screening and optimization of radiation dose for elimination of resistant cancer cells.SKMCH&RC, Yorkshire Cancer Researc

Isolated Idiopathic Aortitis with an Unusually Thickened Aortic Wall: Case Report

Aortitis includes a broad range of disorders involving inflammation of the aorta. While most forms of aortitis can be linked to a specific cause, patients with idiopathic aortitis (IDA), are asymptomatic and usually diagnosed after surgical removal. The specific pathophysiology is not well understood, but can be strongly associated with tobacco smoking, young age at presentation, and family history of aortic aneurysm. Wall thickening is the most common physical characteristic of aortitis, and the inflammation can affect any layer of the aorta. The normal wall thickness of the aorta is less than 4 mm and can be as thick as 9 mm. Few studies document a correlation between wall thickness and the severity of aortitis. This paper presents a unique case of severe aortic aneurysm associated with an abnormal thickening of the ascending aorta

Correlation Between Previous Caesarean Section and Adverse Maternal Outcomes Accordingly With Robson Classification: Systematic Review and Meta-Analysis

Background: The increasing rates of Caesarean section (CS) beyond the WHO standards (10–15%) pose a significant global health concern. Objective: Systematic review and meta-analysis to identify an association between CS history and maternal adverse outcomes for the subsequent pregnancy and delivery among women classified in Robson classification (RC). Search Strategy: PubMed/Medline, EbscoHost, ProQuest, Embase, Web of Science, BIOSIS, MEDLINE, and Russian Science Citation Index databases were searched from 2008 to 2018. Selection Criteria: Based on Robson classification, studies reporting one or more of the 14 adverse maternal outcomes were considered eligible for this review. Data Collection: Study design data, interventions used, CS history, and adverse maternal outcomes were extracted. Main Results: From 4,084 studies, 28 (n = 1,524,695 women) met the inclusion criteria. RC group 5 showed the highest proportion among deliveries followed by RC10, RC7, and RC8 (67.71, 32.27, 0.02, and 0.001%). Among adverse maternal outcomes, hysterectomy had the highest association after preterm delivery OR = 3.39 (95% CI 1.56–7.36), followed by Severe Maternal Outcomes OR = 2.95 (95% CI 1.00–8.67). We identified over one and a half million pregnant women, of whom the majority were found to belong to RC group 5. Conclusions: Previous CS was observed to be associated with adverse maternal outcomes for the subsequent pregnancies. CS rates need to be monitored given the prospective risks which may occur for maternal and child health in subsequent births

Correlation of FT-IR fingerprint and α-glucosidase inhibitory activity of Salak (Salacca zalacca) fruit extracts utilizing orthogonal partial least square

Salak fruit (Salacca zalacca), commonly known as snake fruit, is used indigenously as food and for medicinal applications in Southeast Asia. This study was conducted to evaluate the α-glucosidase inhibitory activity of salak fruit extracts in correlation to its Fourier transform infrared spectroscopy (FT-IR) fingerprint, utilizing orthogonal partial least square. This calibration model was applied to develop a rapid analytical method tool for quality control of this fruit. A total of 36 extracts prepared with different solvent ratios of ethanol–water (100, 80, 60, 40.20, 0% v/v) and their α-glucosidase inhibitory activities determined. The FT-IR spectra of ethanol–water extracts measured in the region of 400 and 4000 cm−1 at a resolution of 4 cm−1. Multivariate analysis with a combination of orthogonal partial least-squares (OPLS) algorithm was used to correlate the bioactivity of the samples with the FT-IR spectral data. The OPLS biplot model identified several functional groups (C–H, C=O, C–N, N–H, C–O, and C=C) which actively induced α-glucosidase inhibitory activity

Evaluation of the Involvement of Pharmacists in Diabetes Self-Care: A Review From the Economic Perspective

Objectives: To analyze the studies encompassing the involvement of pharmacists in diabetes self-care.Method: We reviewed studies conducted from 2005 to 2017 on the involvement of pharmacists in diabetes self-care. The keywords mainly used in this search are pharmacoeconomic analysis, diabetes self-care, pharmacist involvement,cost-effectiveness analysis, cost of utilization, cost of illness, cost of minimization and cost-benefit analysis. PubMed, Science Direct, Springer Link and Medline searched for the relevant studies. These databases searched for full text articles ranging from 2007 to 2017. We tried to limit the search with the inclusion of studies having any sort of pharmacoeconomically relevant component.Key Findings: Cost of illness varied among the countries in managing diabetes mellitus, and the cost of managing diabetes complications were twice the cost of management of diabetes. Continuous involvement of the pharmacist in primary health care is a cost-effective strategy and pronounced to be essential for helping diabetes patient in controlling and managing their disease. Implementation of diabetes self-care by pharmacists such as lifestyle intervention rendered improved quality of life of patient without any increase in health care cost. Self-care management generates intensive blood glucose control and improved quality of life.Conclusions: Implementation of diabetic self-care intervention including intensive lifestyle intervention, education, self-monitoring of blood glucose and adherence toward medication-initiated reduction in the overall healthcare cost of diabetic patients compared to patients relying on only any one of the interventions. Impact of diabetes self-care intervention by pharmacist reported to significantly reduce the HbA1C levels of diabetic patients along with the reduction of yearly healthcare cost. This review showed that pharmacist involvement in diabetes self-care interventions prove to be cost-effective and can significantly affect the condition of the diabetic patients and reduces the risk of complications