HOSPITAL PHARMACY PRACTICE IN HEALTH INSTITUTIONS OF KATHMANDU VALLEY OF NEPAL: GENERAL SCENARIO

Abstract: Hospital pharmacy aims to contribute to health improvement and to help patients with health problems by making the best use of the medicines. Pharmacy is the last place where any patient encounters the health professionals before the starting of medication. Dispenser should be well qualified to ensure that patient/patient attendant receive all the necessary information before s/he leaves the pharmacy which is possible through good interaction between them. However besides the personnel involved in pharmacy, quality service from the pharmacy might also be affected by the location, facilities, and overall environment of the pharmacy, types and volume of prescribed drugs etc. The study aims to assess the facilities & personnel of hospital pharmacy based on National Good Pharmacy Practice guideline, and to see the dispensing practice, by analyzing the dispensing time, assessing the quality of label, the communication between dispenser and patient/patient attendant and the dispensing knowledge of the dispenser. It is a prospective study and has involved observation of the site and questionnaires (based on GPP guidelines and general) designed by the researchers to assess the aforementioned based on the response given by 68 dispensers. To assess the dispensing time, quality of label and interaction between dispenser and patient and patient attendant etc, a total of dispensing of 252 prescriptions in 19 hospitals were observed. None of pharmacies in hospital were seen to fully comply with all the selected GPP guidelines. Only 6.67% of pharmacies had separate counseling room. Majority of dispensers were found to be ignoring the importance of apron during dispensing. However Narcotic drugs were stored in lock and key system in all the hospital. Only 5.08% of pharmacy had its own compounding area. 60.29% of the dispensers were of D.Pharm qualified. 27.19% were B. Pharm graduate working as the Incharge of pharmacy. 55.93% hospital pharmacist were not under the management of hospital administration. Only 13.56% hospital had Drugs and Therapeutics Committee (DTC). The average dispensing time was found to be 90.44 seconds. None of prescriptions were adequately labeled. The results show that lots of improvement needs to be done in the dispensing practice. Similarly, the concept of GPP is still in budding stage and all the related sector should work together for proper implementation of GPP

Predicting Motif-Mediated Interactions Based on Viral Genomic Composition

Viruses manipulate host cellular machinery to propagate their life cycle, with one key strategy being the mimicry of short linear motifs (SLiMs) found in host proteins. While databases continue to expand with virus–host protein–protein interaction (vhPPI) data, accurately predicting viral mimicry remains challenging due to the inherent degeneracy of SLiMs. In this study, we investigate how viral genomic composition influences motif mimicry and the mechanisms through which viruses hijack host cellular functions. We assessed domain–motif interaction (DMI) enrichment differences, and also predicted new DMIs based on known viral motifs with varying stringency levels, using SLiMEnrich v.1.5.1. Our findings reveal that dsDNA viruses capture significantly more known DMIs compared to other viral groups, with dsRNA viruses also exhibiting higher DMI enrichment than ssRNA viruses. Additionally, we identified new vhPPIs mediated via SLiMs, particularly within different viral genomic contexts. Understanding these interactions is vital for elucidating viral strategies to hijack host functions, which could inform the development of targeted antiviral therapies.</jats:p

Targeting Oncogenic Signaling Pathways in Lung Cancer: The Emerging Role of Nobiletin, a flavonoid from citrus peel

Lung cancer continues to have a high incidence rate, exhibiting a five-year overall survival percentage of merely 18.6%. Despite advancements in conventional therapeutic approaches, drug resistance and treatment-associated toxicities remain major challenges. Recent research has focused on plant-derived molecules as promising therapeutic alternatives due to their low toxicity and significant anticancer effects. Nobiletin, a flavonoid enriched with polymethoxylated groups present in citrus peel, has exhibited diverse therapeutic properties, including antioxidants, immunomodulatory, neuroprotective, and antitumor activities. This review highlights anti-lung cancer activity of nobiletin by modulating critical tumor-promoting signaling pathways thereby suppressing cancer cell proliferation, infiltration, and metastasis. Most importantly, nobiletin triggers cancer cell apoptosis by caspase-3 activation and poly-(ADP-ribose) polymerase cleavage and functions as a key regulator in mitigating drug resistance by regulating various signaling pathways. However, its medical use is constrained by poor aqueous solubility and limited bioavailability. To mitigate these challenges, advanced drug delivery systems have been explored, including polymeric nanoparticles, nano-dispersed solids, micelles, and nano emulsions. Nanotechnology-based formulations such as self-micro emulsifying drug delivery systems, chitosan-based microemulsions, and liposomal encapsulation have significantly improved the nobiletin’s stability, solubility, and targeted delivery. These approaches enhance its therapeutic efficacy, positioning nobiletin as a potential therapeutic strategy for lung cancer treatment

Cellular senescence in chronic obstructive pulmonary disease: Molecular mechanisms and therapeutic interventionsa.

Chronic obstructive pulmonary disease (COPD) is the world's fourth highest reason for mortality, accounting for 3.5 million deaths in 2021, and about 5% of total global deaths. Emphysema and chronic bronchitis are the two major pathologies of COPD. Tobacco smoke, dust, vapors, and fumes, outdoor air pollutants, genetic factors, ageing, infections, and asthma are the risk factors of COPD. On the other hand, senescence is permanent halt in cell cycle accompanied by phenotypic alterations due to ageing, oxidative stress like; irreparable DNA damage, telomere shortening, oncogene activation or inactivation of tumor suppressors. COPD is often considered an accelerated ageing process of the lungs, with senescent cells impairing tissue repair and regeneration, causing progressive lung function decline. Although, cellular senescence is seen as powerful defense against risk of carcinogenesis in COPD as it arrests cell proliferation irreversibly, excessive collection of senescent cells releases senescence-associated secretory phenotype (SASP) that increase oxidative stress to lungs and leads to long-term inflammation, tissue damage, and hindered lung recovery. This review will address the accelerated ageing process and cellular senescence in COPD, therapeutic approaches targeting senescence regulation in COPD; clinical research and trial studies demonstrating the use of therapies aimed at senescence in COPD along with current obstacles and potential solutions

The Role of Cultural and Family Values on Social Connectedness and Loneliness among Ethnic Minority Elders

Objectives: Ethnic minority elders have high levels of social isolation and loneliness. Assumptions about the family providing enough social support exist in the literature, contradicting ethnic minority elders’ reported levels of isolation and loneliness. While structural barriers influence feelings of isolation and loneliness, limited information exists about the role of cultural factors such as acculturation and family values. Accordingly, this study investigated the roles of acculturation and family values on loneliness and social isolation among ethnic minority elders. Methods: Ethnic minority elders (N = 123) completed a questionnaire that assessed their social connectedness, measured by social network and levels of loneliness, and structural factors such as income.. Additionally, cultural and family values were assessed by acculturation and the ‘family as referents’ dimension of familism, which refers to the belief that family members’ behaviour should meet with familial expectations. Results: Statistical analysis using hierarchical regression indicated that ‘family as referents’ and acculturation predicted loneliness, but not social network. Conclusions: This study raises the importance of considering cultural values when investigating predictors of loneliness among ethnic minority elders. Clinical implications: The finding highlight the importance of addressing familial expectations in programs aimed at alleviating loneliness among ethnic minority elders

Factors Associated With Small Size at Birth in Nepal: Further Analysis of Nepal Demographic and Health Survey 2011

Background: The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children. Methods: Data from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.Results: A total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams). The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males. Conclusion: One in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal