Knowledge, Attitude, and Practice (KAP) of Pharmacists about Natural Products Used for Urolithiasis in Shiraz, Iran

Background and objectives: We wanted to figure out how pharmacists make their judgments about the efficacy of natural products in urolithiasis and how they make suggestions about these products. Methods: A self-made descriptive questionnaire was designed, evaluated, and performed to assess pharmacists’ knowledge, attitude, and practice (KAP) about natural products in urolithiasis in 46 young pharmacists and final year pharmacy students in Shiraz. Results: In all of the KAP sections, Rowatinex®, Cystone®, and Sankol® were the most known, believed to be effective, and preferred pharmacist products. Respondents had received different education hours. About 54% of them believed their education was averagely adequate. Brochures (63.0%), web-search (60.9%), and applications (45.7%) were the primary resources used by pharmacists, mainly to check the instruction of use. About 80% of pharmacists were unaware of the mechanism of action of at least 5 of 14 products. Generally, respondents had a positive view of natural products. In addition, they thought price and advertisements were effective in patients’ and physicians’ choice of products. More than half of pharmacists preferred to use clinical trials (52.2%) rather than systematic reviews (19.6%). Conclusion: Providing a vast amount of information in the education process is not the best solution for preparing pharmacists for their role in community pharmacies. Besides the need for increasing clinical trials about complementary and alternative medicines and developing evidence-based databases, we need to train pharmacy students in professional ways to gain knowledge about complementary and alternative medicines

Influence of Liposomes and Niosomes on the In Vitro Permeation and Skin Retention of Finasteride: Permeation study of finasteride-entrapped vesicles

In this work we sought to determine whether vesicles (liposomes/niosomes) were able to enhance finasteride concentration in the dermis layer, including the pilosebaceous units (PSU). Such enhancement could be beneficial in the treatment of some androgen-related skin disorders. Hamster flank skin was used to study 3Hfinasteride permeation via vesicles and a hydroalcoholic solution (HA). The drug-containing vesicles were composed of dimyristoyl phosphatidylcholine (DMPC) or egg lecithin: cholesterol: dicetyl phosphate (liposomes) and polyoxyethylene alkyl ethers (Brij® series) or sorbitan monopalmitate (Span 40):cholesterol: dicetyl phosphate (niosomes) and were prepared by the film hydration technique. Determination of finasteride content by HPLC showed 80-97% drug entrapment efficiency in the vesicles. The amount of 3H-finasteride penetrated into and permeated through hamster skin 24 h after topical application of vesicles ranged from 5.5 to 13% of the initial dose, compared to 24%, observed with HA (p<0.05). The amount of finasteride deposited within the different skin strata via gelstate Span 40 and lecithin vesicles was lower, when compared with liquid-state Brij97, Brij 76: Brij 97 and DMPC vesicles. The fraction of finasteride found in the dermis layer was greatest where DMPC liposomes were used (7.8%). The vesicles significantly reduced drug permeation as indicated by the flux of finasteride from vesicles (0.025-0.058 µg/cm2.h), where compared with the HA (0.13 µg/cm2.h), (p<0.01). This study demonstrated the potentials of liquid-state vesicles in reducing the percutaneous absorption of finasteride and increasing its concentration and retention in the dermis layer

Burn Wound Healing Effect of a Sterilized Traditional Formulation of Boswellia carteri vs. Silver Sulfadiazine Cream 1% in Patients Presenting Second-degree Burn Wounds: A Randomized, Double-blind Clinical Trial

Background: Burn wounds rank among the most serious healthcare issues. Many studies reported the effectiveness of natural products in the wound-healing process. The present study compared the effects of a standardized herbal formulation derived from Boswellia carteri (B. carteri) and silver sulfadiazine (SSD) cream 1% on the healing of burn wounds.Methods: This randomized double-blind clinical trial was conducted at Shiraz Burn Hospital (Shiraz, Iran) between July 2012 to August 2013. A sterilized formulation comprising B. carteri 40% was prepared. 54 second-degree burn patients of both sexes with age ranges of 20 to 60 were invited to participate in this double-blind, randomized clinical trial. They were randomly divided into two groups and given either the Boswellia formulation or SSD cream. The healing index was determined based on the wound area assessment using the planimetry technique. The Kaplan-Meier survival analysis was used to assess the primary outcome, which was the amount of time until complete healing.Results: The trial was completed by 17 patients from the SSD group and 15 patients from the Boswellia group. During the study period, both groups showed a progressive healing trend. The mean (95% CI) healing time in the SSD group was 10.94 (9.03-12.85) days and 10.73 (9.23-12.23) days in the Boswellia group (P=0.71), indicating no significant difference. On the 17th day, the healing index of all patients in the Boswellia group reached 1.Conclusion: Boswellia topical formulation had a burn wound healing effect comparable to that of the standard SSD 1% treatment. Based on the findings of this study, the likelihood of contact dermatitis with Boswellia should be taken into consideration