Journal of Pharmaceutical Health Care and Sciences最新文献

Background: Given the high prevalence of menstrual disorders such as premenstrual syndrome (PMS) and dysmenorrhea among students and the anti-inflammatory and antioxidant properties of curcumin, we decided to conduct a study to determine the effects of curcumin on PMS and dysmenorrhea among medical students in Tabriz-Iran.

Methods: This double-blind randomized controlled trial was conducted on 62 students from Tabriz University of Medical Sciences in Iran during the 2023-2024 academic year. The participants were randomly assigned to the intervention (n = 31) and control (n = 31) groups. They were given curcumin and placebo capsules with the same dose of 500 mg once daily for 10 days during each of the two menstrual cycles (7 days before to 3 days after the estimated onset of menstruation). Data collection involved a sociodemographic characteristics questionnaire, the Premenstrual Symptoms Screening Tool (PSST), the Visual Analogue Scale (VAS), and a checklist to evaluate potential side effects. Independent t test and ANCOVA were employed to compare the results between the two groups.

Results: There was no significant difference between the study groups regarding sociodemographic characteristics and baseline values before the intervention. Based on the ANCOVA test and by adjusting the baseline values, the curcumin group showed a significant reduction in average score of PSST in 2nd menstrual cycle (MD: -5.2; 95% CI: -9.6 to -0.9; P = 0.018) and average score of VAS in 2nd menstrual cycle (MD: -0.8; 95% CI: -1.4 to -0.1; P = 0.012) and 3rd menstrual cycle (MD: -0.8; 95% CI: -1.5 to -0.08; P = 0.029) compared to the placebo group. None of the study groups reported adverse effects. There were no dropouts and all participants completed the treatment period successfully.

Conclusion: This study highlights the increasing evidence that curcumin is an effective natural treatment for PMS and dysmenorrhea. Further research into dose optimization, combination therapies, and long-term effects will strengthen its position in clinical practice.

Trial registration: Iranian Registry of Clinical Trials (IRCT) IRCT20120718010324N71. Date of first registration 18/09/2022. Date of first sampling 20/09/2022. URL https://irct.behdasht.gov.ir/trial/65582 .

Background: The immediate post-diagnosis period is a critical phase for cancer patients, marked by significant informational and emotional distress. Although pharmacists are well-positioned to provide support during this time, limited research has investigated patients' specific concerns and consultation needs immediately after diagnosis, particularly in differentiating between hospital and community pharmacists. This study aimed to clarify cancer patients' concrete concerns and consultation preferences immediately following diagnosis, with a focus on the respective roles of hospital and community pharmacists.

Methods: A nationwide cross-sectional web-based survey was conducted among 1,031 adult cancer patients in Japan. Participants selected relevant concerns from a 21-item structured questionnaire across four domains: Cancer and Cancer Treatment (CCT), Cancer Pain and Palliative Care (CPPC), Medications Other Than Cancer Treatment (MOCT), and Daily Life During Cancer Treatment (DLCT). For each concern, participants indicated whether they preferred to consult hospital pharmacists, community pharmacists, or both. McNemar tests were used to compare paired proportions (P < 0.001).

Results: A total of 89.2% of participants reported at least one concern at diagnosis. The most frequently reported concerns were treatment-related, including side effects (49.2%), treatment costs (48.0%), psychological distress (41.6%), and mechanisms of anticancer drugs (38.8%). Patients expressed significantly stronger preferences for consulting hospital pharmacists over community pharmacists on treatment-specific topics such as side effects (34.7% vs. 13.8%), drug mechanisms (39.3% vs. 18.5%), and medications to relieve physical discomfort (36.1% vs. 17.0%) [all P < 0.001]. In contrast, MOCT-related concerns, such as drug interactions and medication management, elicited similarly high consultation preferences for both pharmacist types (> 40%). DLCT and CPPC-related concerns were associated with relatively lower consultation demands overall.

Conclusions: Cancer patients experience diverse and substantial informational and emotional needs immediately after diagnosis. Hospital pharmacists are particularly valued for treatment-specific support, while both hospital and community pharmacists are seen as essential resources for broader medication-related concerns. Enhancing cooperation between hospital and community pharmacists, and strengthening pharmacist-led support tailored to patients' needs at diagnosis may significantly improve patient-centered care and quality of life.

Background: Cetuximab sarotalocan, which utilizes the light-activatable dye IRDye700Dx conjugated with cetuximab, is a first-in-class drug based on photoimmunotherapy for treating recurrent head and neck squamous cell carcinoma. Cetuximab frequently induces hypomagnesemia and secondary hypocalcemia. Herein, we report a case of independent hypocalcemia without hypomagnesemia during treatment and discuss symptom progression.

Case presentation: A female patient with left epipharyngeal cancer, hypothyroidism, and hypoparathyroidism was treated with cetuximab and sarotalocan. On day 3, serum-adjusted calcium levels decreased from 9.6 to 7.4 mg/dL, increased to 8.2 mg/dL on day 9, and further increased to 8.8 mg/dL on day 27; serum magnesium levels were not evaluated. After the second administration, serum-adjusted calcium levels decreased two days later, fluctuating between 7.6 and 8.1 mg/dL for three weeks. Serum magnesium levels were within the normal range, with no significant variation detected during the second cycle. A similar symptom course was observed during the third cycle. The patient received enteral nutrition daily with 424.8-1,038.4 mg of calcium, with daily adjustment during the administration, except on day 2. She received peripheral intravenous nutrition for several days after tumor illumination. Concomitant medications did not appear to affect serum calcium levels. Considering the case process and previous reports, we hypothesized that concomitant hypoparathyroidism, in addition to reduced calcium intake due to the treatment, may have contributed to the observed reduction.

Conclusions: Hypocalcemia without hypomagnesemia can occur in patients with hypoparathyroidism receiving near-infrared photoimmunotherapy with cetuximab sarotalocan. The precise mechanisms and epidemiological features warrant further investigations.

Background: The use of propranolol in the treatment of panic attacks has historically been widespread. However, there is insufficient precise evidence regarding the combination of propranolol with sertraline in this context. Panic attacks are a common health issue among women, significantly affecting their personal and social lives. Therefore, this study aimed to determine the effect of sertraline, with or without propranolol, on the severity of panic attack symptoms and depressive symptoms.

Methods: This randomized controlled clinical trial included 60 women who attended a specialized university clinic in Tabriz. Participants were randomly assigned to either the sertraline with propranolol group (n = 30) or the sertraline with propranolol placebo group (n = 30) using block randomization method. Both groups received drugs for four weeks. Data were collected using the Panic Disorder Severity Scale- Self-Report (PDSS-SR) and the Beck Depression Inventory-Short Form (BDI-13). The Mann-Whitney U test was employed to compare outcomes between the two groups, and Wilcoxon tests were used for within-group comparisons.

Results: Samples were enrolled from July 22, 2024, to February 11, 2025. The two groups exhibited no statistically significant differences in sociodemographic characteristics (p > 0.05). After the intervention, the mean score for the severity of panic attack symptoms in the sertraline with propranolol group was 6.6 (SD: 4.4), compared to 13.1 (SD: 5.4) in the sertraline with propranolol placebo group, indicating a statistically significant difference (P < 0.001). Additionally, the mean (SD) post-intervention depression score was 8.9 (4.8) in the sertraline with propranolol group and 15.5 (7.2) in the sertraline with propranolol placebo group, with the sertraline with propranolol group demonstrating a significantly lower mean depression score according to the Mann-Whitney U test (p = 0.001). Within-group comparisons also revealed a significant reduction in the severity scores for both panic attack symptoms and depression in the sertraline with propranolol group (P < 0.001).

Conclusion: Based on the results of this trial, using propranolol alongside sertraline reduces the severity of panic attacks. Given these promising results, further studies in various settings are recommended to provide high-certainty evidence in this field.

Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N70. Date of registration: 2022-08-31; URL: https://irct.behdasht.gov.ir/user/trial/65033/view .

Background: Delirium, a significant complication in older patients, often occurs during hospitalization and is associated with poor clinical outcomes. Effective strategies to prevent delirium are essential, particularly in emergency department (ED) settings where older patients frequently present with acute abdominal conditions. This study evaluated the impact of high-dose intravenous acetaminophen (≥ 1,000 mg) on the onset of delirium in older patients.

Methods: This retrospective cohort study included 411 patients aged 70 years or older diagnosed with acute abdomen at the ED of Tosei General Hospital from October 2015 to December 2022. Patients were divided into high-dose (≥ 1,000 mg/administration) and low-dose (< 1,000 mg/administration) groups based on acetaminophen dosage. Multivariate logistic regression analysis was performed to adjust for confounding factors, including neurodegenerative diseases, sensory impairments, and serum albumin levels.

Results: Of the 411 patients included in this study, 53 (12.9%) developed delirium during hospitalization, with the high-dose acetaminophen group demonstrating a significantly lower risk of delirium onset than that of the low-dose group (odds ratio: 0.391; 95% confidence interval: 0.193-0.791). Multivariate logistic regression analysis confirmed the protective effect of high-dose acetaminophen treatment after adjusting for potential confounding factors, suggesting this treatment protocol as a promising therapeutic approach for preventing delirium in older patients with acute abdominal conditions.

Conclusions: High-dose intravenous acetaminophen may effectively reduce the risk of delirium onset in older patients hospitalized with acute abdomen. These findings suggest a valuable role for high-dose acetaminophen in improving patient outcomes and reducing the burden of delirium in emergency and hospital care.

Trial registration: Retrospectively registered.

Background: Although questionnaire-based surveys enable pharmacists to systematically assess patient needs, healthcare practices, and medication outcomes, it is essential to minimize various biases to ensure that the data obtained from surveys are both reliable and valid. The present study aimed to elucidate whether a workshop on questionnaire-based surveys could enhance research awareness and motivation among community and hospital pharmacists in Mie prefecture.

Methods: The workshop comprised three parts: lecture (15 min), group work (90 min), and presentation (60 min). The participants' awareness and motivation for questionnaire-based survey was assessed through a questionnaire before and after the workshop, focusing on three questions. A customer satisfaction analysis was also conducted to identify areas for improvement in workshops on questionnaire-based surveys for future workshops.

Results: Response rate of the questionnaire was 100% (16/16 participants). In the question 1 "I think that it would be beneficial to conduct a questionnaire-based survey on daily tasks and present the findings at conferences or publish them in academic journals", no respondents answered "Disagree" when asked after workshop. In the question 2 "I would like to conduct a questionnaire-based survey if there is a specific theme", the proportions of respondents selecting "Neutral" (p = 0.027) and "Somewhat disagree" (p = 0.001) also decreased after workshop, and all participants responded with either "Agree" or "Somewhat agree." In the question 3 "I think that I can independently design a research project about questionnaire-based survey.", the proportion of respondents who selected "Agree" significantly increased from 6.3% before-workshop to 25% after-workshop (p = 0.003). The customer satisfaction graph revealed that only "Understanding of the lecture" was located in the priority maintenance area. On the other hand, "Time allocation of the presentation" and "Usefulness of the mentor" were located in the priority improvement area.

Conclusion: The present study revealed that a workshop for questionnaire-based surveys enhanced research awareness and motivation among community and hospital pharmacists. Increasing the time allocated for discussions among participants was suggested to enhance participant satisfaction and potentially influence their understanding and skills in questionnaire-based surveys.

Background: Linezolid (LZD)-associated hyponatremia is a rare side effect, and no reports have compared intravenous and oral administration in relation to the development of hyponatremia. This study aimed to identify risk factors for LZD-associated hyponatremia and to evaluate whether there are differences in the development of hyponatremia between intravenous and oral administration.

Methods: We conducted a retrospective study that included patients aged ≥ 20 years who received LZD of 1200 mg/day intravenously or orally at Kanazawa Medical University Hospital from January 2011 to December 2023. Patient information was retrospectively examined, and multiple logistic regression analysis was used to assess the risk of intravenous administration for hyponatremia. Additionally, propensity scores were calculated for the intravenous and oral administration groups, and these scores were subsequently used in a propensity score matching analysis.

Results: This retrospective study revealed hyponatremia in 32 of 240 (13.3%) patients. Intravenous administration (OR = 17.137, 95% CI = 2.029-144.712, P = 0.009), serum sodium level before administration (OR = 0.626, 95% CI = 0.528-0.744, P < 0.001), and creatinine clearance (OR = 0.987, 95% CI = 0.975-0.999, P = 0.040) were identified as independent variables associated with hyponatremia. After propensity score matching, the incidence of LZD-associated hyponatremia was higher with intravenous administration than with oral administration (OR = 9.697, 95% CI = 1.153-81.545, P = 0.029).

Conclusions: This study identified intravenous administration as an independent risk factor for LZD-associated hyponatremia, and that the risk of hyponatremia was significantly higher with the intravenous administration compared with the oral administration. Patients with the identified risk factors should be administered intravenous LZD more cautiously and carefully monitored for serum sodium levels.

Background: Pharmacy formulary systems have been established recently in various fields of pharmacotherapies. We evaluated the effectiveness of pharmacy formulary interventions on proton pump inhibitors (PPI) used to prevent drug-induced peptic ulcers in a Japanese tertiary hospital.

Methods: A retrospective cohort study was conducted in Kurashiki Central Hospital. A pharmacy formulary system of PPIs was implemented on October 1, 2020. Between April 2020 and March 2021, six months before and after the implementation date of the formulary system, inpatients aged ≥ 18 years were included if they newly received drugs (low-dose aspirin, anti-platelets, or non-steroidal anti-inflammatory drugs) recommended for prophylactic PPI use for peptic ulcers within seven days from hospital admission. Eligible patients were divided into two groups based on the implementation date, and changes in PPI prescription patterns were evaluated by interrupted time series analysis, along with the risk of drug-induced peptic ulcers and drug costs.

Results: In total, 2,449 inpatients were included. The median age of the pre- and post-formulary group was 60 and 58 years, respectively. The proportion of the targeted PPI prescription increased by 8.75% (95% confidence interval (CI); 0.12, 17.38) in level change, without increased risk of drug-induced peptic ulcers (risk difference -0.41%, 95% CI; -1.38, 0.55). The distribution of medication days in the two groups was similar, and $1,000 per 90 patient days was saved on drug costs.

Conclusion: The formulary system on oral PPIs in a Japanese tertiary hospital contributed to a positive level change in the prescription patterns, without increased risk of drug-induced peptic ulcers. Although slight, the drug costs were saved.

Background: Women often experience a decline in sexual desire as they age, particularly during menopause. An increase in sexual dysfunction is associated with the worsening of genitourinary symptoms that occur with menopause. Anxiety, fear, and depression in postmenopausal women may further deteriorate sexual dysfunction. Utilizing modern and effective methods to enhance sexual desire in these women is a priority in midwifery care. Given previous studies, ginseng is a herbal medicine that may be suitable in this regard. This study aimed to determine the effect of ginseng on sexual function (primary outcome), menopause symptoms, depression symptoms and side events (secondary outcomes) in postmenopausal women with major depression.

Methods: This triple-blind randomized controlled trial was conducted on postmenopausal women with major depression in Tabriz, Iran between December 2022 and March 2024. A total of 66 postmenopausal women aged 45 to 60 with major depressive disorder were randomly assigned to intervention and control groups using block randomization. The intervention group received a 250-mg ginseng capsule twice daily after meals for eight weeks, while the control group received two gelatin placebo capsules (containing liquid edible paraffin) daily, similar in appearance to the ginseng capsules. Data collection was performed using the Female Sexual Function Index (FSFI), the Beck Depression Inventory (BDI), and the Greene Climactric Scale (GCS). The independent t-test and ANCOVA were used for data analysis.

Results: The two groups did not show statistically significant differences in terms of demographic and baseline outcome measures. After the intervention, the mean overall sexual function score in the ginseng group was significantly higher than in the control group (adjusted mean difference (AMD): 2.17; 95% confidence interval (95%CI): 1.32 to 3.03, P = 0.001). The mean overall menopause symptoms score (AMD: -3.61; 95% CI: -5.47 to -1.74, P < 0.001) and depression score (AMD: -3.96; 95% CI: -5.76 to -2.20, P < 0.001) were significantly lower in the ginseng group compared to the placebo group.

Conclusion: Ginseng is effective in improving sexual function and reducing menopause symptoms and depression in women with major depression. However, further research is needed to draw definitive conclusions.

Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N74. Date of registration: 10/12/2022; URL: https://irct.behdasht.gov.ir/user/trial/65711/view ; Date of first registration: 20/12/2022.