Pub Date : 2023-10-30DOI: 10.3897/pharmacia.70.e113462
Petya Milushewa, Stilyana Blagova, Presiyana Stefanova, Konstantin Tachkov, Guenka Petrova
Objective : The primary aim of this study was to evaluate, for the first time, the use of the EU-7 PIM List in identifying potentially inappropriate medications among older patients. Researchers have firmly established the connection between drug-related problems, which include increased morbidity and mortality rates and the heightened utilization of healthcare services. While previous studies have focused on methodologies for identifying potentially inappropriate medications in Bulgaria, further research is warranted to explore the applicability of the widely recognized EU(7)- PIM List. Materials and methods : A prospective review was conducted on patient prescriptions aligned with the National Health and Insurance Fund, explicitly focusing on patients aged over 65 years from a single pharmacy in Veliko Turnovo City, Bulgaria. The review spanned from November 2022 to April 2023. The prescriptions analyzed in this study exclusively comprised medications covered by the insurance fund. The pharmacy manager provided patient prescription data in a coded form, which included information on the patients’ age, corresponding medications, and accompanying ICD codes. Results : The study analyzed a sample of 255 patients. Healthcare providers prescribed 2,623 medications, and 61.96% of the patients had polypharmacy, taking more than five medications daily. Among the study population, 67% with polypharmacy had at least one PIM based on the EU (7)-PIM List criteria. In total, 173 potentially inappropriate medications (PIMs) were identified. The main PIMs were categorized into four groups: alimentary tract and metabolism, blood and blood-forming organs, cardiovascular system (CVS), and nervous system. Most PIMs (75.72%) were in the ATC cardiovascular system. Within the CVS category, 11 PIMs were associated with digoxin intake and 11 with antiarrhythmics such as propafenone, flecainide, and amiodarone. In addition, trimetazidine was linked to 9 PIMs, and centrally acting antiadrenergic agents had 22 PIMs, with moxonidine being the most prevalent (n=16). Peripherally acting agents were linked to 22 PIMs, primarily doxazosin. The study identified 24 PIMs related to diuretics, specifically spironolactone, and 18 PIMs related to selective calcium channel blockers such as verapamil. The antithrombotic agent category had the highest share, with 30 identified PIMs, including acenocoumarol, dabigatran, rivaroxaban, and apixaban. Furthermore, the examination of ICD codes confirmed that most PIMs occurred within CVS, with patients having ICD I11.0 and ICD I11.9 being associated with 40 and 47 PIMs, respectively. Conclusion : This study highlights many PIMs among patients with cardiovascular diseases. Using the EU (7)-PIM List as a pilot study demonstrates its effectiveness in managing adult patients’ conditions. Given the significant role of PIMs in deprescribing strategies for older patients with polypharmacy, there is a need for prescribers, educators, and drug regulat
{"title":"Evaluating potentially inappropriate medications in elderly patients in a pharmacy setting in Bulgaria: A pilot study utilizing the EU (7)-PIM List","authors":"Petya Milushewa, Stilyana Blagova, Presiyana Stefanova, Konstantin Tachkov, Guenka Petrova","doi":"10.3897/pharmacia.70.e113462","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e113462","url":null,"abstract":"Objective : The primary aim of this study was to evaluate, for the first time, the use of the EU-7 PIM List in identifying potentially inappropriate medications among older patients. Researchers have firmly established the connection between drug-related problems, which include increased morbidity and mortality rates and the heightened utilization of healthcare services. While previous studies have focused on methodologies for identifying potentially inappropriate medications in Bulgaria, further research is warranted to explore the applicability of the widely recognized EU(7)- PIM List. Materials and methods : A prospective review was conducted on patient prescriptions aligned with the National Health and Insurance Fund, explicitly focusing on patients aged over 65 years from a single pharmacy in Veliko Turnovo City, Bulgaria. The review spanned from November 2022 to April 2023. The prescriptions analyzed in this study exclusively comprised medications covered by the insurance fund. The pharmacy manager provided patient prescription data in a coded form, which included information on the patients’ age, corresponding medications, and accompanying ICD codes. Results : The study analyzed a sample of 255 patients. Healthcare providers prescribed 2,623 medications, and 61.96% of the patients had polypharmacy, taking more than five medications daily. Among the study population, 67% with polypharmacy had at least one PIM based on the EU (7)-PIM List criteria. In total, 173 potentially inappropriate medications (PIMs) were identified. The main PIMs were categorized into four groups: alimentary tract and metabolism, blood and blood-forming organs, cardiovascular system (CVS), and nervous system. Most PIMs (75.72%) were in the ATC cardiovascular system. Within the CVS category, 11 PIMs were associated with digoxin intake and 11 with antiarrhythmics such as propafenone, flecainide, and amiodarone. In addition, trimetazidine was linked to 9 PIMs, and centrally acting antiadrenergic agents had 22 PIMs, with moxonidine being the most prevalent (n=16). Peripherally acting agents were linked to 22 PIMs, primarily doxazosin. The study identified 24 PIMs related to diuretics, specifically spironolactone, and 18 PIMs related to selective calcium channel blockers such as verapamil. The antithrombotic agent category had the highest share, with 30 identified PIMs, including acenocoumarol, dabigatran, rivaroxaban, and apixaban. Furthermore, the examination of ICD codes confirmed that most PIMs occurred within CVS, with patients having ICD I11.0 and ICD I11.9 being associated with 40 and 47 PIMs, respectively. Conclusion : This study highlights many PIMs among patients with cardiovascular diseases. Using the EU (7)-PIM List as a pilot study demonstrates its effectiveness in managing adult patients’ conditions. Given the significant role of PIMs in deprescribing strategies for older patients with polypharmacy, there is a need for prescribers, educators, and drug regulat","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"59 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.3897/pharmacia.70.e114071
Maria Stamova Vakrilova Becheva, Angelina Georgieva Kirkova-Bogdanova, Stefka Аchkova Ivanova, Petar Jordanov Atanasov, Mariya Sevdelinova Chaneva, Valentina Boyanova Petkova
Cardiovascular diseases (CVD) are socially significant diseases due to high morbidity and loss of people of working age. In Bulgaria, they are the leading cause of mortality among the population and are a consequence of the effect of cardiovascular risk factors. The draft of the National Health Strategy (NHS) 2021–2030 reports on their wide distribution, as well as on the insufficient knowledge, skills and motivation for their prevention and control. The purpose of this review is to address the prevention of cardiovascular disease, which is a significant problem worldwide. Prevention goals for patients with established cardiovascular disease and those at high risk include smoking cessation, healthy eating, physical activity, and lowering body mass index. There are various methods that are part of health promotion to reduce CVD risks. These methods include motivational interviewing, non-pharmacological means, the use of certain medications for CVD prevention, as well as physical activity. Strategies for effective primary prevention refer to engaging the patient to change their lifestyle and identifying risk factors, while secondary prevention is aimed at activities to detect the disease early and to slow down its progression. It is necessary to create a strategy for timely preventive actions with a view to preventing the negative influence of risk factors and improving people‘s heart health.
{"title":"Prevention of cardiovascular diseases","authors":"Maria Stamova Vakrilova Becheva, Angelina Georgieva Kirkova-Bogdanova, Stefka Аchkova Ivanova, Petar Jordanov Atanasov, Mariya Sevdelinova Chaneva, Valentina Boyanova Petkova","doi":"10.3897/pharmacia.70.e114071","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e114071","url":null,"abstract":"Cardiovascular diseases (CVD) are socially significant diseases due to high morbidity and loss of people of working age. In Bulgaria, they are the leading cause of mortality among the population and are a consequence of the effect of cardiovascular risk factors. The draft of the National Health Strategy (NHS) 2021–2030 reports on their wide distribution, as well as on the insufficient knowledge, skills and motivation for their prevention and control. The purpose of this review is to address the prevention of cardiovascular disease, which is a significant problem worldwide. Prevention goals for patients with established cardiovascular disease and those at high risk include smoking cessation, healthy eating, physical activity, and lowering body mass index. There are various methods that are part of health promotion to reduce CVD risks. These methods include motivational interviewing, non-pharmacological means, the use of certain medications for CVD prevention, as well as physical activity. Strategies for effective primary prevention refer to engaging the patient to change their lifestyle and identifying risk factors, while secondary prevention is aimed at activities to detect the disease early and to slow down its progression. It is necessary to create a strategy for timely preventive actions with a view to preventing the negative influence of risk factors and improving people‘s heart health.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"22 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136236032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-25DOI: 10.3897/pharmacia.70.e111279
Olha Khvorost, Yevheniia Zudova, Liliia Budniak, Liudmyla Slobodianiuk, Hanna Kramar, Olha Palamarchuk, Anna Ocheretniuk
One of the fundamental issues in modern pharmacy is the expansion of the range of medications based on plant-derived raw materials with specific targeted effects. An example of such a plant is the woolly-flowered milkvetch ( Astragalus dasyanthus Pall.). This perennial herbaceous medicinal plant belongs to the Fabaceae family and is listed in the Red Book of Europe. Astragalus dasyanthus Pall. is cultivated for pharmaceutical purposes. The herb of a plant exhibits sedative, cardiotonic, hypotensive, and diuretic effects, as well as hepatoprotective and antioxidant properties. The herb of Astragalus dasyanthus Pall. contains polysaccharides (arabinose, bassorin), flavonoids (quercetin, kaempferol), glycyrrhizin, starch, and triterpenoid saponins, which contribute to the broad spectrum of the plant’s pharmacological activity. Continuing the investigation of this plant, it is advisable to study the qualitative and quantitative composition of organic and fatty acids. By the HPLC method, the following organic acids were identified and determined quantitative content: tartaric (8.68 mg/g), citric (7.69 mg/g), oxalic (6.90 mg/g), succinic (5.01 mg/g), isocitric (1.30 mg/g), and malic (0.49 mg/g). The saturated and unsaturated fatty acids were determined by the GC/MS method. The Astragalus dasyanthus Pall. herb contained seven fatty acids. High concentrations of fatty acids such as pentadecanoic acid (4.16 mg/g), linoleic acid (1.73 mg/g), and stearic acid (1.14 mg/g) predominate in woolly-flowered milkvetch. The character of many processes in which these organic and fatty acids take part may be associated with the medicinal properties of this plant pursuant to its use in medicine and, therefore, may contribute to the insight into its therapeutic properties.
{"title":"Analysis of carboxylic acids of Astragalus dasyanthus Pall. herb","authors":"Olha Khvorost, Yevheniia Zudova, Liliia Budniak, Liudmyla Slobodianiuk, Hanna Kramar, Olha Palamarchuk, Anna Ocheretniuk","doi":"10.3897/pharmacia.70.e111279","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e111279","url":null,"abstract":"One of the fundamental issues in modern pharmacy is the expansion of the range of medications based on plant-derived raw materials with specific targeted effects. An example of such a plant is the woolly-flowered milkvetch ( Astragalus dasyanthus Pall.). This perennial herbaceous medicinal plant belongs to the Fabaceae family and is listed in the Red Book of Europe. Astragalus dasyanthus Pall. is cultivated for pharmaceutical purposes. The herb of a plant exhibits sedative, cardiotonic, hypotensive, and diuretic effects, as well as hepatoprotective and antioxidant properties. The herb of Astragalus dasyanthus Pall. contains polysaccharides (arabinose, bassorin), flavonoids (quercetin, kaempferol), glycyrrhizin, starch, and triterpenoid saponins, which contribute to the broad spectrum of the plant’s pharmacological activity. Continuing the investigation of this plant, it is advisable to study the qualitative and quantitative composition of organic and fatty acids. By the HPLC method, the following organic acids were identified and determined quantitative content: tartaric (8.68 mg/g), citric (7.69 mg/g), oxalic (6.90 mg/g), succinic (5.01 mg/g), isocitric (1.30 mg/g), and malic (0.49 mg/g). The saturated and unsaturated fatty acids were determined by the GC/MS method. The Astragalus dasyanthus Pall. herb contained seven fatty acids. High concentrations of fatty acids such as pentadecanoic acid (4.16 mg/g), linoleic acid (1.73 mg/g), and stearic acid (1.14 mg/g) predominate in woolly-flowered milkvetch. The character of many processes in which these organic and fatty acids take part may be associated with the medicinal properties of this plant pursuant to its use in medicine and, therefore, may contribute to the insight into its therapeutic properties.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"2 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-25DOI: 10.3897/pharmacia.70.e103566
Embun Suci Nasution, Hari Ronaldo Tanjung, Inggianti Putri
Background : Evaluation of the use of antibiotics is the control of antimicrobial resistance. The ATC/DDD method was recommended to evaluate drug use quantitatively which can be used to compare the quantity of antibiotic use between hospitals and between countries. This research was a descriptive study with retrospective data collection cross-sectional. This research was conducted at the ICU of Universitas Sumatera Utara hospital in August-November 2022 from medical record data for the period January-December 2021 which included patient demographics, patient diagnoses, antibiotic dosage forms, routes of administration, types of antibiotics, dosage, duration of antibiotics use, and duration of treatment. Methods : Evaluation of antibiotic doses using the ATC/DDD method. The results of the study from 57 medical records that met the inclusion criteria showed that the ICU patients who used the most antibiotics were male (59.7%), the age group was >56 years (56.14%), patient diagnoses with COVID-19 (33.33%), and the dosage form was injection with the intravenous route of administration. The most frequently used antibiotics were levofloxacin (48.54%) 45.61 DDD/100 patient-days and ceftriaxone (30.06%) 28.25 DDD/100 patient-days, and the average value of Length of Stay (LOS) is 5.4 ±3.98 days with a total DDD/100 patient-days value of 93.96 (reference value of 51–67 DDD/100 patient-days). DU 90% segment namely levofloxacin (48.69%), ceftriaxone (30.16%) and meropenem (12.82%). The results of the study concluded that the use of antibiotics in ICU patients at Universitas Sumatera Utara Hospital showed a high DDD/100 patient-days rate. Therefore, it is necessary for hospital to continuously monitor and evaluated the rational use of antibiotics to prevent resistance of antibiotics.
{"title":"Evaluation of antibiotics using ATC/DDD and DU 90% methods on ICU patients at Universitas Sumatera Utara Hospital","authors":"Embun Suci Nasution, Hari Ronaldo Tanjung, Inggianti Putri","doi":"10.3897/pharmacia.70.e103566","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e103566","url":null,"abstract":"Background : Evaluation of the use of antibiotics is the control of antimicrobial resistance. The ATC/DDD method was recommended to evaluate drug use quantitatively which can be used to compare the quantity of antibiotic use between hospitals and between countries. This research was a descriptive study with retrospective data collection cross-sectional. This research was conducted at the ICU of Universitas Sumatera Utara hospital in August-November 2022 from medical record data for the period January-December 2021 which included patient demographics, patient diagnoses, antibiotic dosage forms, routes of administration, types of antibiotics, dosage, duration of antibiotics use, and duration of treatment. Methods : Evaluation of antibiotic doses using the ATC/DDD method. The results of the study from 57 medical records that met the inclusion criteria showed that the ICU patients who used the most antibiotics were male (59.7%), the age group was >56 years (56.14%), patient diagnoses with COVID-19 (33.33%), and the dosage form was injection with the intravenous route of administration. The most frequently used antibiotics were levofloxacin (48.54%) 45.61 DDD/100 patient-days and ceftriaxone (30.06%) 28.25 DDD/100 patient-days, and the average value of Length of Stay (LOS) is 5.4 ±3.98 days with a total DDD/100 patient-days value of 93.96 (reference value of 51–67 DDD/100 patient-days). DU 90% segment namely levofloxacin (48.69%), ceftriaxone (30.16%) and meropenem (12.82%). The results of the study concluded that the use of antibiotics in ICU patients at Universitas Sumatera Utara Hospital showed a high DDD/100 patient-days rate. Therefore, it is necessary for hospital to continuously monitor and evaluated the rational use of antibiotics to prevent resistance of antibiotics.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135111515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-25DOI: 10.3897/pharmacia.70.e113883
Konstantin Kostov, Vesselin Marinov, Stefka Ivanova, Mariya Chaneva, Petar Atanasov, Venceslava Atanasova
Purpose : The study aims to assess the current outcomes and complications of laparoscopic ventral hernia repair using intraperitoneal onlay mesh with defect closure (IPOM PLUS) technique by use of dual-sided synthetic mesh. Material and methods : Retrospectively clinical data for 27 patients with umbilical, paraumbilical, incisional, ventral, and primary hernia, operated in the Department of General, Visceral and Emergency Surgery “Pirogov” from 01.06.2022 to 01.06. 2022 was analyzed. The diagnosis was based on history, physical examination(mainly), ultrasound, and CT. Of the hospitalized, women were 16 (59.26%) men 11 (40.74%). Results : Of the selected group, 13 patients had umbilical defects, 3 with an epigastric hernia, 7 with a paraumbilical hernia, and 4 with incisional defects. Adhesiolysis was needed in 18 cases, while others were performed straight with hernia closure. The operating time varied between 49 and 127 minutes (average 57.4 minutes). The hospital stay ranged from 1 day to 4 days (average 1.7 days). We had noticed complications in three of the cases (11.11%). Conclusion : IPOM PLUS repair is safe, practicable, and advantageous over a standard IPOM or open repair as reported in the literature. Accordingly, we prefer this approach with the closure of the fascial defect first while repairing ventral abdominal wall hernias.
{"title":"Laparoscopic IPOMPLUS repair-current outcomes and complications","authors":"Konstantin Kostov, Vesselin Marinov, Stefka Ivanova, Mariya Chaneva, Petar Atanasov, Venceslava Atanasova","doi":"10.3897/pharmacia.70.e113883","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e113883","url":null,"abstract":"Purpose : The study aims to assess the current outcomes and complications of laparoscopic ventral hernia repair using intraperitoneal onlay mesh with defect closure (IPOM PLUS) technique by use of dual-sided synthetic mesh. Material and methods : Retrospectively clinical data for 27 patients with umbilical, paraumbilical, incisional, ventral, and primary hernia, operated in the Department of General, Visceral and Emergency Surgery “Pirogov” from 01.06.2022 to 01.06. 2022 was analyzed. The diagnosis was based on history, physical examination(mainly), ultrasound, and CT. Of the hospitalized, women were 16 (59.26%) men 11 (40.74%). Results : Of the selected group, 13 patients had umbilical defects, 3 with an epigastric hernia, 7 with a paraumbilical hernia, and 4 with incisional defects. Adhesiolysis was needed in 18 cases, while others were performed straight with hernia closure. The operating time varied between 49 and 127 minutes (average 57.4 minutes). The hospital stay ranged from 1 day to 4 days (average 1.7 days). We had noticed complications in three of the cases (11.11%). Conclusion : IPOM PLUS repair is safe, practicable, and advantageous over a standard IPOM or open repair as reported in the literature. Accordingly, we prefer this approach with the closure of the fascial defect first while repairing ventral abdominal wall hernias.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135216008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.3897/pharmacia.70.e112645
Ema Pristi Yunita, Rayfika Nokha Kusuma Wardani, Bambang Sidharta
Human Immunodeficiency Virus (HIV) is a virus that attacks and weakens the human immune system, leading to Acquired Immune Deficiency Syndrome (AIDS) symptoms. East Java is one of the provinces in Indonesia with a high HIV prevalence. Antiretroviral therapy (ART) is a critical approach to slow down the growth rate of HIV since no medicine has been found for HIV/AIDS patients. Therefore, high adherence to ART is necessary to reduce viral replication and prevent the development of resistance. This study aimed to investigate the correlation between knowledge level, side effect severity, family support, and ART adherence in HIV/AIDS patients. This observational analytic study with a cross-sectional design was conducted in September-October 2022 at the Netral Plus Indonesia Foundation and Malang Islamic Hospital. The study included 55 HIV/AIDS patients, and the Spearman correlation test was used to analyze the data. There was no significant relationship between knowledge level, side effects, and adherence to ART treatment (p = 0.959; p = 0.719). However, family support was found to be significantly related to adherence to ART treatment (p = 0.004). The findings of this study suggest that family support is a crucial factor in the adherence to ART treatment among HIV/AIDS patients.
{"title":"Correlation between knowledge level, side effect severity, family support, and antiretroviral therapy adherence in HIV/AIDS patients in Greater Malang, East Java, Indonesia","authors":"Ema Pristi Yunita, Rayfika Nokha Kusuma Wardani, Bambang Sidharta","doi":"10.3897/pharmacia.70.e112645","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e112645","url":null,"abstract":"Human Immunodeficiency Virus (HIV) is a virus that attacks and weakens the human immune system, leading to Acquired Immune Deficiency Syndrome (AIDS) symptoms. East Java is one of the provinces in Indonesia with a high HIV prevalence. Antiretroviral therapy (ART) is a critical approach to slow down the growth rate of HIV since no medicine has been found for HIV/AIDS patients. Therefore, high adherence to ART is necessary to reduce viral replication and prevent the development of resistance. This study aimed to investigate the correlation between knowledge level, side effect severity, family support, and ART adherence in HIV/AIDS patients. This observational analytic study with a cross-sectional design was conducted in September-October 2022 at the Netral Plus Indonesia Foundation and Malang Islamic Hospital. The study included 55 HIV/AIDS patients, and the Spearman correlation test was used to analyze the data. There was no significant relationship between knowledge level, side effects, and adherence to ART treatment (p = 0.959; p = 0.719). However, family support was found to be significantly related to adherence to ART treatment (p = 0.004). The findings of this study suggest that family support is a crucial factor in the adherence to ART treatment among HIV/AIDS patients.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"12 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135268290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.3897/pharmacia.70.e110402
Yancho Zarev
Robinia pseudoacacia , a deciduous tree native to North America, has various medicinal properties, including antioxidant, antitumour, diuretic and antispasmodic effects. The plant contains various bioactive compounds, such as alkaloids, flavonoids, tannins, and phenols. However, caution is advised as all parts of the plant, except the flowers, are poisonous due to the phytotoxin robinin and its glycoside. The bark, on the other hand, shows resistance to rot due to the antifungal compounds dihydrorobinetin and robinetin. This study focuses on the stem bark of R. pseudoacacia from Bulgaria, a widely distributed wild species. Using advanced chromatographic techniques, we isolated and identified 3- O -caffeoyloleanolic acid, a new compound in the genus Robinia and R. pseudoacacia . Structural characterization was performed by state-of-the-art spectroscopic methods, including 1 H NMR, 13 C NMR and 2D NMR (COSY, HSQC, HMBC), as well as by LC-HRESI-MS analysis.
{"title":"Isolation and characterization of 3- O-caffeoyloleanolic acid from Robinia pseudoacacia stem bark","authors":"Yancho Zarev","doi":"10.3897/pharmacia.70.e110402","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e110402","url":null,"abstract":"Robinia pseudoacacia , a deciduous tree native to North America, has various medicinal properties, including antioxidant, antitumour, diuretic and antispasmodic effects. The plant contains various bioactive compounds, such as alkaloids, flavonoids, tannins, and phenols. However, caution is advised as all parts of the plant, except the flowers, are poisonous due to the phytotoxin robinin and its glycoside. The bark, on the other hand, shows resistance to rot due to the antifungal compounds dihydrorobinetin and robinetin. This study focuses on the stem bark of R. pseudoacacia from Bulgaria, a widely distributed wild species. Using advanced chromatographic techniques, we isolated and identified 3- O -caffeoyloleanolic acid, a new compound in the genus Robinia and R. pseudoacacia . Structural characterization was performed by state-of-the-art spectroscopic methods, including 1 H NMR, 13 C NMR and 2D NMR (COSY, HSQC, HMBC), as well as by LC-HRESI-MS analysis.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"52 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mucuna pruriens contains saponins and flavonoids, which help to decrease cholesterol, treat hypertension, provide protein and vitamins and prevent premature ageing. This research followed the NIH guidelines (NIH publication 85–23, revised in 1996). Rats weighing 200–250 g were assigned into six groups (n = 6), normal saline only (control), normal saline (NS), Ethyl acetate fraction of Mucuna pruriens leaves (EAFMP) (100, 200 and 400 mg/kg) and Silymarin (100 mg/kg) treated orally for five days, diclofenac (DFN) was administered on days 3 and 4 via intraperitoneal route, biochemical and histology parameters were determined in serum and liver. This research revealed that treatment with EAFMP reversed the elevation of liver enzymes, total bilirubin, LDL and total cholesterol and lipid peroxidation; liver SOD, GSH, and CAT were elevated in EAFMP and Silymarin groups. The hepatic histological lesions in EAFMP were reduced in a dose-dependent manner. This research shows that EAFMP attenuates the deleterious effect of diclofenac-induced liver toxicity in rats.
{"title":"Ethyl acetate fraction of Mucuna pruriens leaves mitigates diclofenac-induced hepatotoxicity via modulation of biochemical and histological parameters changes in Wistar Rats","authors":"Oladapo Oyinloye, Abdullahi Murtala, Farouk Oladoja, Olufemi Okunye, Emmanuel Kasumu, Peter Iloka","doi":"10.3897/pharmacia.70.e100720","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e100720","url":null,"abstract":"Mucuna pruriens contains saponins and flavonoids, which help to decrease cholesterol, treat hypertension, provide protein and vitamins and prevent premature ageing. This research followed the NIH guidelines (NIH publication 85–23, revised in 1996). Rats weighing 200–250 g were assigned into six groups (n = 6), normal saline only (control), normal saline (NS), Ethyl acetate fraction of Mucuna pruriens leaves (EAFMP) (100, 200 and 400 mg/kg) and Silymarin (100 mg/kg) treated orally for five days, diclofenac (DFN) was administered on days 3 and 4 via intraperitoneal route, biochemical and histology parameters were determined in serum and liver. This research revealed that treatment with EAFMP reversed the elevation of liver enzymes, total bilirubin, LDL and total cholesterol and lipid peroxidation; liver SOD, GSH, and CAT were elevated in EAFMP and Silymarin groups. The hepatic histological lesions in EAFMP were reduced in a dose-dependent manner. This research shows that EAFMP attenuates the deleterious effect of diclofenac-induced liver toxicity in rats.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"48 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135274216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.3897/pharmacia.70.e113881
Lora Varbanova, Konstantin Ivanov Kostov, Mariya Sevdalinova Chaneva, Stefka Achkova Ivanova, Petar Yordanov Atanasov, Venceslava Atanasova
Introduction : Acute cholecystitis is the second most common non-obstetric surgical disease during pregnancy. There have been several trials comparing operative and non-operative management in the past. Purpose : To present a clinical case from our practice and to compare clinical management with worldwide standards. Materials and methods : A 42-year-old patient in the 20 th gestational week presented to our department with complaints of pain in the epigastrium and RUQ, as well as a single incidence of vomiting, during the last two days. Results : We operated 15 h after admission and did a standard laparoscopy. The patient was discharged on the 4 th postoperative day. Conclusion : A review of the available literature shows the prevalence of early laparoscopic cholecystectomy, while non-operative management has proven to have higher complication rates. Laparoscopic surgery in pregnancy has proven to be safe for both mother and fetus. In our case, the patient was operated on within the first 24 hours of admission. We did not observe any complications during her stay and follow-up.
{"title":"Operative management of acute cholecystitis in pregnancy: Case report","authors":"Lora Varbanova, Konstantin Ivanov Kostov, Mariya Sevdalinova Chaneva, Stefka Achkova Ivanova, Petar Yordanov Atanasov, Venceslava Atanasova","doi":"10.3897/pharmacia.70.e113881","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e113881","url":null,"abstract":"Introduction : Acute cholecystitis is the second most common non-obstetric surgical disease during pregnancy. There have been several trials comparing operative and non-operative management in the past. Purpose : To present a clinical case from our practice and to compare clinical management with worldwide standards. Materials and methods : A 42-year-old patient in the 20 th gestational week presented to our department with complaints of pain in the epigastrium and RUQ, as well as a single incidence of vomiting, during the last two days. Results : We operated 15 h after admission and did a standard laparoscopy. The patient was discharged on the 4 th postoperative day. Conclusion : A review of the available literature shows the prevalence of early laparoscopic cholecystectomy, while non-operative management has proven to have higher complication rates. Laparoscopic surgery in pregnancy has proven to be safe for both mother and fetus. In our case, the patient was operated on within the first 24 hours of admission. We did not observe any complications during her stay and follow-up.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"10 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135367000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-20DOI: 10.3897/pharmacia.70.e112550
Vanyo Mitev
Millions of publications and thousands of clinical trials have not led to the discovery of an effective treatment for COVID-19. We believe that the reason for this is the inaccurate strategy of inhibiting target molecules involved in the pathogenesis of the disease. The leading cause of death in COVID-19 is the cytokine storm, which is caused by an NLRP3 inflammasome hyperreaction. WHO recommends for the outpatients treatment drugs blocking the replication of SARS-CoV-2. However, viral load and replication are not directly related to NLRP3 inflammasome hyperreactivity. This also explains the partial success of the WHO favorite paxlovid to reduce hospitalizations (51%). For hospital treatment, WHO suggests antibodies against the interleukin-6 receptor and Janus kinase (JAK) inhibition. Although important, IL-6 is one of dozens of cytokines elevated as a consequence of cytokine storm. The JAK inhibitor baricitinib inhibited the effect of not only IL-6 but also other elevated cytokines. But if the NLRP3 inflammasome is inhibited, the cytokines will not be elevated, and there will be no need for baricitinib. All medicines recommended by the WHO are distinguished by their very high prices. Our therapeutic strategy is based on inhibition of SARS-CoV-2 entry into the cell and inhibition of the NLRP3 inflammasome. We offer two readily available, cheap and well-known medications - bromhexine hydrochloride and colchicine. The many studies on the treatment of COVID-19 so far have not produced the expected result. The devil is buried in the details. For bromhexine, the reason is the way and its late application. Bromhexine is most effective when given prophylactically or started by inhalation after contact with a person with COVID-19. Its earliest possible application is crucial for its effect. Increased doses of colchicine are necessary for COVID-19 treatment due to the fact that it accumulates in leukocytes, and this leads to inhibition of NLRP3. The high doses we administer have been given widely in the past and are completely safe. Our highest dose is about 5 times lower per kg of weight than the lowest severe toxic dose of colchicine described. Our results show about a 5-fold decrease in hospital mortality and almost complete prevention of hospitalizations if outpatients are treated with inhaled bromhexine and colchicine.
{"title":"Comparison of treatment of COVID-19 with inhaled bromhexine, higher doses of colchicine and hymecromone with WHO-recommended paxlovid, molnupiravir, remdesivir, anti-IL-6 receptor antibodies and baricitinib","authors":"Vanyo Mitev","doi":"10.3897/pharmacia.70.e112550","DOIUrl":"https://doi.org/10.3897/pharmacia.70.e112550","url":null,"abstract":"Millions of publications and thousands of clinical trials have not led to the discovery of an effective treatment for COVID-19. We believe that the reason for this is the inaccurate strategy of inhibiting target molecules involved in the pathogenesis of the disease. The leading cause of death in COVID-19 is the cytokine storm, which is caused by an NLRP3 inflammasome hyperreaction. WHO recommends for the outpatients treatment drugs blocking the replication of SARS-CoV-2. However, viral load and replication are not directly related to NLRP3 inflammasome hyperreactivity. This also explains the partial success of the WHO favorite paxlovid to reduce hospitalizations (51%). For hospital treatment, WHO suggests antibodies against the interleukin-6 receptor and Janus kinase (JAK) inhibition. Although important, IL-6 is one of dozens of cytokines elevated as a consequence of cytokine storm. The JAK inhibitor baricitinib inhibited the effect of not only IL-6 but also other elevated cytokines. But if the NLRP3 inflammasome is inhibited, the cytokines will not be elevated, and there will be no need for baricitinib. All medicines recommended by the WHO are distinguished by their very high prices. Our therapeutic strategy is based on inhibition of SARS-CoV-2 entry into the cell and inhibition of the NLRP3 inflammasome. We offer two readily available, cheap and well-known medications - bromhexine hydrochloride and colchicine. The many studies on the treatment of COVID-19 so far have not produced the expected result. The devil is buried in the details. For bromhexine, the reason is the way and its late application. Bromhexine is most effective when given prophylactically or started by inhalation after contact with a person with COVID-19. Its earliest possible application is crucial for its effect. Increased doses of colchicine are necessary for COVID-19 treatment due to the fact that it accumulates in leukocytes, and this leads to inhibition of NLRP3. The high doses we administer have been given widely in the past and are completely safe. Our highest dose is about 5 times lower per kg of weight than the lowest severe toxic dose of colchicine described. Our results show about a 5-fold decrease in hospital mortality and almost complete prevention of hospitalizations if outpatients are treated with inhaled bromhexine and colchicine.","PeriodicalId":20086,"journal":{"name":"Pharmacia","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135569203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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