This study aimed to assess prescription transfer and medicines collection through Wasfaty, an electronic prescription service recently introduced in Saudi Arabia. A link to a cross-sectional online questionnaire was sent to all students and staff at the University of Jeddah, targeting beneficiaries who received e-prescriptions at the University Medical Centre (n = 2067). The questionnaire comprised 20 items under the following sections; demographics, patient perceptions and satisfaction with the Wasfaty service, and the availability of medicines. Of the 217 questionnaires received, the majority were filled by females (n = 125, 57.6%). Most were satisfied with the initial registration process of Wasfaty (n = 183, 84.1%). However, almost one-third of the participants reported that they could not find the prescribed medicines (n = 64, 29.7%), and most of them had to look for another pharmacy to obtain their treatment (n = 138, 63.9%). Respondents voiced their displeasure owing to the lack of access to certain pharmaceuticals, including anti-hypertensives and antidiabetics. This pilot study identified some challenges relating to the use of the Wasfaty service. Further attention to these challenges is required from the service providers, and a large-scale national study is warranted.

Aim: The majority of medicines used in Poland are generic drugs – substitutions of the original. Objective of the study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The study was conducted based on a self-developed questionnaire. The questionnaire consisted of 25 questions, including questions regarding their knowledge about generics, their previous experience and the factors behind these choices. Results: Overall, 1220 questionnaires were analyzed. Among all patients, 66.39% reportedly heard about generics. Of these 61.48% of patients had used the generic drugs in past. A significant proportion of participants had never been recommended to switch to a generic medicine by their health care professional (22.95% physician and 13.93% pharmacist). Statistically relevant differences were observed regarding the respondents’ kind and level of education, place of residence, and net income per household. Conclusions: Significant gaps were identified in the knowledge and perceptions among patients regarding generic medicines especially in relation to efficacy and safety of generic medicines. Efforts must be directed towards increasing public awareness of generic medicines and should also focus on educating patients about generic medicines.

Cervical cancer is the fourth most common type of cancer in the world that causes death in women. It is mainly caused by persistent infection by human papillomavirus (HPV) that triggers a chronic inflammatory process. Therefore, the use of anti-inflammatory drugs is a potential treatment option. The effects of piperine, an amino alkaloid derived from Piper nigrum, are poorly understood in cervical cancer inflammation, making it a target of research. This work aimed to investigate the antitumor effect of piperine on cervical cancer and to determine whether this effect is modulated by the cyclooxygenase 2 (PTGS2) pathway using in vitro model of cervical cancer (HeLa, SiHa, CaSki), and non-tumoral (HaCaT) cell lines. The results showed that, piperine reduces in vitro parameters associated with neoplastic evolution such proliferation, viability and migration by cell cycle arrest in the G1/G0 and G2/M phases, with subsequent induction of apoptosis. This action was modulated by downregulated of cyclooxygenase 2 (PTGS2) pathway, which in turn regulates the secretion of cytokines and the expression of mitogen activated protein kinases (MAPKs), metalloproteinases (MMPs), and their antagonists (TIMPs). These findings indicate the phytotherapeutic potential of piperine as complementary treatment in cervical cancer.

Medicinal plants have antibacterial, antifungal and antiviral activities. More or less all plants have medicinal properties. In this research article, we have selected four economically important plants (three fruit plants and an economically important plant), Malus domestica Borkh., Prunus persica L., Ricinus communis L., and Carica papaya L. found in several areas of Indian state Uttarakhand. Using the methanolic extract of leaves, we have screened those four plants against four human pathogenic bacteria, Escherichia coli, Streptococcus pneumoniae, Staphylococcus aureus and Micrococcus luteus. For our experiment we have screened the methanolic leaf extracts of four plants against the above-mentioned bacteria. Statistical analysis was also performed for validation. Result revealed the said bacteria have potential antibacterial activities. So, these leaves can be used for clinical trial. These plants can also be used for making herbal medicines.

Background: Fluoride toothpaste (FT) has recently been included in the World Health Organization’s (WHO) Model List of Essential Medicines. Whereas it is essential for preventing dental caries, its current affordability around the globe remains unclear. This study aimed to analyse the affordability of FT in as many as possible countries worldwide. Methods: A standardized protocol was developed to collect country-specific information about the characteristics of the cheapest FT at a common point of purchase. 82 members of the WHO Global Oral Health Network of Chief Dental Officers (CDOs), directors of WHO Collaborative Centres and other oral health experts collected data using mobile phone technology. The Fluoride Toothpaste Affordability Ratio (FTAR) was calculated as the price associated with the recommended annual consumption of FT, relative to the daily wage of the lowest-paid unskilled government worker (FTAR >1 = unaffordable spending on fluoride toothpaste). The daily expenditure per capita of the poorest 15% of the income distrubition was used as the main proxy of the daily wage, using World Bank data. Alternatively, we used the daily minimum wage as a proxy of the daily wage. Stratified descriptive statistics were undertaken with respect to different World Bank Income Groups and WHO Regions. Results: There are significant discrepancies in the affordability of FT across 78 countries. FT was strongly affordable in high-income countries, relatively affordable in upper middle-income countries, and strongly unaffordable in lower middle-income and low-income countries. The affordability of FT across WHO Regions was dependent upon the economic mix of WHO Regions’ member states. Conclusion: FT is still unaffordable for many people, particularly in low-resource settings. Health policy members should develop better strategies to address and improve the universal affordability of FTs, for the incidence of dental caries to be reduced at a global level.

Selective laser sintering (SLS) has drawn attention for the fabrication of three-dimensional oral dosage forms due to the plurality of drug formulations that can be processed. The aim of this work was to employ SLS with a CO2 laser for the manufacturing of carvedilol personalised dos-age forms of various strengths. Carvedilol (CVD) and vinylpyrrolidone-vinyl acetate copolymer (Kollidon VA64) blends of various ratios were sintered to produce CVD tablets of 3.125, 6.25 and 12.5 mg. The tuning of the SLS processing parameter laser intensity, improved printability and impacted the tablet hardness, friability, CVD dissolution rate, and the total amount of drug re-leased. Physicochemical characterization showed the presence of CVD in the amorphous state. X-ray micro-CT analysis demonstrated that the applied CO2 intensity affected the total tablet po-rosity, which was reduced with increased laser intensity. The study demonstrated that SLS is a suitable technology for the development of personalised medicines that meet the required specifications and patient needs.

Spread of severe acute respiratory syndrome coronavirus (SARS-CoV-2) made a historic transition between December 2019 to March 2020. In the present scenario SARS-CoV-2 as becomes a major burden on public health and economic stability of societies around the globe. From the substantial evidences gained from the pandemic of SARS-CoV-2 and MERS-CoV (Middle East respiratory syndrome coronavirus), scientists and clinicians strongly believes that these pathogenic viruses share common homology of some biologically active enzymes which includes RNA-dependent RNA polymerase (RdRP), 3-chymotrypsin-like protease (3CL^pro), papain-like protease (PL^pro) etc. RdRP relatively grabs higher level of clinical importance in comparison with other enzyme target. Indian system of traditional medicine pioneering the therapy towards infectious disease since several centuries. In view of this potential therapeutic leads from some of the Indian medicines along with standard drug favipiravir subjected to docking investigation targeting SARS-CoV-2- RNA dependent RNA polymerase (RdRp). Residual proximity analysis reveals 18 out of 28 compounds reveals potential binding affinity of about 100% with the target amino acid residue (618 ASP, 760 ASP,761 ASP), 7 out of 28 reveals 75% binding efficacy and 3 out of 28 reveals 25% binding efficacy with that of the target residue. Hence further clinical validation may be warranted with proper in-vitro and in-vivo studies prior to the clinical recommendation in treating COVID-19 patient’s.

Cortex Periplocae, as a traditional Chinese herbal medicine, has been widely used for autoimmune diseases, especially rheumatoid arthritis. Due to its potential pharmaceutical values, more studies about the biological activities of Cortex Periplocae have been conducted recently. Meanwhile, the adverse reaction of Cortex Periplocae is not a negligible problem in clinic. In this article, we reviewed a series of articles and summarized the recent studies of Cortex Periplocae in the areas of phytochemistry and pharmacology. More than 100 constituents have been isolated and identified from Cortex Periplocae, including steroids, cardiac glycosides, terpenoids, and fatty acid compounds. The crude extracts of Cortex Periplocae and its active compounds exhibit various biological activities, such as cardiotonic effect, anticancer action, and anti-inflammatory effect. This paper aims to provide an overall review on the bioactive ingredients, pharmacological effect, and toxicity of this plant. Furthermore, this review suggests investigating and developing new clinical usages according to the above pharmacological effects.

A handheld NIR spectrophotometric method was developed, validated and applied for determination of tadalafil in tablets. The aim of our work was to develop analytical methods based on vibrational techniques and using low-cost portable equipment. Based on different chemometric modeling, we attempt to validate the method, that gave encouraging results from the principal component analysis (PCA), DD-SIMCA and PLS modeling. Then came optimization using an appropriate experiment plan. For validation, we used the total error approach with acceptance limits set at ±10% with a risk level of 5%. The method showed that it was possible to perform both qualitative and quantitative analysis of pharmaceutical products using low-cost portable NIR systems with chemometric tools. The developed approach enabled to cross the first step in implementing a NIR method for quality control of Tadalafil-based drugs in the DRC. Validation difficulties of PLS method resulted from the lack of information about inter-days serial variations of spectral responses. This would be interesting to extend the study to a larger calibration interval in order to correct uncertainties that may result from the variability observed under different conditions, and to verify robustness. These are the limitations of this work, but the results are nevertheless very encouraging.

Rivea hypocrateriformis (Desr.) Choisy is a robust woody climbing shrub of the genus Rivea which is found in India, Nepal, Sri Lanka, Pakistan, Bangladesh, Myanmar and Thailand. R. hypocrateriformis is a promising medicinal herb with enormous helpful and wellbeing advancing impacts. R. hypocrateriformis has been utilized as a customary medication for a long time to treat rheumatic pain, fever, urogenital problem, snake bite, cough, piles, malaria, and skin disease. Apart from the traditional uses its leaves and young shoots are cooked and eaten as a vegetable and for preparation of bread with millet flour. This review comprehensively summarizes the up-to-date information on the botanical characterization, distribution, traditional uses, phytochemistry, pharmacology and toxicity study of R. hypocrateriformis. Phytochemical investigation has been revealed that alkaloids, glycosides, coumarins, flavonoids, xanthones, stilbenes, and other organic compounds are contained in R. hypocrateriformis. Crude extracts and isolated compounds have exhibited numerous pharmacological activities such as anovulatory effect, antifertility activity, antiarthritic, antimicrobial, anticancer, antioxidant, hepatoprotective, antilithiatic, antimitotic. R. hypocrateriformis is a promising restorative spice with monstrous remedial and wellbeing advancing impacts. Along these lines, further investigations on the bioactive mixtures and systems of R. hypocrateriformis are justified. Extra clinical and toxicological examinations are expected to assess its wellbeing.

Access to medicines is one of the essential problems in Public Health of low- and middle-income countries (LMICs). The World Health Organization (WHO) defines access to medicines as the possibility of "having continuously accessible and affordable medicines in public or private health facilities that are within a kilometer of the place of residence." Access to medicines, as defined by the WHO, is not fully guaranteed in many LMICs and even in many regions of high-resource countries. The WHO identifies several factors as determinants of limitations in the access to medicines: rational selection, affordable prices, sustainable financing, and reliable health services. The action on these factors makes it possible to improve universal access to medicines with consequent improvement in Public Health. Adequate access to antibiotics and vaccination will avoid a large part of the deaths caused by infectious diseases in the LMICs. However, the emergence of resistance and the difficulties in vaccination campaigns due to socio-political or cultural problems make it challenging to fight many easily treatable infectious diseases. The use and abuse of antibiotics are inevitably associated with the appearance of resistances that make them ineffective. Thus, whereas limited access to antibiotics raises mortality rates from infectious diseases, generalized open access to them ends up eliminating their clinical value. Moreover, the contraction of research in this field for many years has reduced the success in discovering new drugs. Additionally, local market regulations, inadequate selection, inaccessible prices, especially for those of second and third-generation, inefficient health systems, and difficulties of administration and control of prescription compliance, especially in the case of combined therapies, are additional obstacles to universal access to antibiotics. In order to simultaneously improve access to antibiotics and keep resistances under control, it is necessary to develop training and education activities at different social levels (from patients to various Health Care Providers) to complement the national or supranational strategic plans.

Zephyranthes citrina Baker is a bulbous herb, commonly known as yellow rain lily belongs to the family Amaryllidaceae. It is a native of tropical and subtropical America but nowadays it is cultivated as a popular ornamental herb in several parts of the world including India. This herb represents one of the richest sources of phytochemicals, especially alkaloids and possesses great potential for pharmaceutical applications. It shows remarkable antiprotozoal, antimicrobial, anti-Alzheimer, cytotoxic, antioxidant, anti-inflammatory, analgesic, and dye removal activities. This review is an effort to give a detailed study of the literature on the biological activities of Zephyranthes citrina. This review concludes that Zephyranthes citrina has a great potential to treat various diseases and could be used as a source for novel healthcare products in the near future, which requires further experimentation.

Although marketing authorization holders (MAHs) are involved in monitoring medication safety, it was unclear how they experience their role and current monitoring activities in pregnancy. Therefore, a qualitative study using online focus groups with MAHs and the Belgian umbrella organisation of MAHs was conducted in June-July 2021. In total, 38 representatives of nine organisations participated. Overall, participants reported multiple difficulties with data collection, including underreporting, collection of incomplete information and loss to follow-up. The limited number of high-quality data collected, the unknown denominator and the lack of comparator data complicate MAHs’ data processing activities, preventing them to timely provide evidence in the pregnancy label. Three ‘conflicts’ inherent to the specific position of MAHs were identified explaining the difficulties they experience, i.e., 1) mistrust from patients and healthcare professionals (HCPs); 2) MAHs’ legal obligations and regulatory framework; 3) MAHs’ position outside the healthcare context. To overcome these barriers, MAHs suggested that data registration should occur in close collaboration with patients and HCPs, organized within the healthcare context and performed by using a user-friendly system. In conclusion, the reported difficulties and underlying conflicts of MAHs highlight the need for more effective, collaborative data collection strategies to generate new evidence on this topic.

Despite the fact that COVID-19 treatment and management are now considerably regulated, SARS-CoV-2 is still one of the leading causes of death in 2022. The availability of COVID-19 vaccines, FDA-approved antivirals, and monoclonal antibodies in low-income countries still poses an issue to be addressed. Natural products, particularly traditional Chinese medicines (TCMs) and medicinal plant extracts (or their active component) have challenged the dominance of drug repurposing and synthetic compound libraries in COVID-19 therapeutics. Abundant resources and excellent antiviral performance make natural products a relatively cheap and easily available alternative for COVID-19 therapeutics. Here, we deliberately review the anti-SARS-CoV-2 mechanisms of the natural products, their potency (pharmacological profiles), and application strategies for COVID-19 intervention. In light of their advantages, this review is intended to acknowledge the potential of natural products as COVID-19 therapeutic candidates.

The Himalayas are known for high floristic diversity and rich ethnobotanical practices. However, not all parts of the Himalayan regions are thoroughly studied. The present study aims to document the ethnoveterinary medicines used by migratory shepherds in Trans-Himalayan Rakchham-Chitkul Wildlife Sanctuary,Baspa (Sangla) valley of the Kinnaur district in Himachal Pradesh. The shepherds are very close to nature as they spend most of their time in forests with their livestock. Shepherding depends more on traditional healthcare practices based on local medicinal plants. In this study, we are reporting for the first time commonly used ethnoveterinary medicines in Rakchham and Chitkul Wildlife Sanctuary and their application, procedures of preparation, as well as listing 51 plant species. Such documentations are done first time in the Himachal Pradesh region of India as per our information. Our research emphasizes the urgent need to document traditional medicine preparation procedures from migratory shepherds. The required information on various ethnoveterinary medicines used by migratory shepherds was collected through personal field visits, participatory observations, interview and using a pretested questionnaire. It was observed that in all 51 species of ethnoveterinary were used by shepherds in Trans-Himalayan Rakchham-Chitkul Wildlife Sanctuary in Baspa (Sangla) valley of Kinnaur district. The results of this survey show that shepherds in tribal areas are highly dependent on ethnoveterinary remedies for their livestock which evolved over generations of practices for healthcare. There is an urgent need to document this vast knowledge of migratory shepherds concerning the use of ethnoveterinary remedies for animal health care in the regions of the Himalayas.

Malaria is a serious infection affecting millions of people in Africa. Our study investigated the personal preferences and applications of antimalarial medicines in Ghana. Based on over 1000 questionnaires distributed in Ghana from January to May 2019, we noticed that although Western medications to fight this disease are widely available, most patients in Ghana prefer treatment with locally produced herbal remedies. This preference appears to be due to a combination of traditional venues for obtaining medicines “on the street” rather than in licensed pharmacies, trust in local and “green” products, extensive advertisement of such local products, and an inherent distrust of imported and synthetic or unnatural medicines. Going local and natural is a trend also observed in other countries across the globe, and adds to the acceptance or rejection of drugs regardless of their activity or toxicity. In fact, adverse side effects associated with herbal remedies, such as general weakness and swollen, sore mouth, do not seem to deter the respondents of this study in Ghana. We propose a combination of (a) increasing public awareness of the benefits of modern medicine and (b) an improvement and control of the quality of herbal remedies to raise the standard of malaria treatment in countries such as Ghana.

(1) Background: Rational use of medicines (RUM) and their assessment is important to ensure optimal use of resources and patient care in hospitals. These assessments are essential to identifying practice gaps for quality improvement. (2) Methods: Assessment of adherence to WHO/ International Network for Rational Use of Drugs core prescribing indicators among out-patients in 2021 was conducted at the University Hospital of the Kwame Nkrumah University of Science and Technology in the Ashanti region of Ghana. We reviewed electronic medical records (EMR) of 110,280 patient encounters in the year which resulted in 336,087 medicines prescribed. (3) Results: The average number of medicines prescribed per encounter was 3 with generics being prescribed in 76% of prescriptions. Injections were prescribed in 7% of encounters while 90% of medicines were from Ghana’s Essential Medicines List 2017. (4) Conclusions: With the exception of patient encounters with injections, all prescribing indicators assessed in this study did not meet WHO optimum levels providing targets for quality improvement in RUM. Implementing prescribing guides and policies, regular audits and feedback as well as continuous professional development training may help to improve prescribing practices in the hospital.