A comparison between senior medical students' and pharmacy pre-registrants' knowledge and perceptions of generic medicines

OBJECTIVE: To ascertain any differences in knowledge and perceptions of generic medicines between senior (final year) medical students and pharmacy pre-registrants in Australia. METHODS: National web-based surveys containing 16 common questions were administered to each group. Responses were compared using Mann-Whitney U-test. RESULTS: Responses were received from 400 medical students (response rate 26.7%) and 289 pharmacy pre-registrants (response rate 30.5%). Both groups scored poorly on the allowable bioequivalence limits when comparing a brand-name medicine with a generic medicine, with pharmacy pre-registrants scoring better (P < 0.001). Pharmacy pre-registrants were more likely (P < 0.001) to report having been introduced to bioequivalence during their courses, and less likely (P < 0.001) to desire more information on bioequivalence testing. Both groups correctly agreed that generic medicines are bioequivalent to corresponding brand-name medicines but not necessarily to each other, and that generic medicines are cheaper. Pharmacy pre-registrants were more aware that generic medicines must be in the same dosage form (P < 0.001) and contain the same dose (P < 0.001) as the comparator brand-name medicine. Both groups incorrectly believed that generic medicines are required to meet higher safety standards, are inferior in quality, are less effective and produce more side-effects. Both groups agreed that it is easier to recognise a drug's therapeutic class from its generic name and that they needed more information about the safety and efficacy of generic medicines, with medical students feeling more strongly about this (P < 0.001). CONCLUSIONS: Although there were some differences in responses, both groups had knowledge deficits about the quality, safety and effectiveness of generic medicines, which need to be addressed by educators in order to increase the future use of generic medicines in Australia.     

Recombinant human alpha fetoprotein synergistically potentiates the anti-cancer effects of 1′-S-1′-acetoxychavicol acetate when used as a complex against human tumours harbouring AFP-receptors

Purpose

Previous in vitro and in vivo studies have reported that 1′-S-1′-acetoxychavicol acetate (ACA) isolated from rhizomes of the Malaysian ethno-medicinal plant Alpinia conchigera Griff (Zingiberaceae) induces apoptosis-mediated cell death in tumour cells via dysregulation of the NF-κB pathway. However there were some clinical development drawbacks such as poor in vivo solubility, depreciation of biological activity upon exposure to an aqueous environment and non-specific targeting of tumour cells. In the present study, all the problems above were addressed using the novel drug complex formulation involving recombinant human alpha fetoprotein (rhAFP) and ACA.

Experimental Design

To study the synergistic effect of both agents on human cancer xenografts, athymic nude (Nu/Nu) mice were used and treated with various combination regimes intraperitoneally. Serum levels of tumour markers for carcinoembryonic antigen (CEA) and prostate specific antigen (PSA) were assessed using sandwich ELISA. IHC and Western blotting were also conducted on in vivo tumour biopsies to investigate the involvement of NF-κB regulated genes and inflammatory biomarkers. Quantification and correlation between drug efficacies and AFP-receptors were done using IF-IC and Pearson''s correlation analysis.

Results

Mice exposed to combined treatments displayed higher reductions in tumour volume compared to stand alone agents, consistent with in vitro cytotoxicity assays. Milder signs of systemic toxicity, such as loss in body weight and inflammation of vital organs were also demonstrated compared to stand alone treatments. Tumour marker levels were consistent within all rhAFP/ACA treatment groups where levels of CEA and PSA were initially elevated upon commencement of treatment, and consecutively reduced corresponding to a decrease in tumour bulk volume. Both IHC and Western blotting results indicated that the combined action of rhAFP/ACA was not only able to down-regulate NF-κB activation, but also reduce the expression of NF-κB regulated genes and inflammatory biomarkers. The efficacy of rhAFP/ACA complex was also found to be weakly negatively correlated to the level of surface AFP-receptors between tumour types.

Conclusions

This drug complex formulation shows great therapeutic potential against AFP-receptor positive tumours, and serves as a basis to overcome insoluble and non-specific anti-neoplastic molecules.     

Menstrual hygiene management and its determinants among adolescent girls in low-income urban areas of Delhi,India: a community-based study

ObjectivesMenstrual hygiene management (MHM) in developing countries is linked to human rights, social justice, and the education and empowerment of young girls. The objective of this study was to assess menstrual hygiene practices and their determinants among adolescent girls, including school dropouts, and the effects of pad distribution programs in urban resettlement areas of Delhi, India.Methods A cross-sectional study was conducted from March 2019 to February 2020 in urban resettlement colonies and 2 villages of Delhi among 1,130 adolescent girls aged 10 to 19 years, who were interviewed face to face.Results In total, 954 participants (84.4%) used only disposable sanitary pads, 150 (13.3%) used both sanitary pads and cloths, and 26 (2.3%) used only cloths (n=1,130). Most school-going girls utilized the scheme for pad distribution, but only two-thirds of the girls who were out of school utilized the scheme. In the adjusted analysis, girls with lower educational status, those who had dropped out of school, and those from the Muslim religious community were more likely to use cloths for MHM.Conclusion More than 4 out of 5 adolescent girls in Delhi in low-income neighborhoods preferred sanitary pads for MHM. The government free pad scheme reached near-universal utilization among school-going girls (97%), but the subsidized pad scheme for girls who did not attend school was insufficiently utilized (75%).     

分期实施异体角膜缘干细胞移植与穿透性角膜移植术治疗严重化学伤

有1位于1996年实施右眼穿透性角膜移植术失败的双眼严重眼表化学伤的患者, 62岁,右眼视力手动,左眼视力光感。于2006-09-16/2007-02-07分别对右眼实施了异体角膜缘干细胞移植术和穿透性角膜移植术,经过术后5m的药物治疗观察,最终获得了右眼最佳矫正视力为6/30,角膜移植片透明,眼表得以重建,并未发现明显排斥迹象的良好效果。     

Double-segment total vertebrectomy for the surgical treatment of congenital kyphoscoliosis: a case report

BACKGROUND CONTEXT: Congenital kyphosis or kyphoscoliosis is an uncommon deformity that usually is progressive without surgical intervention. In the lately diagnosed or neglected cases of congenital kyphoscoliosis, the patients may come with shoulder-trunk imbalance anomalies, severe deformity in coronal and sagittal plane, rib cage deformities, pelvic tilt, presence of intramedullary anomalies, neurological deficit, and difficulty in walking and cardiopulmonary problems. PURPOSE: To present a technical note related with double-segment total vertebrectomy for the surgical treatment of a patient who had neglected congenital kyphoscoliosis in lumbar spine. STUDY DESIGN: Case report. METHODS: A 19-year-old girl had submitted to our center with complaints of deformity and pain in her back. Her physical examination revealed scoliosis and gibbosity in lumbar region. Her neurological examination was normal. In the radiological examination, X-ray films showed 42 degrees lumbar scoliosis in frontal plane and 35 degrees kyphotic curvature in the sagittal plane. RESULTS: Three-staged (posterior-anterior-posterior) surgery in the same session (same anesthesia) was performed. CONCLUSION: Total or partial vertebrectomy on the apex of the deformity and the adjacent vertebral bodies along with anterior stabilization by means of a cylindrical cage combined in one operative procedure preceded by temporary posterior instrumentation and followed by posterior instrumentation and fusion may be preferred for the treatment of congenital kyphoscoliosis in neglected cases to provide spinal cord decompression.     

Association between posterior crossbite and/or deep bite and temporomandibular disorders among Palestinian adolescents: A sex comparison

ABSTRACT

Objective: To assess the prevalence of temporomandibular disorders (TMDs) and posterior crossbite and/or deep bite and any possible association between them.

Methods: One thousand-nineteen adolescents responded to a questionnaire regarding oral habits and TMD symptoms. Afterwards, they were diagnosed according to the Axis I of the DC/TMD and underwent a dental examination. The chi-square test was used for statistical analysis.

Results: A significant association was found between posterior crossbite and some TMD diagnosis, but no association was found between deep bite and TMD, nor between occlusal diagnosis and bruxism. TMDs were more prevalent in girls. There was a significant sex difference (more among females) in the prevalence of painful TMDs.

Conclusion: Posterior crossbite in the adolescent population analyzed may be related to TMDs, in contrary to deep-bite. The presence of posterior crossbite may have different impact on TMD findings between the sexes.     

Arginine selective biosensor based on arginase-urease immobilized in gelatin

Arginase and urease enzymes were immobilized on the surface of pH electrode by using gelatin membrane which is then cross-linked with glutaraldehyde. Sensor response was maximum when 2.5 mM, Tris-HCl buffer (pH 8.5) was used at 25 degrees C. The biosensor response depends linearly on arginine concentration between 0.025-0.310 mM with response time 10 min. Furthermore, application of the system for the arginine detection in serum samples was also tested.     

Perspectives of physicians practicing in low and middle income countries towards generic medicines: A narrative review

Objectives

This review was conducted to document published literature related to physicians’ knowledge, attitudes, and perceptions of generic medicines in low- and middle-income countries (LMICs) and to compare the findings with high-income countries.

Methods

A systematic search of articles published in peer-reviewed journals from January 2001 to February 2013 was performed. The search comprised nine electronic databases. The search strategy involved using Boolean operators for combinations of the following terms: generic medicines, generic medications, generic drugs, generic, generic substitution, generic prescribing, international non-proprietary, prescribers, doctors, general practitioners, physicians, and specialists.

Results

Sixteen articles were included in this review. The majority (n = 11) were from high income countries and five from LMICs. The main difference between high income countries and LMICs is that physicians from high income countries generally have positive views whereas those from LMICs tend to have mixed views regarding generic medicines. Few similarities were identified among different country income groups namely low level of physicians’ knowledge of the basis of bioequivalence testing, cost of generic medicines as an encouraging factor for generic medicine prescribing, physicians’ concerns towards safety and quality of generic medicines and effect of pharmaceutical sales representative on generic medicine prescribing.

Conclusion

The present literature review revealed that physicians from LMICs tend to have mixed views regarding generic medicines. This may be due to differences in the health care system and pharmaceutical funding system, medicine policies, the level of educational interventions, and drug information sources in countries of different income levels.     

Effects of Highly Consumed Dietary Oils on Several Hepatic Transaminases and Lipid Oxidation in Chick

The incidence of cardiovascular disease is well correlated with diets high in saturated fatty acids (such as butter). On the other hand, oils, which are rich in unsaturated fatty acids (e.g., sunflower oil and corn oils), reduce cholesterol synthesis and thus show protective effects against arteriosclerosis. However, sunflower oil and corn oil are also considered as risk factors for their sensitivities to free radical formation because of their high contents of polyunsaturated fatty acids (PUFAs). The aim of the present study described herein was to investigate the production of reactive oxygen metabolites (an indicator of oxidative stress) and the activities of several transaminases (markers of hepatic injury) in chick liver treated with highly consumed dietary oils (differing in the degree of saturation). The animals were randomly assigned to six groups of 29 and fed dietary butter, margarine, olive oil, sunflower oil, or corn oil for 2 months. The results indicated that the level of reactive oxygen metabolites (ROM) was lowest in the dietary butter-fed group but highest in the corn oil-fed group. Similarly, the activities of all transaminases measured were lowest in the butter group, and in the margarine-fed group only the Gama-glutamyl transaminase activity was lowest as compared to the control group. From these findings, it was concluded that the dietary butter was the most resistant oil to lipid oxidation, whereas corn oil was the most susceptible one, which may thus challenge the antioxidant defense system and increase the susceptibility of tissues to degradation products of lipid oxidation.