Mediterranean Journal of Pharmacy and Pharmaceutical Sciences (Mediterr J Pharm Pharm Sci) is a broad spectrum, International, peer-reviewed, and open-access journal committed to publishing high-quality articles in the field of Pharmaceutical Sciences (see "Area of Interest" under ABOUT JOURNAL). Mediterr J Pharm Pharm Sci is the official journal of the Libyan Association for Pharmacists (LAP). The journal accepts articles from all the countries conducted in all branches of pharmacy. The journal is published online quarterly in March, June, September, and December. The language of the journal is English Supervisors: Fathi M Sherif and Abdussalam AM Amara Phone: 00218912117258 Address: Libyan Association for Pharmacists LAP
HOW TO CITE THIS Gamag et al. (2024) Glycosylated hemoglobin in type 2 diabetic patients as a bio... more HOW TO CITE THIS Gamag et al. (2024) Glycosylated hemoglobin in type 2 diabetic patients as a biomarker for predicting dyslipidemia.
My journey as a teacher started in 1971, keeping the student's interests in mind. The experiences... more My journey as a teacher started in 1971, keeping the student's interests in mind. The experiences gained through observing some of the best teachers in mind like Dr. Gopalan (Director General of ICMR) Dr. Srikantia (Director, National Institute of Nutrition, Hyderabad), and Dr. Copper (Madras Medical College) I developed an interest in teaching. What I learned was to teach in a simple language that is relevant to the field of education. Being a Rotarian as well as having the opportunity of being a Student Advisory Council chairman, IISc, Banglore, and Ad Hoc President of the Research Scholar’s Association, Madras University, I learned the art of speaking and communication. One of the key points of my learning is to learn the ability to develop a rapport with the students whom I teach. The workshops and training imparted by Medical Education Nodal centers, refined and made my teaching relevant to medical students. One of the most important requirements is to have practical skills that help you to adapt your teaching to the needs of the students. I developed this skill as I ran one of the ICMR-recognized diagnostic centers. The center gave me the opportunity to gain my practical skills for basic and clinical Biochemistry.
Midazolam, a benzodiazepine medication, is used for sedation during diagnostic and therapeutic me... more Midazolam, a benzodiazepine medication, is used for sedation during diagnostic and therapeutic medical procedures. Insufficient doses of sedatives, including midazolam, can result in patient anxiety and awareness during the procedure. Several brands of midazolam are available in the Libyan market. This study aims to identify and estimate the medication content of intravenous midazolam in various marketed products using different analytical methods. Product identity was confirmed using Infrared methods (IR) and retention times of High-Performance Liquid Chromatographic methods (HPLC). Quantification was performed using a rapid reverse-phase HPLC method. Chromatographic analysis was conducted on a C18 column (250 mm×3.3 mm I.D., 5.0 μm particle size) with a mobile phase comprising acetonitrile, methanol, and 0.065 M ammonium acetate buffer (50: 20: 30, v/v/v), adjusted to a pH of 5.5±0.02 with orthophosphoric acid, at a flow rate of 1.0 ml/min. Ultraviolet (UV) detection was set at 220 nm. The identification results met British Pharmacopeia (BP) standards. However, the midazolam content in the Tunisian brand was shallow compared to the products from Germany and Switzerland. Thus, post-marketing testing is essential to assess the quality of critical drugs like midazolam, and further investigations, including clinical evaluations and regulatory follow-up, are necessary.
In scientific and analytical research, Ultraviolet-visible spectroscopy, Fourier Transform Infrar... more In scientific and analytical research, Ultraviolet-visible spectroscopy, Fourier Transform Infrared spectroscopy, and Nuclear Magnetic Resonance spectroscopy have widely been used to analyze and characterize various substances. Ultraviolet, infrared, and Nuclear Magnetic Resonance spectroscopy were studied for diastereoisotopic protons of dorzolamide, which is used to treat glaucoma and ocular hypertension. Methanol was used as a solvent in Ultraviolet and we obtained three wavelengths: 203 nm, 253 nm, and 257 nm, where Ultraviolet spectroscopy was employed for stability testing of pharmaceuticals. By analyzing the Fourier Transform Infrared spectrum, we also can determine the presence or absence of specific functional groups in a compound, helping to identify the compound or confirm its structure in analyzing the Nuclear Magnetic Resonance spectrum. It can determine the types and numbers of hydrogen (proton) and carbon atoms in a molecule and their chemical environment, which helps elucidate the molecular structure.
In several counties, Vitex negundo have been claimed to have anti-inflammatory, analgesic, and an... more In several counties, Vitex negundo have been claimed to have anti-inflammatory, analgesic, and antioxidant activities. It's frequently used in folk medicine for the treatment of various pain disorders. The methanol extract of Vitex negundo leaves was studied for its biological effects. To investigate different biological exertions of the methanol extract of Vitex negundo, the leaf extracts were obtained with pure methanol. In-vitro anti-oxidant activity was resolved using a DPPH radical scavenging assay. A clot lysis test was used to assess the thrombolytic activity. Antiproliferative effects of DMSO Vitex negundo in cell lines acquired from human cervix adenocarcinoma (HeLa cells). Using the brine shrimp lethality bioassay method, the plant extracts were evaluated for cytotoxic action. LC50 values were determined through probit analysis of mortality percentages. In hole cross-test and open-field test, neuropharmacological activities of mice were assessed in mice. The findings revealed that Vitex negundo leaf extract possessed antioxidant effects, streptokinase exposed significant clot lysis and human cervix adenocarcinoma cells demonstrated mild cervical antiproliferative activity. Significant neuropharmacological action (antidepressant and anxiolytic) and cytotoxic action were shown by the methanol extract of Vitex negundo leaves.
Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study ... more Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study aimed to perform a comparative assessment of the methanol extracts of the fruit and the leaf of Solanum melongena against multi-drug-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The crude extracts were obtained from the leaves and fruits of the plant using methanol. The plant extracts were tested for the presence of various phytochemical constituents qualitatively. The antibacterial assay and minimum inhibitory concentration for the crude extracts were carried out using the agar well diffusion and agar dilution methods, respectively. Phytochemical analysis of methanol extracts of Solanum melongena revealed the presence of various phytoconstituents. Antibacterial assay of methanol extracts of Staphylococcus melongena against multi-drug-resistant Staphylococcus aureus isolates with ciprofloxacin as a reference control revealed inhibition zone diameter ranging from 04.0±0.0 to 11.0±0.0 mm; in contrast that of multi-drug-resistant Pseudomonas aeruginosa isolates revealed inhibition zone diameter, with ciprofloxacin showing no inhibition. The minimum inhibitory concentration of the methanol extracts on Pseudomonas aeruginosa isolates ranges from 25.0 to 50.0 mg/ml and 25.0->50.0 mg/ml, respectively, in comparison, the minimum inhibitory concentration of the methanol extracts on Staphylococcus aureus isolates ranges from 6.25 to 50.0 mg/ml and 6.25->50.0 mg/ml respectively. Thus, the fruit extract had better activity against test multi-drugresistant Pseudomonas aeruginosa and Staphylococcus aureus than the leaf extract of Solanum melongena.
Metformin hydrochloride is the first-line anti-diabetic drug used to treat type 2 diabetes mellit... more Metformin hydrochloride is the first-line anti-diabetic drug used to treat type 2 diabetes mellites and helps to control blood sugar levels. Various brands of metformin are available in the Libyan market which makes it challenging to select, an effective and economical one. This study aimed to compare different brands of metformin available in the Misurata and evaluate the quality parameter according to the British Pharmacopoeia. Six brands of metformin tablets (850 mg) were taken from the market and assessed. To achieve this purpose five tests were done on each brand, the uniformity of weight test shows the average weight and 5.0% deviation, the friability test gives how much the tablet can stand attrition, the disintegration time test shows the time taken by the tablet to disintegrate, dissolution test to confirm the rate of drug release, weight variation and friability test of all brands was within the specified limit. Disintegration time for all the brands was within 30 minutes. All six brands of metformin hydrochloride tablets fulfilled the in-vitro dissolution rate test specification not less than 80% of the drug is released within 45 minutes. Using Ultraviolet-visible (UV) spectroscopy, UV analysis of different samples shows that the percentage content of active ingredients of five brands of metformin hydrochloride tablets was within the monograph specification (95%-105%) of drug content but one brand failed this test. The study indicated that strict quality control of imported drugs should enforced to ensure effective and safe medicines in the Libyan market.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
In developing nations, pneumonia is the leading cause of death for young children; however, morta... more In developing nations, pneumonia is the leading cause of death for young children; however, mortality can be effectively decreased with early diagnosis and care. The objectives of the review are to evaluate the significance of clinical signs and symptoms in diagnosing pneumonia, and treatment in children under the age of five, as well as to examine the precision of WHO criteria in diagnosing clinical pneumonia in general people. According to the World Health Organization's definition and the Integrated Management of Childhood Illness (IMCI) initiative, pneumonia is clinically characterized by an acute cough, with or without fever, accompanied by dyspnea or tachypnea. Acute infections of the gut and gastroenteritis can be effectively controlled and treated. Acute respiratory infections, particularly pneumonia, are increasingly regarded as the leading infectious cause of mortality among children in developing nations. The diagnosis of pneumonia is primarily clinical and categorized into four domains: clinical assessment, epidemiological factors, radiographic imaging, and standard laboratory results. Pneumonia can be classified into three categories: bacterial, viral, and acute pneumonia. In every instance, a potential diagnosis should be made and the appropriate course of therapy should be administered based on the features of that pneumonia. Preventing and lowering the death and morbidity of this significant disease in children can be greatly aided by physicians having precise and accurate information on how to identify and treat it without incurring additional expenses.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Recent studies have shown that pharmacists have an interest in conducting research. However, barr... more Recent studies have shown that pharmacists have an interest in conducting research. However, barriers such as lack of confidence prevent pharmacists from participating in ruling research. This study evaluated pharmacists' self-perceived competence and confidence scores for health-related research. A validated self-designed questionnaire was distributed to randomly recruited Libyan pharmacists in hospitals and community pharmacies. Both descriptive and inferential statistical analyses were applied to the data. The analysis included 191 responses. Most respondents had prior research experience (67.0%). Over two-thirds (72.3%) rated their ability to conduct health-related research as good to excellent. The majority had not published articles in peer-reviewed journals in the past five years (71.2%) and had no abstracts or posters published at local/regional (65.4%) or international conferences (79.1%). Lack of support (55.5%) was the most common barrier to participating in health-related research, followed by lack of funds (42.9%), time (29.3%), and knowledge (26.2%). At least two-thirds of pharmacists felt somewhat competent or confident in conceptualizing research ideas, collecting data, managing and storing data, and preparing presentations. Less than 60% felt competent /confident in outlining statistical plans and using statistical software. Overall, pharmacists displayed moderate competence (median score=38.0/65) and confidence (median score=40/65) in planning and conducting health-related research. Those with prior research experience (median score=42.0 vs. 29.0) and training (median score=41.0 vs. 28.0) had significantly higher scores. Higher scores were also noted among those who had published in peer-reviewed journals (median score=46.0 vs. 37.0) and presented at regional/local conferences (median score=46.5 vs. 34.0). Most pharmacists in Libya were interested in conducting research, and the majority of them had previous research experience and previous research-related training. The pharmacists had moderate competence and confidence to plan and conduct research. Research training was recommended for practicing pharmacists and pharmacy students to improve pharmacists' research involvement and promote the advancement of pharmacy practice in Libya.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Warfarin is the most widely used anticoagulant drug which reduces the risk of blood clots forming... more Warfarin is the most widely used anticoagulant drug which reduces the risk of blood clots forming. This review aims to highlight the significant research on the synthesis of warfarin and its derivatives using numerous methods such as Michael reactions, green enantioselective, one-pot condensation, and catalytic synthesis. The synthesis of warfarin derivatives was discussed since they have proven to have higher biological activity than warfarin itself. Further, this review was carried out to figure out the shortcomings in the synthesis methods and shed light on the contribution of each research on the development and design of stereospecific synthesis of warfarin or its derivatives which were proven to be potent hits with an acceptable cost. Moreover, the contribution of some methods in green chemistry advancement has been investigated.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Anemia is a common health problem among Libyan women. Age, heavy menstruation, and pregnancy are ... more Anemia is a common health problem among Libyan women. Age, heavy menstruation, and pregnancy are vital risk factors for this problem. In this study, we prospectively examined 60 Libyan women all of which were diagnosed with iron deficiency anemia, their hemoglobin levels were less than 10.0 g/dl. The level of hemoglobin is also analyzed for vegetarian and charcoal-eating women. We found that during pregnancy charcoal-eating women exhibit lower hemoglobin levels than non-eating women. Pregnant young women in the age of 17-27 years have the lowest hemoglobin levels than the other age groups. In addition, vegetarians, heavy coffee and tea drinking, and heavy menstruation in non-pregnant women, as well as breastfeeding, strongly lower hemoglobin levels as measured by their complete blood count.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Justicia carnea, a plant rich in bioactive compounds, has traditionally been used as a haemoglobi... more Justicia carnea, a plant rich in bioactive compounds, has traditionally been used as a haemoglobin booster by herbal practitioners in rural areas of Edo State of Nigeria. In this study, the methanol leaves extract of Justicia carnea was investigated for its antisickling potential in hemoglobin SS (HbSS) in-vitro by sodium metabisulphite assay and characterized by Gas Chromatography-Mass Spectrometry (GC-MS) and High-Performance Liquid Chromatography (HPLC). Terpenoids, saponins, glycosides, phenolics, flavonoids and alkaloids were present except tannins. Photomicrograph examinations revealed a reduction of sickle cells with a percentage decrease from 37.50%, and 22.22% down to 3.85% with 100 mg/mL crude extract of Justicia carnea at three durations, respectively. Detected compounds from Gas Chromatography-Mass Spectrometry included hexadecanoic acid methyl ester (
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Ascorbic acid (vitamin C) is a water-soluble vitamin; it is present in the highest concentration ... more Ascorbic acid (vitamin C) is a water-soluble vitamin; it is present in the highest concentration in the brain. Ascorbic acid in high doses acts as a potential treatment for various neuropathological and psychiatric conditions. Flumazenil is a benzodiazepine antagonist; it competitively inhibits the activity of benzodiazepine and non-benzodiazepine substances that interact with benzodiazepine receptors site on the GABA/benzodiazepine receptor complex. This study aims to investigate the effect of flumazenil on the anxiolytic action of ascorbic acid using an elevated plus maze model of anxiety in rats. Male Albino Wistar rats weighing between 250 and 320 grams were used. Rats were divided into four equal groups of seven rats each and treated as follows: Group I, the control group received a single dose of 1.0% tween 80; Group II treated with a single dose of 125 mg/kg ascorbic acid; Group III was injected by a single dose of 1.0 mg/kg flumazenil; Group IV received a combination treatment of 125 mg/kg ascorbic acid and 1.0 mg/kg flumazenil. Behavioural measurements using a plus maze were scored 30 min after the administration. The parameters scored are the time spent on the open and closed arms, the lines and number of entries into open and closed arms, and the anxiety measure. Ascorbic acid decreased anxiety measure and increased the total lines and total number of entries; this effect was abolished by the administration of flumazenil with ascorbic acid. Thus, ascorbic acid produces an anxiolytic-like effect in rats; this effect was abolished by flumazenil administration with ascorbic acid. This may indicate that the GABA/benzodiazepine receptor complex has to be stimulated to produce the anxiolytic effect.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences , 2024
Monkeypox, an infectious disease caused by the Orthopoxvirus, was identified in humans in 1970. I... more Monkeypox, an infectious disease caused by the Orthopoxvirus, was identified in humans in 1970. It has recently emerged as a global health concern due to outbreaks beyond its endemic regions in Central and West Africa. This review examines the current state of medical treatments for monkeypox as of 2024, focusing on antiviral agents, immunotherapies, and supportive care measures. Monkeypox manifests with symptoms including fever, rash, and lymphadenopathy, with severe cases more common in immunocompromised individuals. Antiviral therapies such as tecovirimat and brincidofovir are central to treatment strategies, with tecovirimat demonstrating efficacy in alleviating symptoms and reducing viral shedding. Emerging treatment strategies involve novel lipid-based formulations and combination therapies that integrate antivirals with immunemodulating agents. Supportive care remains essential, involving analgesics and antibiotics for secondary infections, while the MVA-BN vaccine plays a critical role in prevention. Research emphasizes the need for a deeper understanding of viral pathogenesis and host immune responses to improve therapeutic and preventive measures. Despite significant advancements, challenges remain, including potential antiviral resistance, disparities in healthcare access, and the necessity for enhanced diagnostic and surveillance capabilities. This review highlights the imperative for ongoing research, international collaboration, and investment in healthcare infrastructure to advance the management and prevention of monkeypox and to prepare for future outbreaks.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infecti... more Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done antimicrobial susceptibility testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays... more Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays a crucial role in healthcare decision-making by evaluating the costs and outcomes of different treatment options. In Libya, however, the implementation of PE evaluations faces various challenges that hinder its effective integration into healthcare systems. This communication analyses the current needs and prospects of PE by examining the challenges in its implementation, the benefits of integrating it into healthcare decision-making, and strategies to enhance its utilization in the country's healthcare landscape. By exploring these different aspects, it is possible to gain a comprehensive understanding of Libya's status and potential advancements in PE. In Libya, the earliest records related to PE trace back to the late 19 th century, specifically around 1835 during the Turkish colonization. During that time, various documents documented details such as drug prices, direct costs associated with specific diseases, expenditures on essential pharmaceuticals, and annual inventories of health and pharmaceutical institutions [2]. Over the past 80 years since modern Libya's establishment after the colonial era, Libyan authorities have consistently published annual statistical reports. These reports cover expenditures on medicines, pharmaceuticals, and therapeutic materials, as well as the stock levels in healthcare facilities [3]. However, despite this data, there remains a significant lack of literature on PE, with a few exceptions that do not meet the standards expected of PE studies. Challenges in implementing PE in Libya are multifaceted and pose significant barriers to its effective utilization. Firstly, the lack of data and resources for PE evaluations hampers the ability to conduct comprehensive cost-effectiveness analyses. Without robust data on treatment costs and patient outcomes, decision-makers cannot make informed choices regarding resource allocation in healthcare. Additionally, there is limited awareness and training in PE among healthcare professionals in Libya, leading to a gap in the expertise needed to perform and interpret PE studies accurately [1]. Moreover, the inadequate healthcare infrastructure in the country further exacerbates the challenges of conducting PE evaluations, as the requisite support systems and expertise are lacking. Integrating PE into healthcare decision-making in Libya offers a range of benefits that can optimize resource allocation and improve patient outcomes. Cost-effectiveness analysis provides policymakers with valuable insights into which interventions deliver the best value for money, enabling them to prioritize healthcare services that offer the greatest benefits to the population. By basing decisions on evidence from PE evaluations, healthcare providers can enhance patient outcomes through the implementation of cost-effective interventions that have been proven to be clinically effective. Besides, the transparency and accountability that PE evaluations bring to healthcare policy decisions can foster public
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
The purpose of this study was to determine the attitudes, expectations, experiences, and barriers... more The purpose of this study was to determine the attitudes, expectations, experiences, and barriers that physicians in Tripoli hospitals experienced when working alongside Clinical Pharmacists (CPs). A descriptive self-administered questionnaire was used for the study, and participants were selected from several Tripoli hospitals. Most of the respondents agreed that CPs are an essential part of patient care teams and that they have the legal authority to review a patient's medication regimen and response. More than half of respondents believe CPs must be responsible for the medications they prescribe to patients. Half of the respondents agreed that CPs should be encouraged to play a more active role in hospitals and other healthcare facilities. The majority of participants agreed that CPs should participate in managing drug side effects and almost half agreed that CPs can contribute to decisions about drug interactions. By a low agreement rate, 42.7% of respondents thought CPs were specially qualified to counsel patients on drug therapy. A similar low trend was observed, with 40.9% agreeing to provide pharmacists with additional responsibility and authority in clinical departments, in contrast, 54.5% expressed their concern about the clinical responsibility of CPs in clinical practice. A minority of physicians agreed that Physicians should consult pharmacists in selecting the best pharmacological treatment. At the same time, the majority think that pharmacists lack clinical skills and 61.8% feel that physicians are unable to communicate effectively with CPs. 43.6% acknowledged that the traditional opposition between the two professions was a barrier to interprofessional collaboration while the absence of pharmacy space in clinical settings was cited by 39.1%. A majority of respondents agreed that physicians and pharmacists may improve their interprofessional collaboration by raising their awareness about it. A minority of respondents thought that laws and regulations governing physician collaboration should be put in place to promote effective collaboration between physicians and CPs. The study discovered that although most physicians endorse the introduction of clinical pharmacy services in hospitals and believe that physicians and pharmacists can collaborate on many tasks, respondents were not as impressed with the CPs' performance and believed that they lacked the professionalism required to carry out clinical responsibilities successfully. To facilitate the growth of clinical pharmacy services, laws and regulations must be put in place.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Parkinson’s disease is a common movement disorder associated primarily with oxidative stress-medi... more Parkinson’s disease is a common movement disorder associated primarily with oxidative stress-mediated degeneration of dopaminergic neurons. Earlier studies showed that Sorghum bicolor-based supplement (SbS) exhibited antioxidant and neuroprotective activities and might likely rescue the death of dopaminergic neurons in Parkinson’s disease. This study examined the effect of SbS on rotenone-induced Parkinsonian-like motor deficits in rats and the involvement of oxidative stress and pro-inflammatory cytokines. Rats were divided into six groups and treated orally with sunflower oil (vehicle-control), rotenone (2.5 mg/kg) alone or in combination with each dose of SbS (50, 100, and 200 mg/kg) and levodopa-carbidopa (10 mg/kg) on an alternate day for 28 days. The changes in motor functions were evaluated on day 28 and the brain concentrations of oxidative stress biomarkers and pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6) were determined. Rotenone caused motor deficits by impaired locomotor activity in the open field test and induced catalepsy in the bar test, which were attenuated by SbS. Rats pretreated with SbS had reduced brain levels of malondialdehyde, nitrite, and pro-inflammatory cytokines compared to rotenone controls. SbS mitigated rotenone-induced depletion of reduced glutathione and antioxidant enzymes in the rat brain. The results suggest that SbS ameliorated rotenone-induced Parkinsonian-like motor dysfunctions by reducing neuronal oxidative stress and pro-inflammatory cytokines in rats.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Metformin is considered the first-line treatment as a monotherapy for patients with type 2 diabet... more Metformin is considered the first-line treatment as a monotherapy for patients with type 2 diabetes mellitus. Emerging evidence suggests that metformin may have a renoprotective role; therefore, understanding the impact of metformin dose and therapy duration on renal function may significantly improve renal outcomes in type 2 diabetes patients. This study aims to investigate the renoprotective effects of metformin by analyzing its dose-dependent impacts on the estimated glomerular filtration rate in patients with type 2 diabetes mellitus. A retrospective cross-sectional study design was used from September 2022 to October 2023. Data from 302 type 2 diabetes patients were collected from patient files at the Benghazi Diabetic Center and the Aljabal Al-Alkdar Diabetic Center, including all with type 2 diabetes mellitus patients on varying doses of metformin. The collected data included age, gender, metformin dose, duration of metformin therapy, urea, and creatinine. Exclusion criteria included patients with significant comorbidities such as chronic kidney disease (other than diabetic nephropathy), liver disease, heart failure, or malignancy; those taking nephrotoxic medications; individuals with recent acute illnesses or surgical procedures; pregnant or lactating women; participants with inadequate medical records; and patients who were non-adherent to metformin therapy. Survival analysis was conducted to evaluate the effect of different metformin doses on the estimated glomerular filtration rate. The study analyzed 302 diabetic patients, of whom 46.0% were male and 54.0% were female. The age was 58.3±11.9 years. The HbA1c was 7.7%±1.3%. The duration of diabetes was 11.4±8.1 years. The creatinine was 1.0±0.9 mg/dL, and the urea was 36.7±23.8 mg/dL. Data analysis revealed a statistically significant difference in survival distribution across the dose groups. Different metformin doses significantly impact the estimated glomerular filtration rate, suggesting that dosage plays a crucial role in maintaining renal function.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
The labeling of medications includes the provision of information and instructions as well as a u... more The labeling of medications includes the provision of information and instructions as well as a unique identity for the medical product. It is one of the most important sources of information for patients. Good labeling practice is critical to ensuring patients' safe and effective use of products. Misreading the label, insufficient data on the label, inappropriate labeling font, writing style, and placement on the dosage form can all have disastrous consequences. The objective of this study was to assess medication labeling practices among community pharmacists in Libya. A simulated client method (SCM) was used, and the study was carried out in the City of Zawia, where 146 local pharmacies were visited over three months for the investigation (January to March 2023). These visits were made at random, without the pharmacist's knowledge. The findings revealed that all dispensed drugs were not labeled, and none of the practicing pharmacists in any pharmacies visited displayed any drug label, printed or handwritten. The majority of pharmacists did not address or explain significant information to the patient in an effective manner, which led to inappropriate and harmful consumption of medications. The absence of dispensed drug labels reduces the patient's knowledge of the necessary information about the medicine, resulting in a treatment deficit or unsuccessful therapy. Thus, more effort should be made by health authorities to instruct pharmacists to use and work according to international labeling standards or to establish local labeling specifications.
HOW TO CITE THIS Gamag et al. (2024) Glycosylated hemoglobin in type 2 diabetic patients as a bio... more HOW TO CITE THIS Gamag et al. (2024) Glycosylated hemoglobin in type 2 diabetic patients as a biomarker for predicting dyslipidemia.
My journey as a teacher started in 1971, keeping the student's interests in mind. The experiences... more My journey as a teacher started in 1971, keeping the student's interests in mind. The experiences gained through observing some of the best teachers in mind like Dr. Gopalan (Director General of ICMR) Dr. Srikantia (Director, National Institute of Nutrition, Hyderabad), and Dr. Copper (Madras Medical College) I developed an interest in teaching. What I learned was to teach in a simple language that is relevant to the field of education. Being a Rotarian as well as having the opportunity of being a Student Advisory Council chairman, IISc, Banglore, and Ad Hoc President of the Research Scholar’s Association, Madras University, I learned the art of speaking and communication. One of the key points of my learning is to learn the ability to develop a rapport with the students whom I teach. The workshops and training imparted by Medical Education Nodal centers, refined and made my teaching relevant to medical students. One of the most important requirements is to have practical skills that help you to adapt your teaching to the needs of the students. I developed this skill as I ran one of the ICMR-recognized diagnostic centers. The center gave me the opportunity to gain my practical skills for basic and clinical Biochemistry.
Midazolam, a benzodiazepine medication, is used for sedation during diagnostic and therapeutic me... more Midazolam, a benzodiazepine medication, is used for sedation during diagnostic and therapeutic medical procedures. Insufficient doses of sedatives, including midazolam, can result in patient anxiety and awareness during the procedure. Several brands of midazolam are available in the Libyan market. This study aims to identify and estimate the medication content of intravenous midazolam in various marketed products using different analytical methods. Product identity was confirmed using Infrared methods (IR) and retention times of High-Performance Liquid Chromatographic methods (HPLC). Quantification was performed using a rapid reverse-phase HPLC method. Chromatographic analysis was conducted on a C18 column (250 mm×3.3 mm I.D., 5.0 μm particle size) with a mobile phase comprising acetonitrile, methanol, and 0.065 M ammonium acetate buffer (50: 20: 30, v/v/v), adjusted to a pH of 5.5±0.02 with orthophosphoric acid, at a flow rate of 1.0 ml/min. Ultraviolet (UV) detection was set at 220 nm. The identification results met British Pharmacopeia (BP) standards. However, the midazolam content in the Tunisian brand was shallow compared to the products from Germany and Switzerland. Thus, post-marketing testing is essential to assess the quality of critical drugs like midazolam, and further investigations, including clinical evaluations and regulatory follow-up, are necessary.
In scientific and analytical research, Ultraviolet-visible spectroscopy, Fourier Transform Infrar... more In scientific and analytical research, Ultraviolet-visible spectroscopy, Fourier Transform Infrared spectroscopy, and Nuclear Magnetic Resonance spectroscopy have widely been used to analyze and characterize various substances. Ultraviolet, infrared, and Nuclear Magnetic Resonance spectroscopy were studied for diastereoisotopic protons of dorzolamide, which is used to treat glaucoma and ocular hypertension. Methanol was used as a solvent in Ultraviolet and we obtained three wavelengths: 203 nm, 253 nm, and 257 nm, where Ultraviolet spectroscopy was employed for stability testing of pharmaceuticals. By analyzing the Fourier Transform Infrared spectrum, we also can determine the presence or absence of specific functional groups in a compound, helping to identify the compound or confirm its structure in analyzing the Nuclear Magnetic Resonance spectrum. It can determine the types and numbers of hydrogen (proton) and carbon atoms in a molecule and their chemical environment, which helps elucidate the molecular structure.
In several counties, Vitex negundo have been claimed to have anti-inflammatory, analgesic, and an... more In several counties, Vitex negundo have been claimed to have anti-inflammatory, analgesic, and antioxidant activities. It's frequently used in folk medicine for the treatment of various pain disorders. The methanol extract of Vitex negundo leaves was studied for its biological effects. To investigate different biological exertions of the methanol extract of Vitex negundo, the leaf extracts were obtained with pure methanol. In-vitro anti-oxidant activity was resolved using a DPPH radical scavenging assay. A clot lysis test was used to assess the thrombolytic activity. Antiproliferative effects of DMSO Vitex negundo in cell lines acquired from human cervix adenocarcinoma (HeLa cells). Using the brine shrimp lethality bioassay method, the plant extracts were evaluated for cytotoxic action. LC50 values were determined through probit analysis of mortality percentages. In hole cross-test and open-field test, neuropharmacological activities of mice were assessed in mice. The findings revealed that Vitex negundo leaf extract possessed antioxidant effects, streptokinase exposed significant clot lysis and human cervix adenocarcinoma cells demonstrated mild cervical antiproliferative activity. Significant neuropharmacological action (antidepressant and anxiolytic) and cytotoxic action were shown by the methanol extract of Vitex negundo leaves.
Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study ... more Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study aimed to perform a comparative assessment of the methanol extracts of the fruit and the leaf of Solanum melongena against multi-drug-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The crude extracts were obtained from the leaves and fruits of the plant using methanol. The plant extracts were tested for the presence of various phytochemical constituents qualitatively. The antibacterial assay and minimum inhibitory concentration for the crude extracts were carried out using the agar well diffusion and agar dilution methods, respectively. Phytochemical analysis of methanol extracts of Solanum melongena revealed the presence of various phytoconstituents. Antibacterial assay of methanol extracts of Staphylococcus melongena against multi-drug-resistant Staphylococcus aureus isolates with ciprofloxacin as a reference control revealed inhibition zone diameter ranging from 04.0±0.0 to 11.0±0.0 mm; in contrast that of multi-drug-resistant Pseudomonas aeruginosa isolates revealed inhibition zone diameter, with ciprofloxacin showing no inhibition. The minimum inhibitory concentration of the methanol extracts on Pseudomonas aeruginosa isolates ranges from 25.0 to 50.0 mg/ml and 25.0->50.0 mg/ml, respectively, in comparison, the minimum inhibitory concentration of the methanol extracts on Staphylococcus aureus isolates ranges from 6.25 to 50.0 mg/ml and 6.25->50.0 mg/ml respectively. Thus, the fruit extract had better activity against test multi-drugresistant Pseudomonas aeruginosa and Staphylococcus aureus than the leaf extract of Solanum melongena.
Metformin hydrochloride is the first-line anti-diabetic drug used to treat type 2 diabetes mellit... more Metformin hydrochloride is the first-line anti-diabetic drug used to treat type 2 diabetes mellites and helps to control blood sugar levels. Various brands of metformin are available in the Libyan market which makes it challenging to select, an effective and economical one. This study aimed to compare different brands of metformin available in the Misurata and evaluate the quality parameter according to the British Pharmacopoeia. Six brands of metformin tablets (850 mg) were taken from the market and assessed. To achieve this purpose five tests were done on each brand, the uniformity of weight test shows the average weight and 5.0% deviation, the friability test gives how much the tablet can stand attrition, the disintegration time test shows the time taken by the tablet to disintegrate, dissolution test to confirm the rate of drug release, weight variation and friability test of all brands was within the specified limit. Disintegration time for all the brands was within 30 minutes. All six brands of metformin hydrochloride tablets fulfilled the in-vitro dissolution rate test specification not less than 80% of the drug is released within 45 minutes. Using Ultraviolet-visible (UV) spectroscopy, UV analysis of different samples shows that the percentage content of active ingredients of five brands of metformin hydrochloride tablets was within the monograph specification (95%-105%) of drug content but one brand failed this test. The study indicated that strict quality control of imported drugs should enforced to ensure effective and safe medicines in the Libyan market.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
In developing nations, pneumonia is the leading cause of death for young children; however, morta... more In developing nations, pneumonia is the leading cause of death for young children; however, mortality can be effectively decreased with early diagnosis and care. The objectives of the review are to evaluate the significance of clinical signs and symptoms in diagnosing pneumonia, and treatment in children under the age of five, as well as to examine the precision of WHO criteria in diagnosing clinical pneumonia in general people. According to the World Health Organization's definition and the Integrated Management of Childhood Illness (IMCI) initiative, pneumonia is clinically characterized by an acute cough, with or without fever, accompanied by dyspnea or tachypnea. Acute infections of the gut and gastroenteritis can be effectively controlled and treated. Acute respiratory infections, particularly pneumonia, are increasingly regarded as the leading infectious cause of mortality among children in developing nations. The diagnosis of pneumonia is primarily clinical and categorized into four domains: clinical assessment, epidemiological factors, radiographic imaging, and standard laboratory results. Pneumonia can be classified into three categories: bacterial, viral, and acute pneumonia. In every instance, a potential diagnosis should be made and the appropriate course of therapy should be administered based on the features of that pneumonia. Preventing and lowering the death and morbidity of this significant disease in children can be greatly aided by physicians having precise and accurate information on how to identify and treat it without incurring additional expenses.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Recent studies have shown that pharmacists have an interest in conducting research. However, barr... more Recent studies have shown that pharmacists have an interest in conducting research. However, barriers such as lack of confidence prevent pharmacists from participating in ruling research. This study evaluated pharmacists' self-perceived competence and confidence scores for health-related research. A validated self-designed questionnaire was distributed to randomly recruited Libyan pharmacists in hospitals and community pharmacies. Both descriptive and inferential statistical analyses were applied to the data. The analysis included 191 responses. Most respondents had prior research experience (67.0%). Over two-thirds (72.3%) rated their ability to conduct health-related research as good to excellent. The majority had not published articles in peer-reviewed journals in the past five years (71.2%) and had no abstracts or posters published at local/regional (65.4%) or international conferences (79.1%). Lack of support (55.5%) was the most common barrier to participating in health-related research, followed by lack of funds (42.9%), time (29.3%), and knowledge (26.2%). At least two-thirds of pharmacists felt somewhat competent or confident in conceptualizing research ideas, collecting data, managing and storing data, and preparing presentations. Less than 60% felt competent /confident in outlining statistical plans and using statistical software. Overall, pharmacists displayed moderate competence (median score=38.0/65) and confidence (median score=40/65) in planning and conducting health-related research. Those with prior research experience (median score=42.0 vs. 29.0) and training (median score=41.0 vs. 28.0) had significantly higher scores. Higher scores were also noted among those who had published in peer-reviewed journals (median score=46.0 vs. 37.0) and presented at regional/local conferences (median score=46.5 vs. 34.0). Most pharmacists in Libya were interested in conducting research, and the majority of them had previous research experience and previous research-related training. The pharmacists had moderate competence and confidence to plan and conduct research. Research training was recommended for practicing pharmacists and pharmacy students to improve pharmacists' research involvement and promote the advancement of pharmacy practice in Libya.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Warfarin is the most widely used anticoagulant drug which reduces the risk of blood clots forming... more Warfarin is the most widely used anticoagulant drug which reduces the risk of blood clots forming. This review aims to highlight the significant research on the synthesis of warfarin and its derivatives using numerous methods such as Michael reactions, green enantioselective, one-pot condensation, and catalytic synthesis. The synthesis of warfarin derivatives was discussed since they have proven to have higher biological activity than warfarin itself. Further, this review was carried out to figure out the shortcomings in the synthesis methods and shed light on the contribution of each research on the development and design of stereospecific synthesis of warfarin or its derivatives which were proven to be potent hits with an acceptable cost. Moreover, the contribution of some methods in green chemistry advancement has been investigated.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Anemia is a common health problem among Libyan women. Age, heavy menstruation, and pregnancy are ... more Anemia is a common health problem among Libyan women. Age, heavy menstruation, and pregnancy are vital risk factors for this problem. In this study, we prospectively examined 60 Libyan women all of which were diagnosed with iron deficiency anemia, their hemoglobin levels were less than 10.0 g/dl. The level of hemoglobin is also analyzed for vegetarian and charcoal-eating women. We found that during pregnancy charcoal-eating women exhibit lower hemoglobin levels than non-eating women. Pregnant young women in the age of 17-27 years have the lowest hemoglobin levels than the other age groups. In addition, vegetarians, heavy coffee and tea drinking, and heavy menstruation in non-pregnant women, as well as breastfeeding, strongly lower hemoglobin levels as measured by their complete blood count.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Justicia carnea, a plant rich in bioactive compounds, has traditionally been used as a haemoglobi... more Justicia carnea, a plant rich in bioactive compounds, has traditionally been used as a haemoglobin booster by herbal practitioners in rural areas of Edo State of Nigeria. In this study, the methanol leaves extract of Justicia carnea was investigated for its antisickling potential in hemoglobin SS (HbSS) in-vitro by sodium metabisulphite assay and characterized by Gas Chromatography-Mass Spectrometry (GC-MS) and High-Performance Liquid Chromatography (HPLC). Terpenoids, saponins, glycosides, phenolics, flavonoids and alkaloids were present except tannins. Photomicrograph examinations revealed a reduction of sickle cells with a percentage decrease from 37.50%, and 22.22% down to 3.85% with 100 mg/mL crude extract of Justicia carnea at three durations, respectively. Detected compounds from Gas Chromatography-Mass Spectrometry included hexadecanoic acid methyl ester (
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Ascorbic acid (vitamin C) is a water-soluble vitamin; it is present in the highest concentration ... more Ascorbic acid (vitamin C) is a water-soluble vitamin; it is present in the highest concentration in the brain. Ascorbic acid in high doses acts as a potential treatment for various neuropathological and psychiatric conditions. Flumazenil is a benzodiazepine antagonist; it competitively inhibits the activity of benzodiazepine and non-benzodiazepine substances that interact with benzodiazepine receptors site on the GABA/benzodiazepine receptor complex. This study aims to investigate the effect of flumazenil on the anxiolytic action of ascorbic acid using an elevated plus maze model of anxiety in rats. Male Albino Wistar rats weighing between 250 and 320 grams were used. Rats were divided into four equal groups of seven rats each and treated as follows: Group I, the control group received a single dose of 1.0% tween 80; Group II treated with a single dose of 125 mg/kg ascorbic acid; Group III was injected by a single dose of 1.0 mg/kg flumazenil; Group IV received a combination treatment of 125 mg/kg ascorbic acid and 1.0 mg/kg flumazenil. Behavioural measurements using a plus maze were scored 30 min after the administration. The parameters scored are the time spent on the open and closed arms, the lines and number of entries into open and closed arms, and the anxiety measure. Ascorbic acid decreased anxiety measure and increased the total lines and total number of entries; this effect was abolished by the administration of flumazenil with ascorbic acid. Thus, ascorbic acid produces an anxiolytic-like effect in rats; this effect was abolished by flumazenil administration with ascorbic acid. This may indicate that the GABA/benzodiazepine receptor complex has to be stimulated to produce the anxiolytic effect.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences , 2024
Monkeypox, an infectious disease caused by the Orthopoxvirus, was identified in humans in 1970. I... more Monkeypox, an infectious disease caused by the Orthopoxvirus, was identified in humans in 1970. It has recently emerged as a global health concern due to outbreaks beyond its endemic regions in Central and West Africa. This review examines the current state of medical treatments for monkeypox as of 2024, focusing on antiviral agents, immunotherapies, and supportive care measures. Monkeypox manifests with symptoms including fever, rash, and lymphadenopathy, with severe cases more common in immunocompromised individuals. Antiviral therapies such as tecovirimat and brincidofovir are central to treatment strategies, with tecovirimat demonstrating efficacy in alleviating symptoms and reducing viral shedding. Emerging treatment strategies involve novel lipid-based formulations and combination therapies that integrate antivirals with immunemodulating agents. Supportive care remains essential, involving analgesics and antibiotics for secondary infections, while the MVA-BN vaccine plays a critical role in prevention. Research emphasizes the need for a deeper understanding of viral pathogenesis and host immune responses to improve therapeutic and preventive measures. Despite significant advancements, challenges remain, including potential antiviral resistance, disparities in healthcare access, and the necessity for enhanced diagnostic and surveillance capabilities. This review highlights the imperative for ongoing research, international collaboration, and investment in healthcare infrastructure to advance the management and prevention of monkeypox and to prepare for future outbreaks.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infecti... more Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done antimicrobial susceptibility testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays... more Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays a crucial role in healthcare decision-making by evaluating the costs and outcomes of different treatment options. In Libya, however, the implementation of PE evaluations faces various challenges that hinder its effective integration into healthcare systems. This communication analyses the current needs and prospects of PE by examining the challenges in its implementation, the benefits of integrating it into healthcare decision-making, and strategies to enhance its utilization in the country's healthcare landscape. By exploring these different aspects, it is possible to gain a comprehensive understanding of Libya's status and potential advancements in PE. In Libya, the earliest records related to PE trace back to the late 19 th century, specifically around 1835 during the Turkish colonization. During that time, various documents documented details such as drug prices, direct costs associated with specific diseases, expenditures on essential pharmaceuticals, and annual inventories of health and pharmaceutical institutions [2]. Over the past 80 years since modern Libya's establishment after the colonial era, Libyan authorities have consistently published annual statistical reports. These reports cover expenditures on medicines, pharmaceuticals, and therapeutic materials, as well as the stock levels in healthcare facilities [3]. However, despite this data, there remains a significant lack of literature on PE, with a few exceptions that do not meet the standards expected of PE studies. Challenges in implementing PE in Libya are multifaceted and pose significant barriers to its effective utilization. Firstly, the lack of data and resources for PE evaluations hampers the ability to conduct comprehensive cost-effectiveness analyses. Without robust data on treatment costs and patient outcomes, decision-makers cannot make informed choices regarding resource allocation in healthcare. Additionally, there is limited awareness and training in PE among healthcare professionals in Libya, leading to a gap in the expertise needed to perform and interpret PE studies accurately [1]. Moreover, the inadequate healthcare infrastructure in the country further exacerbates the challenges of conducting PE evaluations, as the requisite support systems and expertise are lacking. Integrating PE into healthcare decision-making in Libya offers a range of benefits that can optimize resource allocation and improve patient outcomes. Cost-effectiveness analysis provides policymakers with valuable insights into which interventions deliver the best value for money, enabling them to prioritize healthcare services that offer the greatest benefits to the population. By basing decisions on evidence from PE evaluations, healthcare providers can enhance patient outcomes through the implementation of cost-effective interventions that have been proven to be clinically effective. Besides, the transparency and accountability that PE evaluations bring to healthcare policy decisions can foster public
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
The purpose of this study was to determine the attitudes, expectations, experiences, and barriers... more The purpose of this study was to determine the attitudes, expectations, experiences, and barriers that physicians in Tripoli hospitals experienced when working alongside Clinical Pharmacists (CPs). A descriptive self-administered questionnaire was used for the study, and participants were selected from several Tripoli hospitals. Most of the respondents agreed that CPs are an essential part of patient care teams and that they have the legal authority to review a patient's medication regimen and response. More than half of respondents believe CPs must be responsible for the medications they prescribe to patients. Half of the respondents agreed that CPs should be encouraged to play a more active role in hospitals and other healthcare facilities. The majority of participants agreed that CPs should participate in managing drug side effects and almost half agreed that CPs can contribute to decisions about drug interactions. By a low agreement rate, 42.7% of respondents thought CPs were specially qualified to counsel patients on drug therapy. A similar low trend was observed, with 40.9% agreeing to provide pharmacists with additional responsibility and authority in clinical departments, in contrast, 54.5% expressed their concern about the clinical responsibility of CPs in clinical practice. A minority of physicians agreed that Physicians should consult pharmacists in selecting the best pharmacological treatment. At the same time, the majority think that pharmacists lack clinical skills and 61.8% feel that physicians are unable to communicate effectively with CPs. 43.6% acknowledged that the traditional opposition between the two professions was a barrier to interprofessional collaboration while the absence of pharmacy space in clinical settings was cited by 39.1%. A majority of respondents agreed that physicians and pharmacists may improve their interprofessional collaboration by raising their awareness about it. A minority of respondents thought that laws and regulations governing physician collaboration should be put in place to promote effective collaboration between physicians and CPs. The study discovered that although most physicians endorse the introduction of clinical pharmacy services in hospitals and believe that physicians and pharmacists can collaborate on many tasks, respondents were not as impressed with the CPs' performance and believed that they lacked the professionalism required to carry out clinical responsibilities successfully. To facilitate the growth of clinical pharmacy services, laws and regulations must be put in place.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Parkinson’s disease is a common movement disorder associated primarily with oxidative stress-medi... more Parkinson’s disease is a common movement disorder associated primarily with oxidative stress-mediated degeneration of dopaminergic neurons. Earlier studies showed that Sorghum bicolor-based supplement (SbS) exhibited antioxidant and neuroprotective activities and might likely rescue the death of dopaminergic neurons in Parkinson’s disease. This study examined the effect of SbS on rotenone-induced Parkinsonian-like motor deficits in rats and the involvement of oxidative stress and pro-inflammatory cytokines. Rats were divided into six groups and treated orally with sunflower oil (vehicle-control), rotenone (2.5 mg/kg) alone or in combination with each dose of SbS (50, 100, and 200 mg/kg) and levodopa-carbidopa (10 mg/kg) on an alternate day for 28 days. The changes in motor functions were evaluated on day 28 and the brain concentrations of oxidative stress biomarkers and pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6) were determined. Rotenone caused motor deficits by impaired locomotor activity in the open field test and induced catalepsy in the bar test, which were attenuated by SbS. Rats pretreated with SbS had reduced brain levels of malondialdehyde, nitrite, and pro-inflammatory cytokines compared to rotenone controls. SbS mitigated rotenone-induced depletion of reduced glutathione and antioxidant enzymes in the rat brain. The results suggest that SbS ameliorated rotenone-induced Parkinsonian-like motor dysfunctions by reducing neuronal oxidative stress and pro-inflammatory cytokines in rats.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
Metformin is considered the first-line treatment as a monotherapy for patients with type 2 diabet... more Metformin is considered the first-line treatment as a monotherapy for patients with type 2 diabetes mellitus. Emerging evidence suggests that metformin may have a renoprotective role; therefore, understanding the impact of metformin dose and therapy duration on renal function may significantly improve renal outcomes in type 2 diabetes patients. This study aims to investigate the renoprotective effects of metformin by analyzing its dose-dependent impacts on the estimated glomerular filtration rate in patients with type 2 diabetes mellitus. A retrospective cross-sectional study design was used from September 2022 to October 2023. Data from 302 type 2 diabetes patients were collected from patient files at the Benghazi Diabetic Center and the Aljabal Al-Alkdar Diabetic Center, including all with type 2 diabetes mellitus patients on varying doses of metformin. The collected data included age, gender, metformin dose, duration of metformin therapy, urea, and creatinine. Exclusion criteria included patients with significant comorbidities such as chronic kidney disease (other than diabetic nephropathy), liver disease, heart failure, or malignancy; those taking nephrotoxic medications; individuals with recent acute illnesses or surgical procedures; pregnant or lactating women; participants with inadequate medical records; and patients who were non-adherent to metformin therapy. Survival analysis was conducted to evaluate the effect of different metformin doses on the estimated glomerular filtration rate. The study analyzed 302 diabetic patients, of whom 46.0% were male and 54.0% were female. The age was 58.3±11.9 years. The HbA1c was 7.7%±1.3%. The duration of diabetes was 11.4±8.1 years. The creatinine was 1.0±0.9 mg/dL, and the urea was 36.7±23.8 mg/dL. Data analysis revealed a statistically significant difference in survival distribution across the dose groups. Different metformin doses significantly impact the estimated glomerular filtration rate, suggesting that dosage plays a crucial role in maintaining renal function.
Mediterranean Journal of Pharmacy and Pharmaceutical Sciences, 2024
The labeling of medications includes the provision of information and instructions as well as a u... more The labeling of medications includes the provision of information and instructions as well as a unique identity for the medical product. It is one of the most important sources of information for patients. Good labeling practice is critical to ensuring patients' safe and effective use of products. Misreading the label, insufficient data on the label, inappropriate labeling font, writing style, and placement on the dosage form can all have disastrous consequences. The objective of this study was to assess medication labeling practices among community pharmacists in Libya. A simulated client method (SCM) was used, and the study was carried out in the City of Zawia, where 146 local pharmacies were visited over three months for the investigation (January to March 2023). These visits were made at random, without the pharmacist's knowledge. The findings revealed that all dispensed drugs were not labeled, and none of the practicing pharmacists in any pharmacies visited displayed any drug label, printed or handwritten. The majority of pharmacists did not address or explain significant information to the patient in an effective manner, which led to inappropriate and harmful consumption of medications. The absence of dispensed drug labels reduces the patient's knowledge of the necessary information about the medicine, resulting in a treatment deficit or unsuccessful therapy. Thus, more effort should be made by health authorities to instruct pharmacists to use and work according to international labeling standards or to establish local labeling specifications.
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