Antimicrobial resistance (AMR) is a leading global health threat, increasing morbidity, mortality, and costs, with excessive and irrational use of antimicrobials contributing to the development of AMR. Consequently, the aims of this study were to evaluate the understanding of antibiotic use, AMR, and antimicrobial stewardship programs (ASPs) among pharmacy technicians serving in ambulatory healthcare settings in Pakistan. A cross-sectional survey was conducted among pharmacy technicians serving in 144 ambulatory care settings in seven districts of Punjab province using a validated questionnaire. Overall, 376 technicians completed the survey (85.8% response rate). The majority were men (89.1%), aged 25–35 years (45.1%), serving in emergency departments (43.9%) and filling 31–60 prescriptions per day (37.5%). Most (79.5%) knew that antibiotics were one of the most frequently prescribed drug classes, while 59.8% believed antibiotics for common colds did not speed up recovery. Inadequate duration (59.6%) and inadequate dosages (57.7%) of antibiotic therapy were reported as the leading causes of AMR. Terms including ‘superbugs’, ‘multidrug resistance’, and ‘extensively drug resistance’ were known to 42.0%, 25.3%, and 20.7% of participants, respectively; however, <10% knew about ASPs, including their core elements and purpose. Our study revealed that pharmacy technicians have adequate awareness of antibiotic use but are currently unaware of AMR and ASPs, which is a concern.
The current study was designed to formulate ternary solid dispersions (TSDs) of dexibuprofen (Dex) by solvent evaporation to augment the solubility and dissolution profile, in turn providing gastric protection and effective anti-inflammatory activity. Initially, nine formulations (S1 to S9) of binary solid dispersions (BSDs) were developed. Formulation S1 comprising a 1:1 weight ratio of Dex and Syloid 244FP® was chosen as the optimum BSD formulation due to its better solubility profile. Afterward, 20 TSD formulations were developed using the optimum BSD. The formulation containing Syloid 244FP® with 40% Gelucire 48/16® (S18) and Poloxamer 188® (S23) successfully enhanced the solubility by 28.23 and 38.02 times, respectively, in pH 6.8, while dissolution was increased by 1.99- and 2.01-fold during the first 5 min as compared to pure drug. The in vivo gastroprotective study in rats suggested that the average gastric lesion index was in the order of pure Dex (8.33 ± 2.02) > S1 (7 ± 1.32) > S18 (2.17 ± 1.61) > S23 (1.83 ± 1.04) > control (0). The in vivo anti-inflammatory study in rats revealed that the percentage inhibition of swelling was in the order of S23 (71.47 ± 2.16) > S18 (64.8 ± 3.79) > S1 (54.14 ± 6.78) > pure drug (18.43 ± 2.21) > control (1.18 ± 0.64) after 6 h. ELISA results further confirmed the anti-inflammatory potential of the developed formulation, where low levels of IL-6 and TNF alpha were reported for animals treated with S23. Therefore, S23 could be considered an effective formulation that not only enhanced the solubility and bioavailability but also reduced the gastric irritation of Dex.
Objectives: To assess the knowledge of dengue disease cause, symptoms, prevention and management in Paramedical students of Independent School of Paramedics. Study Design: Descriptive cross sectional study Setting: Independent School of Paramedics Faisalabad. Period: From February till May 2018. Material & Methods: There were total of 140 paramedical students and all 140 paramedical students of Independent School of Paramedics were selected through convenience sampling technique. Data was collected through self-administered structured questionnaire after taking informed consent from all the participants. Questionnaire was adapted from already published studies. Knowledge of dengue was categorized as adequate (>80%), moderate (60-80%) and inadequate (<60%) depending upon the correct response for a particular question by study participants. Results: Knowledge on the transmission, symptoms of dengue and methods to prevent dengue was found to be adequate that is, 130 (92.9%), 113 (80.7%) and 122 (87.1%) respectively. Knowledge on cause of dengue 16 (11.4%), species of mosquito involved in transmission 30 (21.4%), likely time for mosquito to bite 32 (22.9%), dengue is preventable 77 (55%), and where to refer a dengue patient 77 (55%) was found to be inadequate. Moderate knowledge was found for route of transmission of dengue 109 (77.9%), natural habitat of mosquito 105 (75%) and medication for dengue 90 (64.3%). Conclusion: Overall knowledge on dengue symptoms and dengue prevention was found to be better than knowledge on cause of dengue and dengue management. This necessitates the comprehensive dengue educational program especially for dengue cause and dengue management for the paramedics.
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