Azadirachta indica A. Juss (neem) is a popular plant in Vietnam that possesses strong hypoglycemic effects. However, limited research reports the formulation of the neem extract in a pharmaceutical dosage form. Thus, this work determined the development and in-vitro/in-vivo evaluation of the film-coated tablets containing neem leaf extract, with moistureprotected ability, for diabetes treatment. To this end, we first investigated the neem leaf's optimal extraction conditions to obtain the extract with the strongest hypoglycemic effect. The best condition was the utilization of ethanol 90% as a solvent, with a plant solid-to-solvent ratio of 1:10 w/w. Then, the optimal film-coated tablet formulations were determined by varying the types/amounts of the tablet adsorbents, diluents, binders, disintegrants, and moistureresistant film-coating polymers. The best formulation possessed good moisture resistance compared to commercial products and acceptable friability and disintegration values. Finally, the product was evaluated for its antidiabetic property by both in-vitro and in-vivo tests, utilizing the α-glucosidase inhibitory assay and mice glucose tolerance test, respectively. The tablets showed significant hypoglycemic effects in inhibiting the α-glucosidase enzyme (43.33% compared to 55.16% of the commercial drug Glucobay) and in-vivo test in mice. In summary, the film-coated tablets containing A. indica A. Juss leaf extract had potential antidiabetic effects in in-vitro/in-vivo settings.
Background: The wide and prolonged use and abuse of antibiotics in livestock and poultry farming, aquaculture, and farming to treat and prevent animal diseases, as well as production purposes, made microorganisms adapt to drugs, facilitate the resistance of many types of antibiotics, and decrease the effectiveness of medicines. Objective: To assess the counseling skills of community pharmacists for antibiotics by using the simulated patient approach. Methods: A cross-sectional study was conducted from June 2021 to June 2022. Data were obtained from a convenience sampling consisting of one pharmacist from each of the 24 participating community pharmacies. To evaluate the pharmacists’ counseling skills, a simulated patient role played a standardized headache case requesting self-medication. The interactions of the simulated patient with the pharmacists were audiovisually recorded using a hidden micro-camera. These recordings were analyzed using a questionnaire designed based on the guidelines of the World Health Organization on the rational and safe use of drugs. Results: 100% of pharmacy retailers sold medicines at clients’ request, 26.7% of the pharmacies and 15.8% of pharmacy counters selling antibiotics for more than 5 days. None of the visited pharmacies asked about past medical history or the history of allergic reactions. The most common advice was to change medicines/use others (n=22, 18.3%). Around 4.2% of pharmacy staff gave instructions for taking the right dose of antibiotics. No simulated patient received information on side effects. The number of pharmacists who gave instructions for the number of drugs used per day (n=40, p<0.05) and for a single dose (n=44, p<0.05) were fewer than the others. Conclusion: This study showed that the pharmacists’ counseling skills, guidance provided by the pharmacists to the patient, and training courses for community pharmacists in Vietnam should be enhanced.
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