Availability and sufficiency of phenobarbital, an essential medication, in Bhutan: a survey of global and neuropsychiatric relevance

Abstract

ObjectiveWe aimed to provide a reliable evidence-based conclusion around manufacturing, import, availability and sufficiency of one essential medication, phenobarbital (PB) through our example location (Bhutan). The relevant details about manufacturing, import, annual quantity, dose strength were obtained.ResultsThere was no local manufacturing of PB and all other anti-seizure medications. A total of 1068 vials of PB 200 mg/mL inj and 489,350 tablets of PB30 mg (i.e. 14.6 kilos) was estimated to annually become available. Of this, 5.3 k (36.3%) was present at the basic health units (BHUs). The PB was absent at 26 (14.7%) BHUs. There was no availability of PB syrup. Treating supposed target of 50.0% of the 20.0% of the prevalent case-load (N = 4523) require 18.1 kilo of PB annually. To conclude, having or not the local manufacturing may or may not be a limitation. There is a need to overcome challenges of inappropriate dose strength, absent pediatric formulation, indirect cost, and low selling price of PB. The possible therapeutic participation of PB in managing disease conditions (like epilepsy) remains limited despite favorable safety and efficacy profile. Strengthening the availability of essential medications is essential to reduce the treatment gap and public health burden of treatable disease conditions.

Therapeutic Health Benefits of Religion Among Elderly- A Population based Representative Survey from Iran

“…Besides, all this, today, Islam is the fastest growing religion in the world and may sooner or later become the most prevalent. For instance, Islam grew 15.0% in the last five years in Australia; the Christians are reduced to 70.0% in Sweden; in 2008, 61.0% of those who annually migrated to France belonged to Meghreb [12] ; by 2040 the Islam would become the 2 nd largest religion in USA; in UK about 100,000 convert to Islam every year which showed a 12.0% growth in the last three years. It is also important to note that for MENA countries, like Algeria and Tunisia, having the nationality of their colonial country (i.e.…”

Availability, affordability, and quality of essential anti‐seizure medication in Cambodia

“…17 Eight molecules of ASM (carbamazepine, phenobarbital, phenytoin, sodium valproate, diazepam, gabapentin, lamotrigine, and magnesium sulfate) are registered in the essential drug list of Cambodia (9th edition, 2018) which are provided free of charge in public healthcare facilities. 18 However, epilepsy has the highest number of treatment dropouts, more than any other neuropsychiatric disorder. 16 A study in Cambodia performed in 2012 has shown that only a third of PWE (34.3%) were treated by ASM, and a high proportion of patients (43%) were not on any treatment.…”