Background: Black box warnings indicating harmful or potentially fatal adverse events are required by the Food and Drug Administration on certain drugs and chemical entities; however it is unclear if prescribing and dispensing habits are impacted by these warnings. This study investigates the knowledge and perceptions of prescribers and pharmacists regarding black box warnings.
Methods: A cross-sectional survey of self-reported behavior related to black box warnings was administered to prescribers and pharmacists across North Carolina between October 2010 and January 2011.
Results: A total of 867 pharmacists and prescribers completed the survey, including 715 pharmacists and 152 prescribers. Of the respondents, 54% were female and 92% described their ethnicity as Caucasian. Overall, pharmacists reported a greater change in behavior than did prescribers in relation to the presence of a boxed warning (P < .01). Pharmacists also demonstrated a significantly greater overall knowledge of boxed warnings compared to prescribers (P < .01). No differences in reported behavior or knowledge were observed between prescribers and pharmacists based on demographic factors.
Limitations: Solicitation through professional association mailing lists resulting in low response rates may impact findings.
Conclusion: Overall knowledge on information pertaining to boxed warnings was lacking. Impact in clinical practice due to the lack of understanding regarding boxed warnings may put patients at increased risk. To improve the overall knowledge of black boxed warnings, the FDA should adopt develop a publicly available central repository for all black box warnings. Curricula in schools of medicine and pharmacy as well as professional continuing education should include a focus on boxed warnings.
Background: The widespread use, misuse and overuse of antibiotics in human and veterinary medicine have resulted in emergence and spread of antibiotics resistance consequently decreasing their effectiveness and efficacy. Recent studies consistently reveal that university students have limited knowledge and widely misuse antibiotics thereby increasing the spread and problem of resistance. This study aims to obtain baseline information on the knowledge, attitude and practice towards antibiotics use and resistance among university students in Uyo, Nigeria.
Methods: A cross-sectional questionnaire based study of the knowledge of, attitude and perception to antibiotics use and resistance was conducted among convenience sample of non-medical students attending one of the major universities in Uyo, South-South of Nigeria for a period of three months between April and June 2017. Descriptive and multivariate logistic regression was used in data analysis.
Results: Out of the 335 questionnaire distributed, 15 were excluded for incomplete demographics and less than 80% filling (response rate, 95.5%). The knowledge assessment test shows poor knowledge of antibiotics use and resistance among two hundred and one non- medical students (62.8%) while one hundred and nineteen students (37.2%) had good knowledge. Year of study and age were significantly associated with knowledge of antibiotics use and resistance while there was no statistical relationship between gender and knowledge scores. More than half of the participants (51.9%) have taken antibiotics within the last six months while only 43.1% completed the last antibiotics prescribed to them. One hundred and eighty nine students have self-medicated in the past and more than one third of them were to treat cold and cough symptoms.
Conclusion: This study substantiates that limited knowledge of antibiotic use and resistance exists among non-medical university students in Uyo, Nigeria. It also suggests a high level of antibiotics misuse in the form of non-adherence to prescribed dose of antibiotics and self-medication majorly for treating respiratory symptoms. Based on these findings, we recommend a sustained continuing medical education for healthcare workers and public health awareness campaigns. In addition, antibiotic sales should be strictly regulated in Nigeria to prevent their indiscriminate use of medicine.
Ochratoxin A is a metabolite of fungal origin with the potential of inciting oxidative stress which results in disease conditions in man and animals. Plant parts from time immemorial have been used to treat disease conditions with considerable success, hence the study is aimed at determining the capacity of Lippia alba leaf extract to reduce the concentration of ochratoxin A in animal serum, kidney, and liver. Albino rats (60) were obtained and maintained, then divided into pre-treated set which were administered plant extract before toxin administration intraperitoneally, and post-treated set administered the toxin then treated with the plant extract. After 7 days of treatment and observation, the animals were euthanized, serum collected, and the organs harvested. Ochratoxin A concentration was determined using HPLC. Results obtained showed that serum of animals in group 5 treated with L. alba extract after toxin administration reduced OTA levels to 0.12 ± 0.06 ng/mL in the pre-treated set, while 0.58 ± 0.01 ng/mL was obtained in the post-treated set. The livers of pre-treated animals presented a 75% reduction in ochratoxin A concentration level compared to post-treated set that obtained 59.57% ochratoxin A reduction. Kidney toxins levels were lower than values obtained in the liver and serum. Though considerable reductions in ochratoxin A levels were recorded in the kidney, there was no significant difference from the control at p<0.05 in values obtained between the post-treated and pre-treat sets unlike values obtained in the serum and liver that presented significant differences at p<0.05. The study concluded that the plant possesses therapeutic capabilities which brought about the effects noted in the study. It is recommended that further study be undertaken to unravel the other potentials of the plant and mechanism of action.
Fresh samples of leaves and roots of Thunbergia grandiflora were collected from forest- reserved area, Ibadan, Nigeria for extraction of their volatile oils. Hydro-distillation method was used in an all-glass Clevenger apparatus designed to British pharmacopeia specifications. It gave yields of 0.09% and 0.10% respectively. The oils were analyzed using gas chromatography [GC], gas chromatography-mass spectrometry [GC-MS] in University of Botswana. A total of thirty-eight compounds were identified in the leaf and root essential oils, twenty-seven compounds were identified in leaf oil, which account for 98.13% of it while seventeen identified compounds are responsible for 73.98% of root oil. Most abundant compounds in leaf oil are α-3-octanol (45.96%), 3,7 dimethyl 1,6-octadien-3-ol (13.22%) and 2- methoxy-3-(2-propenyl) phenol (8.36%). Dominant compounds in root oil are methyl salicylate (44.80%), 2,21,5,51-tetramethyl-1,11 - biphenyl (5.05%) and i-propyl hexadecanoate (2.87%). leaf oil is dominated by following classes of compounds (%); alcohols (68.58), carboxylic acid (4.01), aldehydes (12.90), ketones (5.18), esters (2.62), aromatics (0.66) and also sulphurates (0.45). Classes of compounds in root oil are esters (47.67), alcohols (2.64), carboxylic acids (0.55), aldehydes (7.69), sulphurates (1.61), aromatics (5.05) and alkane (5.02). The two oils contain alcohols and esters in good amounts. Our results indicate that alcohols, esters and aldehydes dominate Thunbergia grandiflora essential oils. We present important compounds in the leaf and root essential oils of Thunbergia grandiflora, which have not been reported earlier in literature.
Background: Children with thalassemia major need regular blood transfusions to survive. These multiple transfusions put them at risk for iron overload, which result in organ damage such as parathyroid gland. The aim of this study is to determine levels of calcium, phosphorus, vitamin D and parathyroid hormone in children with thalassemia major and compare them with controls, and analyze their correlation with serum ferritin level.
Methodology: This was a cross-sectional study in 37 patients with thalassemia major in Department of Pediatrics, Dr. M. Jamil Hospital Padang and 37 age- and sex-matched healthy controls. Serum calcium ion, inorganic phosphorus, vitamin D (25-hydroxycholecalciferol), parathyroid hormone (PTH) and ferritin levels were measured.
Results: There were 18 boys and 19 girls in each group. Their age ranged between 2 and 16 years, with 20 (54%) children aged more than 10 years. Median of ferritin level in patients and controls were 2981 (IQR 3662) ng/mL and 36.6 (IQR 27.5) ng/mL respectively. Mean level of calcium ion and phosphorus levels in patients were 1.17 (SD 0.07) mmol/L and 5.42 (SD 0.76) mg/dL respectively. Median values of vitamin D and PTH in patients were 54.3 (IQR 21.1) ng/mL and 127.5 (IQR 183.1) pg/mL respectively. Compared to healthy controls, calcium ion level in patients was significantly lower (P = .001). On the contrary, phosphorous, vitamin D and PTH levels were not significantly different. Vitamin D and PTH levels had no significant correlation with serum ferritin levels (P = 0.147 and P = 0.2 respectively, while calcium ion level showed significant negative correlation with serum ferritin levels (r=-0.44, P=0.007).
Conclusion: Vitamin D and PTH levels have no significant correlation with serum ferritin level. The calcium ion level has a moderate negative correlation with serum ferritin level.