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- Formulation and Characterization of Essential Oils Based Antibacterial
Hand Sanitizer Gels Abstract: Purpose: The usage of herbal-based antibacterial sanitizers is increasing, and they have considerably shown fewer side-effects than sanitizers with synthetic compounds. In the present study, essential oils obtained from cinnamon and lime were used to formulate hand sanitizer gels, and their efficacy was evaluated. Method: Three different hand sanitizer gel formulations were prepared using cinnamon oil (Formulation A), lime oil (Formulation B) and a mixture of cinnamon and lime oil (Formulation C). Carbopol 940 was used as the gelling agent. Tests for organoleptic, physicochemical characteristics and stability were conducted on the prepared formulations. The antibacterial activity of the prepared formulations was evaluated using the agar diffusion method. All three formulations were compared with a commercial liquid hand wash product for their in vitro antibacterial activity. Three-way ANOVA with Tukey's honestly significant difference test was used to compare the antibacterial activity of the hand sanitizer gel formulations. Stability of the three hand sanitizer formulations were assessed. Results: Considerable differences in the pH and viscosity were not observed between the prepared hand sanitizer gel formulations. However, considerable changes in the spreadability were observed between the prepared hand sanitizer gel formulations. A statistically significant difference in antibacterial activity was observed among the three hand sanitizer gels and the commercial hand wash (p<0.05). Formulation C showed the highest antibacterial activity among the prepared hand sanitizer formulations. Based on the stability studies, Formulation A was found to be the most stable. Conclusion: Hand sanitizer gel containing a mixture of cinnamon and lime oils showed the highest antibacterial activity among prepared formulations. However, the most stable formulation was the hand sanitizer gel containing cinnamon oil. Published on 2021-12-31 00:00:00
- Antimicrobial Effect of Polyphenols Enriched Fractions of Moringa oleifera
Lam. Leaves at the Flowering Stage Against Microbial Strains Causing Oral and Wound Infections Abstract: Purpose: Various parts of Moringa oleifera Lam. (Moringaceae) are used in traditional systems of medicine. This study investigates the antimicrobial activity of the crude aqueous extract and polyphenol enriched fractions of M. oleifera leaves at the flowering stage against microbial strains causing oral and wound infections. Methods: Polyphenol enriched fractions (hydroalcoholic extract, methanol fresh leaves extract, methanol dry leaves extract and decoction) were prepared using four different methods and total polyphenolic content (TPC) and total flavonoid content (TFC) of the extracts were determined. Crude aqueous extract and the fractions were tested against ATCC reference strains of Escherichia coli and Candida albicans (oral pathogens) and Streptococcus aureus and Staphylococcus pyogenes (wound pathogens) using agar well diffusion method. Gentamycin and clotrimazole were used as the positive controls for bacteria and fungi respectively and distilled water was used as the negative control. Results: Methanol dry leaves extract demonstrated highest values of TPC (11.92 ±0.39 mg GAE/g) and TFC (41.68±0.82 mg QE/g). Each polyphenol fraction demonstrated antibacterial activity against E. coli, S. aureus and S. pyogenes at concentrations of 500 - 1000 mg/ml. Hydro-alcoholic and methanol (fresh leaves) extracts demonstrated antifungal activity against C. albicans. The crude aqueous extract exhibited dose dependent antibacterial activity against S. aureus. All extracts demonstrated less antibacterial activity against S. pyogenes compared to S. aureus. Conclusion: Polyphenol rich fractions of M. oleifera leaves at the flowering stage possessed antimicrobial activity against E. coli, S. aureus, S. pyogenes and C. albicans. Published on 2021-12-31 00:00:00
- Calculation Strategies of Molar Ratio Based Homeopathic Dilutions and the
need for Pharmaceutical Scientists' Engagement Abstract: Purpose: A deficit was identified in the traditional method of making homeopathic dilutions by 1:9 or 1:99 serial dilutions based on the physical units of mass or volume. When the chemical unit mole is considered, the 1:9 mass-based dilution of nitroglycerin in ethyl alcohol has a 1:48.8 molar ratio. In order to provide the 1:9 molar ratio, the mass ratios required for formulations with lithium carbonate: lactose (diluent) and lead phosphate: lactose are 1:41.7 and 1:3.8 respectively. The extreme incongruity between the mass and the volume-based 1:9 ratios and the ratios based on chemical unit mole show the need to adopt the later scheme which is based on sound principles of chemistry. Method: Detailed calculations in determining the 1:9 molar ratio of drug: diluent are explained. Method for the molar ratio calculation of chemically less defined medicines such as plant extracts are proposed. Results: A Molar Ratio Universal Formula for the calculation of the amount of diluent to be used in preparing a given potency of a homeopathic preparation is introduced. Conclusion: The molar ratio dilutions based on principles of chemistry stand for wider acceptance of homeopathic medicines by the scientific community and for the advancement of the homeopathic system of medicine. Published on 2021-12-31 00:00:00
- Attitudes and Perceptions About the Role of a Clinical Pharmacist in
In-Patient Management among Nurses at a Tertiary Government Hospital, Sri Lanka Abstract: Background: In many countries, clinical pharmacy services are accepted and implemented for safe use of medications. The main function of a clinical pharmacist is to identify and prevent drug related problems. Clinical pharmacy services in Sri Lanka are yet to be accepted. Positive attitudes of healthcare professionals including nurses are important determinants for implementation of clinical pharmacy services. Objectives: To assess attitudes and perceptions about the role of a clinical pharmacist in in-patient management and the influence of socio demographic, work-related and personal factors among nurses at a selected teaching hospital, Sri Lanka. Method: A descriptive crosssectional study was conducted among 278 nurses working at a selected teaching hospital, Sri Lanka. A pre-tested, validated, self-administered questionnaire was used to collect data and were analyzed using Statistical Package of Social Science (SPSS) version 23. Descriptive and bivariate analysis was used to analyze data. Result: The respondent rate was (N=278) 68.4%. Most of the participants (79.9%) were females and mean age was 31.24±5.93 years. The majority of the participants had positive (N=234, 84.2%) attitudes and perceptions on the role of a clinical pharmacist in in-patient management. However, low acceptance was observed on clinical pharmacists, providing drug knowledge to nurses (25.9%), instructing nurses on incompatibilities in drug admixtures (63.3%), involvement in drug utilization review (61.9%), and developing individualized dosage regimes (71.2%). Age (p=0.046), practicing in special units (p=0.019), views on clinical pharmacists (p=0.003), need for drug information (p=0.007), and methods used to search drug information (p=0.015) were significantly associated with attitudes and perceptions on the role of clinical pharmacist in in-patient management. Conclusion: The current study revealed that there was positive attitudes and perceptions among nurses of the study hospital towards the role of a clinical pharmacist in in-patient management. Published on 2020-12-31 03:19:32
- Awareness and Perceptions of State Hospital Pharmacists on Dispensing
Errors – Evidence from Three Hospitals in Sri Lanka Abstract: Background: Errors may happen during the dispensing process and result in patient harm. Dispensing errors are preventable by error-proofing the system together with vigilance by pharmacists. Objectives: To assess awareness and perceptions on the prevalence, nature and possible causes of dispensing errors among pharmacists in selected hospitals in Sri Lanka. Methodology: The study was a descriptive, cross sectional and multi-center study where all pharmacists in three hospitals (one tertiary care and two secondary care) in three different districts were interviewed (N=48). A pretested and validated (content and face) interviewer administered questionnaire was used to collect data and data were analyzed using IBM SPSS (version 25.0). The questionnaire assessed perceptions of pharmacists on the prevalence, types, and possible causes of dispensing errors. Results: Most pharmacists were within the age 20- 40 years (67%) and 54% were women. Most pharmacists agreed that dispensing errors could happen (90%) in Sri Lanka while the rest had ‘no idea’ about dispensing errors. The majority (62%) agreed that they are prone to commit a dispensing error in the current hospital setup. Over 90% of pharmacists correctly identified the different types of dispensing errors. However, missing or wrong medicine information on dispensing labels, and dispensing the wrong quantity of medicine units were not considered as dispensing errors by a few. Among many reasons, pharmacists perceived, illegible handwriting on prescriptions (92%), similar or confusing medicine names (85%), dispensing of incomplete prescriptions (83%), and over worked pharmacists (81%) as main causes for dispensing errors in Sri Lanka. Conclusions: Most pharmacists in Sri Lanka were aware of the nature and prevalence of dispensing errors and highlighted numerous system issues that may cause them. These concerns must be urgently addressed by medical administrators to ensure medication safety of patients. Published on 2020-12-31 02:53:22
- Bloodless Circulatory Systems Including Axonal Transport and Eye Therapy
Through Medicating the Toe Abstract: A number of vital circulatory systems operate in the body which are devoid of blood. Each of these systems operate in isolation. This article intends to treat these bloodless circulatory systems as one whole new physiological entity so that they receive due attention. They carryout most functions of blood other than those related to erythrocytes. Unique among these is the neuron axonal transport of biological materials, now known to transport drugs. Treating eye diseases in Ayurveda through medication of the big toe of the foot for millennia appeared as an impossibility. Under this review it was possible to trace the probable axonal connecting pathway from big toe to the eyes. Strange enough, in this almost six-foot pathway, the drug molecules have to pass through only four biological cells except for 4-5 inches within the brain. Published on 2020-12-31 02:35:03
- Strategies to be Implemented in Sri Lanka to Improve Appropriate
Antibiotic Dispensing Practices: A Narrative Review Abstract: Background: Antimicrobial resistance (AMR) is a critical global health challenge. Sri Lanka a developing country is more vulnerable to AMR than developed nations due to numerous complex healthcare system issues including inappropriate dispensing practices of antibiotics at community pharmacies leading to inappropriate antimicrobial use. Objective: The aim of this review is to describe possible strategies for implementation in Sri Lanka to improve the appropriate antibiotic dispensing practices. Methods: Using EMBASE, MEDLINE and International Pharmaceutical Abstracts (IPA), a literature search was conducted for articles published between January 1980 and November 2017 that described studies involved in antibiotic dispensing at community pharmacies. Results: Inappropriate antibiotic dispensing is substantial in developing countries and a major contributing reason for overuse and misuse of antimicrobials in the community. Evidenced-based interventional studies showed; enforcement of law, education for pharmacy staff, awareness of consumers, and peer influence can minimize inappropriate dispensing practices at community pharmacies in developing countries. Conclusion: A multi-faceted approach is required to improve appropriate antibiotic dispensing practices in a developing country like Sri Lanka. Interventional strategies such as enforcement of existing medicines regulations, provision of targeted education and extensive training of pharmacy personnel, increased awareness of appropriate antibiotic use and AMR by consumers, and implementation of an antimicrobial stewardship program should be implemented and evaluated to help overcome the enablers of inappropriate antibiotics dispensing practices. Published on 2020-12-31 02:34:58
- Rational Prescribing of Oral Dosage Forms of Medicines to Children at a
Teaching Hospital in Sri Lanka Abstract: Purpose: Rational use of medicine includes prescribing practices at all levels. According to the available literature prescribing practices especially in children has been a challenge and poor prescribing practices are seen widely. Hence there is a need to investigate whether oral dosage forms of medicines are prescribed rationally to children. The objective of this study was to describe the rational prescribing practice of oral dosage forms of medicines to children in a teaching hospital in Sri Lanka. Methods: A descriptive cross-sectional study was conducted to assess the prescribing practices of 1800 oral dosage forms of medicines prescribed to children under the age of 12 years over a period of one year using validated indicators. Required data were extracted from the prescriptions using a structured pre-tested data extraction sheet. Descriptive statistics was used to analyse the data. Results: A total of 2195 medicine were prescribed during the study period and 1800 (82%) were oral dosage forms. Only 24 % of the oral dosage forms were prescribed appropriate to the weight of the child. The majority of the oral dosage forms were liquid and solid dosage forms were prescribed even to children under two years. Capsules were rarely prescribed to children. Conclusion: Prescribing practices of oral dosage forms of medicines to children has to be improved in the healthcare setting. Published on 2020-12-31 02:34:52
- Composite Astringent Index and the Determination of Anti-infective
Properties of Selected Folklore Therapies Abstract: Purpose: An attempt was made to quantify comparative astringent powers among selected substances taking tannic acid as the reference standard. The measurements were to be based on composite astringent power of all contributing compounds present in extracts. Among the folklore antimicrobial measures, consumption of black tea and black coffee in diarrheal conditions are well established. Their effectiveness was to be determined through demonstration of reduction in bacterial colony counts. Method: Astringent power of selected materials were determined using standard egg albumin solution by titrating with different astringent preparations. End points were determined when protein precipitation was completed using UV absorption measurements and biuret test. To evaluate anti-microbial activity of black tea and black coffee infusions, experiments on growth inhibition by a reduction of colony forming units were carried out. Results: The strongest astringent activity was found with Terminalia chebula (aralu) extract and the weakest with coriander extract. Black tea and black coffee infusions showed a high percentage of inhibitory activity against both Escherichia coli and Salmonella typhi in a range 70.83%±3.6 to 87.50%±0.00. Conclusion: Using astringent power of substances, the Composite Astringent Index was established. It was clear that consumption of black tea and black coffee infusions during diarrheal states can achieve significant anti-diarrheal effects. Materials with greater astringency showed greater anti-diarrheal effects. Materials with minimum end point values for the protein precipitation assay yielded the lowest astringent power values. Published on 2020-12-31 02:34:48
- Antibiotic Consumption in the State Sector of Sri Lanka Over 25 Years:
1994 - 2018 Using the GAP Methodology Abstract: Purpose: Surveillance of antibiotic consumption is one of the five pillars of the World Health Organizations global action plan to combat antimicrobial resistance. This study determined the feasibility of using the WHO-GAP methodology to develop a sustainable Antimicrobial Medicines Consumption (AMC) monitoring system in Sri Lanka. The aggregated distribution data (1994 – 2018) in the State sector was used to test feasibility and incite interest. Methods: Aggregated data on J01 defined as antibacterials for systemic use, distributed to the State sector from 1994 to 2018 were extracted from the database of the Medical Supplies Division, Ministry of Health. The Anatomical Therapeutic Chemical (ATC) classification and the Defined Daily Dose methodology was used to calculate the total consumption as DDDs per 1000 inhabitants per day (DID), relative use measures (percentages), and extent of use of WHO Access, Watch and Reserve group antibiotics. Results: Antibiotic consumption increased from 6.79 DID in 1994 to 13.89 DID in 2018 with the number of chemical substances increasing from 19 to 41 respectively. The most consumed was J01C (beta-lactam antibacterials) while the largest increase in rate of consumption was seen in J01D (other beta-lactam antibacterials). From 2008 the top ten oral and parenteral antibiotics showed a significant shift to broad spectrum from narrow spectrum with their ratio increasing from 0.19 to 2.37, due to predominant consumption of cefuroxime, ceftriaxone and co-amoxiclav. Consumption of the RESERVE group though low is rapidly increasing with time. Conclusion: This paper provides the Ministry of Health the impetus and direction to begin a sustainable monitoring system to track trends and drivers of AMC in Sri Lanka. Published on 2020-12-31 02:34:42
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