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Biomedical silk protein optics has become the subject of intensive research aimed at solving the challenges associated with traditional medical devices in terms of biocompatibility and performance balance. With its significant potential for biomedical applications in the field of drug storage and wound monitoring, it is dedicated to reducing the perturbation of neighbouring tissues. The transparency and biocompatibility of silk proteins make them ideal materials in the field of optical device fabrication, effectively overcoming the challenges posed by conventional materials. In this paper, we explore in detail the complex aspects of the design, synthesis and application related to biomedical silk protein optical devices and comprehensively analyse the potential use of silk protein-centric microstructures (e.g., micropillars, microneedles, and photonic crystals) in the development of optical devices. This review also offers insights into the challenges of applying silk protein optical devices in healthcare and their future trends, aiming to provide a comprehensive overview of the advances, potential impacts and emerging research directions in the field of biomedical silk protein optical devices. [ABSTRACT FROM AUTHOR]

Currently, blockchain-based solutions for drug traceability encounter challenges related to counterfeit drug prevention, user identity verification, and scalability. This paper presents BE-AC, an enhanced blockchain-based drug traceability solution. To bolster the authenticity and integrity of drug information, we innovatively upgraded the EdDSA (Edwards-curve Digital Signature Algorithm) digital signature algorithm. Our enhancement incorporates the more advanced and efficient BLAKE3 hash function, replacing the conventional SHA-512 (Secure Hash Algorithm 512-bit). By employing larger hash windows and secure, efficient hash iteration modes, we expedite the generation and verification of digital signatures for drug information, thereby enhancing the overall performance and security of the system. Additionally, we have devised a decentralized identity authentication scheme. Through on-chain stored identity information, all participants can mutually verify each other's identities, effectively preventing identity impersonation and fraudulent transactions. Furthermore, we have implemented smart contracts to record and store all transaction information on-chain during the drug distribution process, ensuring reliable and convenient drug transaction traceability. To address scalability and information security, we introduced a collaborative on-chain and off-chain drug information storage solution. Experimental results demonstrate a remarkable 78.65% improvement in signature verification efficiency compared to the original algorithm. The designed solution exhibits noteworthy enhancements in identity authentication, system throughput, and storage efficiency. [ABSTRACT FROM AUTHOR]

Dried blood spot sampling technique has been a prevalent approach in therapeutic drug monitoring due to its numerous advantages over conventional blood or plasma sampling. But the effects of storage conditions, drying time in air and paper substrates on the stability and analysis sensitivity of therapeutic drugs are still lack. Herein we systematically investigated the effects of storage conditions and paper substrates on the appearance of dried blood spots and stability of different therapeutic drugs by using a facile paper spray mass spectrometry. The results demonstrated using silica coated paper SG81 favored to get an abundant signal due to the unique elution behavior of target compounds in dried blood spots relative to that with grade ET31 and grade 1 paper substrates. By examining the effects of light illumination and air on the stability of therapeutic drug, it reveals that both have a similar impact on the degradation of the tested drugs, whereas storing the samples in a zip-foiled bag could effectively suppress the degradation of the analytes in dried blood. The analysis sensitivity of different drugs in blood samples was also compared under different storage conditions. An improvement of 2–10-fold analysis sensitivity was obtained for these drugs when the DBS were stored in a zip-foiled bag relative to that exposure to air. [ABSTRACT FROM AUTHOR]

The paper discusses the development of a multiscale computational model for predicting the permeability of multilayer protective films consisting of multiple polymeric and hybrid layers containing clay minerals as fillers. The presented approach combines three levels of computation: continuous, full atomic, and quantitative structure–property correlations (QSPR). Oxygen and water are chosen as penetrant molecules. The main predictions are made using the continuum model, which takes into account the real scales of films and nanoparticles. It is shown that reliable predictions of the permeability coefficients can be obtained for oxygen molecules, which is not always possible for water. The latter requires the refinement of existing QSPR methods and interatomic interaction potentials for the atomistic level of calculations. Nevertheless, we show that the maximum effect on permeability reduction from the addition of clay fillers to the hybrid layer can be achieved by using nanoparticles with large aspect ratios and a high degree of orientational order. In addition, the use of the hybrid layer should be combined with the use of polymer layers with minimal oxygen and water permeability. The constructed model can be used to improve the properties of protective coatings for food and drug storage and to regulate the gas permeability of polymeric materials. [ABSTRACT FROM AUTHOR]

Monoclonal antibodies are complex molecules that often require high concentration formulations to meet clinical requirement and bulk drug substance storage. Stability is a common concern in both high and low concentration formulations, however, high concentration formulations are further complicated by an increase in viscosity, leading to manufacturing and administration challenges. To manage stability and viscosity, drug developers typically use salt, amino acids, sugars, polyols, and surfactant. It is possible that excipients control some of the product quality attributes (CQAs), at the cost of several others. In this paper, we have evaluated several amino acid derivatives and identified bis acetyl lysine and propionyl serine to be efficient and superior to commonly used parenteral excipients for minimizing antibody solution viscosity, as well as mitigating physical and chemical degradation by controlling protein-protein interactions and deamidation. [ABSTRACT FROM AUTHOR]

The article reports on a general handout that details requirements linked with the use of investigational oral chemotherapy medication. Topics mentioned include a paper released by the Hematology/Oncology Pharmacy Association in 2014 that calls for best practice standards within an investigational drug service, oral chemotherapy education sheets with information to patients with cancer and caregivers, and the increased needs and risks associated with the use of oral investigational medications.

Purpose Describe patient-, clinician-, system-, and community-level interventions for pain management developed and employed by 9 healthcare systems across the United States and report on lessons learned from the implementation of these interventions. Summary The high cost associated with pain coupled with the frequent use of opioid analgesics as primary treatment options has made novel pain management strategies a necessity. Interventions that target multiple levels within healthcare are needed to help combat the opioid epidemic and improve strategies to manage chronic pain. Patient-level interventions implemented ranged from traditional paper-based educational tools to videos, digital applications, and peer networks. Clinician-level interventions focused on providing education, ensuring proper follow-up care, and establishing multidisciplinary teams that included prescribers, pharmacists, nurses, and other healthcare professionals. System- and community-level interventions included metric tracking and analytics, electronic health record tools, lockbox distribution for safe storage, medication return bins for removal of opioids, risk assessment tool utilization, and improved access to reversal agents. Conclusion Strategies to better manage pain can be implemented within health systems at multiple levels and on many fronts; however, these changes are most effective when accepted and widely used by the population for which they are targeted. [ABSTRACT FROM AUTHOR]

The freezing step plays a central role in reaching the most stringent requirements of quality, homogeneity and standardization of freeze-dried products. In this paper, a systematic procedure has been proposed to obtain a quantitative estimation of the pore-size variability of lyophilized products resulting from uncontrollable variations of the nucleation temperature. This procedure consisted in collecting the nucleation temperature from a statistically significant number of samples and correlating each nucleation temperature to the corresponding product morphology, using a mathematical model, to obtain a statistical description of the lyophilized product structure. This approach can also be used to obtain an estimation of the variability of the mass transfer resistance to vapor flow and, finally, of the drying time. Two different freezing configurations, i.e., conventional and suspended-vial freezing, have been used as case studies since they can produce significantly different freezing rates. [ABSTRACT FROM AUTHOR]

Recently, the therapeutic effect of chemotherapy has been obviously impaired due to premature drug release, low tumor penetration, and multidrug resistance of nanoplatforms. In this paper, a novel multiple-sensitive drug delivery system (MC-ss-CDs) was developed by gating long-wavelength emitting carbon dots (CDs) on the openings of mesoporous carbon nanoparticles (MC) through disulfide bonds. The MC with excellent photothermal transition efficiency and high drug storage capacity for doxorubicin (DOX) was used as the delivery carrier. The CDs had multiple functions, including intelligent switching to hinder unwanted release, photothermal therapy (PTT) agents to improve the heat generation effect of MCs and bioimaging trackers to monitor drug delivery. The disulfide bonds, as the linkers between MC carriers and CDs, are stable under normal physical conditions and relatively labile under high GSH concentrations in the cytoplasm of tumor cells. After arriving at the tumor microenvironment, DOX/MC-ss-CDs can rapidly break into DOX/MC and CDs under high GSH concentrations. DOX/MC could realize efficient integration of PTT and chemotherapy on the surface of the tumor by stimuli-responsive DOX release and synergetic heating of MC and CDs. The small-sized CDs with excellent penetrating ability could effectively enter the deep tumor and realize NIR-triggered photothermal ablation. The DOX/MC-ss-CDs showed a chemophotothermal effect with a combination index of 0.38 in vitro and in vivo. Therefore, the DOX/MC-ss-CDs could be employed as a trackable nanovehicle for synergistic chemotherapy and PTT at different depths. [Display omitted] • Mesoporous carbon (MC) was used as a NIR-absorbing carrier with high drug loading. • Red-emitting CDs were gated on the openings of MC by disulfide bonds. • CDs were used as photothermal agents, smart capping, and fluorescence marker. • DOX/MC-ss-CDs can realize synergistic chemotherapy and PTT at different depths. [ABSTRACT FROM AUTHOR]

This paper introduces a new concept and method for long-term sterile storage of turbid product, which is potentially subject to microbial contamination. The method uses intermittent delivery of pulsed electric fields (IDPEF) throughout the storage at time intervals that are prescribed according to microorganisms' growth kinetics. This new approach facilitates sterile storage without the need for chemical preservatives, additives, radiation or the complex infrastructure demanded by refrigeration. Unlike ultraviolet radiation, IDPEF can be used in turbid media. The first part of this paper is a theoretical discussion on the growth kinetics of microorganisms treated by IDPEF. We then provide a preliminary experimental study on the kinetics of microorganism growth in a turbid microbial growth media as a function of the IDPEF delivery intervals. Last, we demonstrate the use of the method using milk as a medium. IDPEF of 30 pulses, 17.5 kV/cm field strength, 40 \mu \s long, 1 Hz delivered every 12 h was found to have the ability to preserve milk in a non-sterile environment at room temperature as effectively as refrigeration at 4 ^\circ\C. The method has many obvious applications in biotechnology, the food industry, and is of particular importance with regard to geographical areas lacking refrigeration for storage of pharmaceuticals and food. This study was performed on the laboratory scale and a substantial adaptations are required in order to apply it to the industrial scale. [ABSTRACT FROM PUBLISHER]

Photothermal therapy (PTT) combined with chemotherapy can break through the limitations of monotherapy and enhance the therapeutic efficacy. Polydopamine (PDA), an organic material with excellent photothermal conversion property and degradability, has broad application prospects in PTT. In this paper, PDA nanoparticles and mesoporous polydopamine (MPDA) nanoparticles were prepared with similar and uniform particle size to compare the photothermal performance, degradability, drug loading efficiency and release behavior. Polyethylene glycol (PEG) was coated on the surfaces of PDA and MPDA to boost their dispersion stability and biocompatibility. In vitro experimental results revealed that the two vehicles had satisfactory photothermal effect, drug storage capacity, and multi-responsive release properties of near-infrared (NIR) light /pH/H 2 O 2 /glutathione (GSH) for doxorubicin (DOX), while MPDA-PEG had superior photothermal performance, drug loading efficiency and longer-lasting release due to the mesoporous structure and higher surface area. Degradation experiments showed that MPDA degraded more quickly than PDA. The degradation behaviors of MPDA under different conditions were observed, and the possible degradation process was illustrated. Furthermore, the cell viability tests verified that DOX/MPDA-PEG had more eminent synergistic therapeutic effects in thermo-chemotherapy with a lower combination index (CI) of 0.313 compared with DOX/PDA-PEG (0.497). Therefore, MPDA has a broader application prospect for thermo-chemotherapy. [Display omitted] [ABSTRACT FROM AUTHOR]

Vaccination is an effective public health measure to prevent and control a number of infectious diseases. However, since vaccines are biological products and are sensitive to both heat and cold, they need to be maintained within a narrow range of temperatures, often referred to as the 'cold-chain'. This range, which is between +2°C and +8°C with a target +5°C, does not allow for refreezing or storage at room temperature. This paper discusses the importance of the cold chain, what should be done both to maintain it, and the actions to be taken, should a break be noted. It is important to note the product information supplied with vaccines, which is taken from the summary of product characteristics that forms part of the licensing requirements for each vaccine, and which will state how it should be stored. Using a vaccine that has not been stored according to these instructions constitutes off-label use, for which the individual practitioner must take responsibility. It also emphasises the fragile nature of many public health interventions, maintenance of which require constant vigilance and close cooperation between many groups and individuals. [ABSTRACT FROM AUTHOR]

An extractable survey is one of several studies performed on a pharmaceutical storage/delivery system as part of the process of demonstrating that the system is suitable for its intended use. In this paper, a solid phase extraction method for the preparation of aqueous extracts generated during an extractable survey is presented. The method offers a convenient means to isolate semi-volatile organic extractable compounds from aqueous extraction solvents for analysis by gas chromatography/mass spectrometry. Following the solid phase extraction procedure, derivatization is performed to convert problematic functionalities (such as amines and acids) into appropriate chromatographically friendly derivatives. Demonstration of method performance is achieved in three ways using a set of 31 commonly observed extractable substances as model compounds. First, a breakthrough experiment was performed with a 2 solvent system consisting of water and 10/90 isopropanol/water over a range of 6 mL to 100 mL. Results from this experiment show only caprolactam possessed a significant level of breakthrough in either solvent over the range of volumes evaluated. Second, a formal accuracy/precision study was conducted using a three solvent system consisting of water, 10/90 isopropanol/water and 1% polysorbate 80. This experiment demonstrates the quantitative ability of the method at levels ranging from 20 ng/mL to 50 μg/mL. Recovery values of 70% to 130% of the theoretical concentration, with relative standard deviation values of less than 15% for replicate preparations, are obtained for a majority of the compounds evaluated. Finally, a case study involving the extraction of an intravenous drug delivery bag with multiple aqueous solvent systems further demonstrates the viability of solid phase extraction for use in an extractables survey. [ABSTRACT FROM AUTHOR]

This paper describes an approach piloted in the Kasserine region of Tunisia to increase the energy efficiency of the distribution of vaccines and temperature sensitive drugs. The objectives of an approach, known as the ‘net zero energy’ (NZE) supply chain were demonstrated within the first year of operation. The existing distribution system was modified to store vaccines and medicines in the same buildings and to transport them according to pre-scheduled and optimized delivery circuits. Electric utility vehicles, dedicated to the integrated delivery of vaccines and medicines, improved the regularity and reliability of the supply chains. Solar energy, linked to the electricity grid at regional and district stores, supplied over 100% of consumption meeting all energy needs for storage, cooling and transportation. Significant benefits to the quality and costs of distribution were demonstrated. Supply trips were scheduled, integrated and reliable, energy consumption was reduced, the recurrent cost of electricity was eliminated and the release of carbon to the atmosphere was reduced. Although the initial capital cost of scaling up implementation of NZE remain high today, commercial forecasts predict cost reduction for solar energy and electric vehicles that may permit a step-wise implementation over the next 7–10 years. Efficiency in the use of energy and in the deployment of transport is already a critical component of distribution logistics in both private and public sectors of industrialized countries. The NZE approach has an intensified rationale in countries where energy costs threaten the maintenance of public health services in areas of low population density. In these countries where the mobility of health personnel and timely arrival of supplies is at risk, NZE has the potential to reduce energy costs and release recurrent budget to other needs of service delivery while also improving the supply chain. [ABSTRACT FROM AUTHOR]

This paper describes a systematic approach to select optimum stabilizer for the preparation of nano-crystalline suspensions of an active pharmaceutical ingredient (API). The stabilizer can be either a dispersant or a combination of dispersant and wetting agent. The proposed screening method is a quick and efficient way to investigate a large number of stabilizers based on the principles of physical-chemistry and employs a stepwise approach. The methodology has been divided in two main parts; the first part being focused on the qualitative screening with the objective of selecting the best candidate(s) for further investigation, the second part has been focused on quantitative screening with the objective to optimize the ratio and amount of wetting and dispersing agents, based on wettability, surface charges measurement, adsorption evaluation, process-ability evaluation and storage stability. The results showed clearly that SDS/PVP 40/60% (w/w) (sodium dodecyl sulfate/poly(vinyl pyrrolidone)) at a total concentration of 1.2% was the optimum stabilizer composition, at which the resulting nanosuspensions were stable for more than 50 days at room temperature. [ABSTRACT FROM AUTHOR]

Critical limb ischemia (CLI) is associated with significant morbidity and mortality. In this study, we developed and characterized an intra-arterial cell suspension containing human mesenchymal stem cells (hMSCs) for the treatment of CLI. Equally, the stability of cells was studied in order to evaluate the optimal conditions of storage that guarantee the viability from cell processing to the administration phase. Effects of various factors, including excipients, storage temperature and time were evaluated to analyze the survival of hMSCs in the finished medicinal product. The viability of hMSCs in different packaging media was studied for 60h at 4°C. The best medium to maintain hMSCs viability was then selected to test storage conditions (4, 8, 25 and 37°C; 60h). The results showed that at 4°C the viability was maintained above 80% for 48h, at 8°C decreased slightly, whereas at room temperature and 37°C decreased drastically. Its biocompatibility was assessed by cell morphology and cell viability assays. During stability study, the stored cells did not show any change in their phenotypic or genotypic characteristics and physicochemical properties remained constant, the ability to differentiate into adipocytes and osteocytes and sterility requirements were also unaltered. Finally, our paper proposes a packing media composed of albumin 20%, glucose 5% and Ringer’s lactate at a concentration of 1×106 cells/mL, which must be stored at 4°C as the most suitable to maintain cell viability (>80%) and without altering their characteristics for more than 48h. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to evaluate the in-use physicochemical and biological stability of the Sandoz rituximab biosimilar, marketed under the trade names Rixathon® and Riximyo® in the European Union, upon preparation for intravenous infusion. Methods Three batches of Rixathon®/Riximyo® in the final month of their 36 month shelf life were exposed to room temperature and light for 14 days to recapitulate a major temperature excursion. Samples were diluted to the lowest allowable concentration of 1 mg/mL in 0.9% NaCl solution in either polypropylene or polyethylene infusion bags and stored for 14 or 30 days at 5 ± 3℃ followed by an additional 24 h at room temperature to simulate product handling. Samples stored in infusion bags were analyzed using SEC, CEX, non-reducing CE-SDS, peptide mapping and CDC to assess physicochemical and biological stability. Results Analysis of Rixathon®/Riximyo® diluted to the lowest allowable concentration in 0.9% sodium chloride in either polypropylene or polyethylene infusion bags revealed no change in molecular weight variants, charge variants, deamidation, oxidation, overall composition or potency over a 31-day period. Conclusion Physicochemical and biological analyses demonstrate that Rixathon®/Riximyo® stability is not impacted by dilution and formulation conditions required for intravenous infusion, even under worst case conditions with regard to product shelf life, temperature excursion, light exposure, dilution factor and infusion bag storage time over a 31-day period. [ABSTRACT FROM AUTHOR]

Abstract: Arctiin, an important lignan compound in Fructus Arctii, has been reported to possess various kinds of bioactivities. Previous studies on the pharmacokinetic of arctiin after oral administration showed that it had a rapid absorption phase followed by a sharp but lasting disappearance. To gain deep insight into the action mechanism of arctiin, the excretion and metabolism of arctiin in vivo should be further studied. In this paper, three metabolites were isolated and identified in rat feces as (−)-enterolactone (M-1), (−)-arctigenin (M-2) and [(2R,3R)-2-(3′-hydroxybenzyl)-3-(3″,4″-dimethoxybenzyl)-butyrolactone] (M-3). Based on the structures of three metabolites, possible metabolic pathways of arctiin in rats are proposed. At the same time, the cumulative excretion rate of arctiin and its metabolites in rat urine and feces were determined, indicating that arctiin was excreted 19.84% in urine and 1.80% in feces, respectively, enterolactone, the most main metabolite, was excreted 35.80% in feces. These results provide very important information for understanding the metabolism and excretion of arctiin in vivo and speculating its action mechanism, they can provide useful information and reference for further metabolic investigations on arctiin in humans. [Copyright &y& Elsevier]

Background/purpose. Transfusion pyrexia (fever) is an important clinical sign/symptom occurring either as an isolated event or as part of a constellation of signs and symptoms in relation to blood transfusion. It is an important cause of morbidity and may be an important sign of life-threatening complications of blood transfusion. Pyrexia is often a reason for the discontinuation of a blood transfusion episode, and adequate evaluation remains a challenge for clinicians. The decision to stop a blood transfusion episode on account of fever is often a difficult one. This paper reviews the differential diagnosis of transfusion pyrexia (TP), the pathogenesis as well as current management measures. Study selection and data source. Literature sources include medical texts, journals, dissertations, and internet-based electronic materials Results and conclusion. Adequate evaluation of pyrexia accompanying blood transfusion remains a challenge for clinicians. An algorithm to assist the clinician in the evaluation of fever occurring in a blood transfusion recipient is developed and presented. Continuous medical education is necessary for clinicians towards improved patient care in transfusion medicine. [ABSTRACT FROM AUTHOR]

Abstract: Methylparaben (MePa), ethylparaben (EtPa) and propylparaben (PrPa) have been widely used, among others, as chemical preservatives in cosmetics, drugs and foods. As these compounds are linked with allergies, dermatitis and estrogenic properties, it is necessary to control the concentration of these substances in different matrices. The aim of this paper are: to evaluate the electrochemical behavior of parabens on the boron-doped diamond (BDD) electrode and the development of a chromatographic method, with electrochemical detection (HPLC-ED), for determination of parabens in shampoo. A BDD (8000ppm) electrode was adapted in a thin layer mode analytical cell consisting of a stainless steel and a platinum wire as reference and auxiliary electrodes, respectively. Chromatographic separations were obtained with a reversed phase C8 analytical column and a mobile phase of 0.025molL−1 disodium phosphate, pH 7.0, and acetonitrile (40:60, v/v), delivered at a flow rate of 1.0mL min−1. Sample preparation was performed by solid phase extraction using C18 cartridges and acetonitrile for elution. Benzylparaben was employed as internal standard. The HPLC-ED method developed, using the BDD electrode, was validated for the determination of parabens in shampoos and presented adequate linearity (>0.999), in the range of 0.0125–0.500% (w/w), detectability 0.01% (w/w), precision (RSD of 2.3–9.8%) and accuracy (93.1–104.4%) and could be applied for routine quality control of shampoos containing MePa, EtPa and PrPa. [Copyright &y& Elsevier]

Abstract: Authentication is fundamental for the standardization of Chinese Materia Medica. Macroscopic identification, an important method of authentication, has a long history rooted in practice and experience over generations. In ancient times, macroscopic features were used not only to identify the genuineness, but also to evaluate the quality of Chinese medicinal materials (CMMs). In many ancient documents, picturesque terms were used to describe the quality of certain specific CMMs. These traditional macroscopic descriptions used for identification are filled with characteristics, quality descriptions, and specifications of CMM that need to be confirmed by modern scientific analysis. In this paper, the essential and fundamental components of macroscopic identification are introduced. As the quality and macroscopic characteristics of CMM are traditionally thought to be closely related, modern scientific approaches to confirm the validity of these associations are discussed. This review clarifies the role of macroscopic features in the quality assessment of CMM. [Copyright &y& Elsevier]

Abstract: A general estimate shows that 80% of communities across the United States receive their goods exclusively by transport trucks, of which a significant number are climate-controlled because they carry perishable goods, pharmaceutical items and many other temperature-sensitive commodities. Keeping the inside of a truck trailer at a constant temperature and relative humidity requires exact amounts of heat and/or moisture management throughout the shipment period, which is regulated via small refrigeration units, placed outside the truck, that operate by burning fuel. These trucks, known as refrigerated truck trailers, are the focus of this paper. In the research presented herein, the conventional method of insulation of the refrigerated truck trailer was modified using phase change materials (PCMs). The limited research carried out in refrigerated transport compared to other refrigeration processes has left spaces for innovative solutions in this area. The research investigated the inclusion of paraffin-based PCMs in the standard trailer walls as a heat transfer reduction technology. An average reduction in peak heat transfer rate of 29.1% was observed when all walls (south, east, north, west, and top) were considered. For individual walls, the peak heat transfer rate was reduced in the range of 11.3–43.8%. Overall average daily heat flow reductions into the refrigerated compartment of 16.3% were observed. These results could potentially translate into energy savings, pollution abatement from diesel-burning refrigeration units, refrigeration equipment size reduction, and extended equipment operational life. The research and its results will help to better understand the scope of this technology. [Copyright &y& Elsevier]

This paper deals about the analysis of the supplying management carried out in an industrial unit involved in the production of drugs. The scope of the study includes purchasing, storing and inventory management activities. [ABSTRACT FROM AUTHOR]

The article discusses the importance of storing patients' home medications during hospitalizations. It mentions that when patients are admitted to hospital, they do not always know what medications they take, therefore, patients are encouraged to bring their medications with them at hospital admission. It is recommended that electronic record and a paper log of home medications stored in the pharmacy must be kept; a systematic approach to storing patients' home medications is important.

The author discusses the reduction in maternal and child deaths citing reference to the 2015 Millennium Development Goals (MDGs) of the United Nations. He also discusses two papers related to the importance of focusing on the poorest and hardest-to-reach children analyzed by the United Nations Children's Fund (UNICEF). The problems like lack of health workers and medicines and financial constraints which hamper the delivery of essential services to the needy are also discussed.