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Abstract Background An adriamycin-induced impairment of wound healing has been demonstrated experimentally in rats. The purpose of this study is to investigate a possible temporal variation in recovery from the impairment of wound healing caused by adriamycin administration. Methods The subjects were 120 female Spraque-Dawley rats. They were divided into eight groups, undergoing adriamycin administration (8 mg/kg, i.v.) at 9 a.m. or 9 p.m. on day 0 and laparotomy on day 0, 7, 14 or 21. Blast pressures were recorded after the incision line had been opened, and tissue samples were kept at -30°C for later measurement of hydroxyproline levels. Results Adriamycin treatment in rats at 9 p.m. resulted in significantly lower blast pressure levels than treatment at 9 a.m. between days 7 and 21, indicating a lag effect of healing time in wounded tissues. However the decreased hydroxyproline levels were not changed at these days and sessions. Conclusion It is concluded that adriamycin-induced impairment of wound healing in adult female rats exhibits nycthemeral variation.

Meticulous antimicrobial management is essential among critically ill patients with acute kidney injury, particularly if renal replacement therapy is needed. Many factors affect drug removal in patients undergoing continuous renal replacement therapy CRRT. In this study, we aimed to compare current databases that are frequently used to adjust CRRT dosages of antimicrobial drugs with the gold standard. The dosage recommendations from various databases for antimicrobial drugs eliminated by CRRT were investigated. The book 'Renal Pharmacotherapy: Dosage Adjustment of Medications Eliminated by the Kidneys' was chosen as the gold standard. There were variations in the databases. Micromedex, UpToDate, and Sanford had similar rates to the gold standard of 45%, 35%, and 30%, respectively. The Micromedex database shows the most similar results to the gold standard source. In addition, a consensus was reached as a result of the expert panel meetings established to discuss the different antimicrobial dose recommendations of the databases.

This study aims to evaluate the clinical pharmacist's contribution impact on the appropriate use of colistin. Our study was conducted prospectively in patients in the Internal Diseases Intensive Care Unit of Gazi University Medical Faculty Hospital for eight months. The first four months of the study were with the observation group, while the next four months were with the intervention group. The study determined how the active participation of clinical pharmacists had affected the appropriateness of colistin use. The results showed that the appropriate use of colistin was higher in the intervention group than in the observational group; furthermore, incidence of nephrotoxicity was lower. The difference between both groups was statistically significant ( p  < 0.001, p  < 0.05), respectively. This study showed that the clinical pharmacist's active intervention by following the patients increased the frequency and percentage of the appropriate use of colistin. This decreased the incidence of nephrotoxicity, colistin's most important side effect.

Introduction: Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient's safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe., Objective: The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations., Method: The Arkesy and O'Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research., Results: There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year., Conclusion: Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must., (© 2023. The Author(s).)

Introduction: The role of a community pharmacist is well recognized in the literature as the most accessible health care provider that promotes health wellness and disease prevention. Evidence supports their role in cancer health promotion though this is not seen yet in practice. The aim of the study was to assess community pharmacists' preparedness in terms of knowledge, role perception and barriers for providing cancer health promotion in North Cyprus., Methods: A cross-sectional face-to-face questionnaire-based study was carried among a randomly selected representative sample of community pharmacists in North Cyprus between June 2020 and August 2020. A pre-validated 31-item questionnaire tool was revised by an expert panel and adopted for purpose of this study., Results: 200 (64.5%) out of 310 approached community pharmacists' have accepted and responded to the questionnaire of which 183 were fully answered. The community pharmacists' awareness of cancer was moderate, as 70% answered correctly. Most respondents (93.4%) agree that pharmacists should be involved in cancer health promotion. Most respondents (> 90%) agree that pharmacist's lack of interest in oncology, lack of educational material and pharmacist's hesitancy about their knowledge of cancer are respectively the most important barriers for cancer health promotion., Conclusion: The study shows that community pharmacist well perceives their role in cancer health promotion despite moderate awareness of cancer related facts and hesitancy of their knowledge necessary for assuming their role. Lack of interest, motivation and cancer educational materials availability are also major barrier to address.

Background: Critically ill patients treated in the intensive care units (ICUs) often suffer from side effects and drug-related problems (DRPs) that can be life-threatening. A way to prevent DRPs and improve drug safety and efficacy is to include clinical pharmacists in the clinical team. This study aims to evaluate the classification of drug-related problems and the implementation of clinical pharmacy services by a clinical pharmacist in the ICU of a university hospital in Turkey., Methods: This study was carried out prospectively between December 2020 and July 2021 in Gazi University Medical Faculty Hospital Internal Diseases ICU. All patients hospitalized in the intensive care unit for more than 24 h were included in the study. During the study, the clinical pharmacist's interventions and other clinical services for patients were recorded. DRPs were classed according to the Pharmaceutical Care Network Europe V.8.02., Results: A total of 151 patients were included during the study period corresponding to 2264 patient-days. Patients with DRPs had a longer hospital stay and a higher mortality rate (p < 0.05). 108 patients had at least one DRP and the total number of DRPs was 206. There was an average of 1.36 DRPs per patient, 71.5% of patients experienced DRP and 89.22 DRPs per 1000 patient-days. A total of 35 ADEs were observed in 32 patients. ADE incidence was per 1000 patient-days 15.45. ADEs were caused by nephrotoxicity (48.57%), electrolyte disorders (17.14%), drug-induced thrombocytopenia (17.14%), liver enzyme increase (8.57%) and other causes (8.57%). Drug selection (40.29%) and dose selection (54.36%) constituted most of the causes of DRPs. Dose change was the highest percentage of planned interventions with a rate of 56.79%. Intervention was accepted at a rate of 90.8% and it was fully implemented., Conclusion: In this study, the importance of the clinical pharmacist in the determination and analysis of DRPs was emphasized. Clinical pharmacy services like the one described should be implemented widely to increase patient safety., (© 2022. The Author(s).)

Background: Multiple factors have been reported to affect adherence to medication, including beliefs about medicines, while specifically tailored pharmaceutical care services for patients may improve adherence. The aim was to assess the impact of counselling by an oncology pharmacist on patients' medication adherence and beliefs., Methods: An interventional prospective study was performed in the oncology department at a tertiary hospital in Northern Cyprus from November 2017 to April 2018. The Beliefs about Medicines Questionnaire was used to evaluate the balance between beliefs about necessity and concerns and medication beliefs before and after an educational intervention. The Morisky Green Levine Test 2018 was used to evaluate adherence., Results: In total, 81 patients (65.4% females; mean age: 59.1 ± 11.34 years; 34.6% hypertensive; 19.8% with diabetes) were analysed before and after receiving counselling from an oncology pharmacist. Pharmacist education significantly enhanced the mean patient necessity-concern balance scores by two-fold (M T0(baseline)  = -3.1 ± 8.6; M T1(posteducation)  =3.0 ± 7.3; p  < 0.0001), with patients who received counselling for the first time experiencing the greatest benefit. Multivariate analysis showed that patients who had a negative balance between their beliefs about the necessity of the medication and their concerns were less likely to adhere to the medication (0.138 (0.025-0.772))., Conclusion: Counselling by an oncology pharmacist was effective in decreasing patient concerns and increasing their understanding of the necessity of the medication, thus enhancing their adherence and consequently improving the care they received.

Background Pharmacogenomics is a branch of biotechnological science integrating medicine, pharmacology, and genomics techniques. Moreover, it focuses on creating drug therapies in order to analyze genetic differences in patients causing various responses to a single therapeutic regimen. Objective This cross sectional study aimed to examine the attitude, knowledge and adoption among pharmacists in North Cyprus and the most appropriate method to improve education among them. Setting Community pharmacy setting. Method A total of 103 out of 140 pharmacists responded to a pre-tested and validated questionnaire consisting of 25 items during July through September 2016. Main outcome measure Pharmacists attitude, knowledge and adoption towards pharmacogenomic tests. Result Data showed that most of the pharmacists in North Cyprus had positive attitude and knowledge scores with mean value of 28.3 ± 5.3 (out of 40) and 6.9 ± 0.8 (out of 10) respectively, further findings showed that there is a significant difference among age groups in their total attitude score (p < 0.05). Conclusion Even though pharmacogenomics is a field promising a variety of benefits, it is vital to implement it in clinical settings in order to improve outcomes. Our findings highlight the necessity for more education on the availability and interpretation of pharmacogenomics tests.

Background In order to achieve patient adherence, individuals require different levels of information. Basic and adequate information must be provided by different health care providers to patients. Objective To assess the information level of patients with asthma and chronic obstructive pulmonary disease (COPD) and to determine the source of their information regarding the medicine they use in addition to their satisfaction, inhalation usage techniques and perception of the information providing role of health care professionals. Setting Respiratory disease clinics in Nicosia and Famagusta state hospitals and community pharmacies in North Cyprus. Method A cross-sectional multicentered observational study was carried out in respiratory disease clinics and community pharmacies. Patients' knowledge and healthcare providers' perceptions of their roles were evaluated using "The satisfaction with information about medicines scale". Evaluation of patient's inhalation techniques was performed using a validated checklist. Main outcome measure (a) Patients' knowledge of their medication and satisfaction with the information provided by health care professionals, (b) the prevalence of critical inhalation mistakes, (c) health care professionals' perceptions of their patient counseling practice. Results A total of 110 patients were evaluated, and 6 physicians and 76 pharmacists were recruited for the interview. The health care professionals reported that they talk about the action and the use of medicines with the patients. The standardized average patients' satisfaction score for action and use was 0.35 (± 0.21), whereas for potential side effects, it was 0.26 (± 0.15). Even though 92% of patients believed that they use their inhaler properly, 75% of the patients made at least one critical mistake while using the inhalation demo, which would likely affect the delivery of the medicine to the lungs. Conclusion In spite of health care professionals feeling comfortable with their counseling practices, the majority of patients reported dissatisfaction with the information they provided about medicine, and three out of four patients were making critical mistakes in the use of inhalers. More effort is warranted by health care professionals on patient education to limit critical mistakes.

Background: Clinical pharmacists have important roles in implementing scientifically valid knowledge and advice on safe, reasonable use of pharmaceuticals. Clinical pharmacy services were introduced and evaluated in oncology clinic in a tertiary university hospital., Methods: A prospective interventional study was conducted from November 2017 to March 2018. Drug-related problems were classified using the Pharmaceutical Care Network Europe drug-related problem classification tool v8.01. The main outcome measure is the proposed interventions aimed at identification of the drug-related problems, the role of the pharmacists in the resolution, and the rate of acceptance of these recommendations by physicians., Results: A total of 102 patients were included in the study, who were treated with at least two cycles of any cancer type and stage. A total of 55 (53.9%) patients had 251 drug-related problems. Drug-related problems mainly involved antihypertensive (31.6%), antidiabetic (17.8%), and herbal agents (31.6%). Treatment effectiveness was the major type of drug-related problems (50.2%) followed by treatment safety (29.1%). A total of 211 (100%) interventions were accepted and regarded as clinically relevant. Prescriber informed only were the most common types of intervention at the prescriber level. Eighty-six point four percent identified drug-related problems were solved, 9.8% of the problems were partially solved, 2.3% problems were unsolved., Conclusion: Clinical pharmacy services may have optimized therapy effectiveness, prevent adverse effects and unclear/compliant problems. The pharmacist interventions were highly acknowledged by oncologists and patients; this may indicate the presence of a great convenience and need to implement Clinical pharmacy services in alternative hospitals in Northern Cyprus.

Background and Objective: the global prevalence of allergic rhinitis (AR) is rising and yet there is scarce information concerning the diagnosis, management and treatment patterns of AR in Northern Cyprus (NC). This study aims to provide a unique perspective on AR management as well as assessing the effectiveness of the pharmacist-led educational intervention for improving care of AR patients., Methods: across-sectional survey was carried out with community pharmacists ( n = 70), patients ( n = 138) and ear, nose and throat (ENT) specialists ( n = 12) in NC. For a controlled interventional trial, trained pharmacists provided a brief education on management of AR and nasal spray technique for patients while other pharmacists provided the usual care. Quality of life (QoL) and other outcome measures on the perceived symptom severity of the two groups were compared after a 6-week period., Results: only 33.3% of the ear, nose and throat (ENT) specialists and 15.7% of the community pharmacists are aware of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. The majority of patients (63%) self-managed with over-the-counter medications. Nasal congestion (96.4%) is the most bothersome symptom and oral antihistamines are the most commonly purchased medications (51.4%), indicating a pattern of suboptimal management. The pharmacists-led educational intervention has resulted in statistically more significant improvement in regards to nasal congestion and QoL for the intervention group patients ( p < 0.05)., Conclusion: the current management of AR has not been in accordance with the ARIA guidelines in NC. An educational intervention of the pharmacists can enhance the symptom management and improve the QoL in patients with AR.

Background Clinical pharmacists are the primary source of scientifically valid information and advice on the safe, rational, and cost-effective use of medications. However, ward-based clinical pharmacy services are not well optimized in Northern Cyprus. Objective Ward based clinical pharmacy services were introduced and evaluated in cardiovascular clinics. Setting Cardiology and cardiovascular surgery departments in a tertiary university hospital. Methods A prospective interventional study introduced and documented clinical pharmacy services for 120 days. Drug-related problems were classified using the Pharmaceutical Care Network Europe PCNE DRP classification tool V6.2. Main outcome measure Interventions proposed and acceptance rate of recommendations. Results A total of 133 patients were reviewed, and, 81 patients had drug-related problems. Only 402 (93.1%) of the 432 suggested interventions were accepted and regarded as clinically relevant. Drug-related problems primarily involved antihypertensive, diuretic, and antithrombotic agents. Treatment effectiveness was the major type of drug-related problems (107; 49.3%) followed by adverse drug reactions (74; 34.1%). Drug dose and selection were the most frequent causes of drug-related problems. Add/change/stop medications were the most common types of intervention at the prescriber level. A total of 171 (78.8%) of the identified 217 drug-related problems were solved, 4 (1.8%) of the problems were partially solved, 32 (14.7%) problems were unsolved, and 10 (4.6%) problems had unknown outcomes. Conclusion Clinical pharmacy services may have optimized therapy effectiveness and prevent adverse effects. The pharmacist interventions were highly accepted by cardiologists; this may indicate the presence of a great opportunity and need to optimize and implement CPS in other hospitals in Northern Cyprus.

We have previously reported that peroxynitrite (ONOO(-)) caused relaxations on isolated rat anococcygeus muscle and in the present study the possible mechanisms of the relaxant effect were investigated. ONOO(-) (0.03- 1.0 mmol/l)-induced relaxations were reduced significantly by the presence of an ATP-sensitive potassium channel (K(+)(ATP) channel) blocker, glibenclamide (0.3 micromol/l), or 1H-(1,2,4)oxadiazolo(4,3-alpha)quinoxalin-1-one (ODQ) (30.0 micromol/l), a guanylyl cyclase inhibitor. However, 3-aminobenzamide (3.0 mmol/l), an inhibitor of poly(ADP- ribose)synthase, did not influence the relaxant effect of ONOO(-) (1.0 mmol/l). Results of the present study implicate that activation of K(+)(ATP) channels and/or cGMP/K(+)(ATP) channel interaction might play a role in the relaxant responses to ONOO(-) in isolated rat anococcygeus muscle., (Copyright 2002 S. Karger AG, Basel)

Effects of peroxynitrite (ONOO-), its stable product 3-nitrotyrosine (NT) and sodium nitroprusside (SNP) on isolated rat anococcygeus muscle were investigated. Administration of 0.1-1.0 mM ONOO- or 0.01-100.0 microM SNP produced concentration-dependent relaxations on the phenylephrine (2 microM)-precontracted muscle. Time courses of these relaxations to ONOO- and SNP were not similar and decomposed ONOO- caused a biphasic response composed of an initial contraction followed by a relaxation. NT (0.01-0.1 mM) either incubated for 20 min prior to precontraction or given during precontraction plateau did not attenuate precontraction or ONOO(-)-induced relaxations. Results of the present study demonstrate that ONOO- relaxes rat anococcygeus muscle specifically while its stable metabolite NT has no effect.