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The rational use of medicinal products is of fundamental importance for a successful and efficiently conducted therapy of the patient. Biomarkers have a crucial role in the rational use of medicines. They provide valuable information and help guide treatment decisions, optimize drug therapies, and improve patient outcomes. Aim: To analyse the role of biomarkers in the rational use of medicinal products. Methods and materials: The literature review was made through a documentary analysis of scientific statistics in the PubMed and Google Scholar platforms. Results: Biomarkers facilitate a personalized approach to drug therapy, improving rational use by providing guidance for accurate patient selection, making a more accurate diagnosis, choosing the appropriate drug according to the patient's condition, accurate dosing for a specific patient, reducing contraindications and risk from the occurrence of ADRs. Their use leads to savings for the health system created by unnecessary use of the wrong drugs, in the wrong quantities, for the wrong patient, and at the wrong time. As well as benefits, biomarkers also have their imperfections, so their application must be strictly monitored and controlled, and they must undergo serious study and validation. Conclusion: Biomarkers contribute significantly to increasing rational use, guiding healthcare professionals in making well-informed decisions about treatments tailored to individual patients, as long as they are wellstudied and their clinical relevance is demonstrated. [ABSTRACT FROM AUTHOR]

The rationality in the use of veterinary drugs among sheep farmers has been a concern, particularly in remote areas of Lesotho. In this light, a descriptive survey was conducted where a cross-sectional design was employed to collect the data on the availability and rational use of veterinary drugs from a total of 102 sheep farmers. SPSS (Version 20.00) was used for data analysis, where the crosstabs within descriptive statistics were used to determine percentages while the significance was tested using both the Chi-square test and Fisher's exact test. Sheep farming in the study area is mostly dominated by adult men who are mostly married and have attained primary school leaving certificates, as reflected by 51.9% and 48.7% in rural and peri-urban villages, respectively. The use of commercial drugs for the control of diseases surpasses the use of medicinal plants, as demonstrated by 95.8% and 86.8% of responses in the rural and peri-urban villages, respectively. Moreover, the greater proportion of sheep farmers (83.3% and 89.1% in the rural and peri-urban, respectively) have not been trained on the use of veterinary drugs; however, it was observed that most of them diagnose and treat their animals on their own. The availability of veterinary services among sheep farming communities is very poor and mostly, farmers rely on farm feeds and hawkers as sources of drugs. The common method for dosage measurement is by guessing the animal's body weight. Most farmers are not aware of the withdrawal period following animal treatment as reflected by 78.2% and 63.8% of farmers in rural and peri-urban villages, respectively. Veterinary drugs are mostly stored at room temperature. In conclusion, the availability of veterinary drugs among farming communities is very poor and drugs are mostly irrationally used. [ABSTRACT FROM AUTHOR]

The rationality in the use of veterinary drugs among sheep farmers has been a concern, particularly in remote areas of Lesotho. In this light, a descriptive survey was conducted where a cross-sectional design was employed to collect the data on the availability and rational use of veterinary drugs from a total of 102 sheep farmers. SPSS (Version 20.00) was used for data analysis, where the crosstabs within descriptive statistics were used to determine percentages while the significance was tested using both the Chi-square test and Fisher‘s exact test. Sheep farming in the study area is mostly dominated by adult men who are mostly married and have attained primary school leaving certificates, as reflected by 51.9% and 48.7% in rural and peri-urban villages, respectively. The use of commercial drugs for the control of diseases surpasses the use of medicinal plants, as demonstrated by 95.8% and 86.8% of responses in the rural and peri-urban villages, respectively. Moreover, the greater proportion of sheep farmers (83.3% and 89.1% in the rural and peri-urban, respectively) have not been trained on the use of veterinary drugs; however, it was observed that most of them diagnose and treat their animals on their own. The availability of veterinary services among sheep farming communities is very poor and mostly, farmers rely on farm feeds and hawkers as sources of drugs. The common method for dosage measurement is by guessing the animal’s body weight. Most farmers are not aware of the withdrawal period following animal treatment as reflected by 78.2% and 63.8% of farmers in rural and peri-urban villages, respectively. Veterinary drugs are mostly stored at room temperature. In conclusion, the availability of veterinary drugs among farming communities is very poor and drugs are mostly irrationally used.

The use of biocide chemicals is crucial for the elimination of microbial species required to prevent the spread of infectious diseases and ensure the safeguarding of animal and human health. Like antimicrobial drug resistance (AMR), anti-biocide resistance (ABR) may be a serious threat to healthcare, agriculture, animal husbandry, pisciculture as well as pharmaceutical and many other industries. Pathways of functioning of the antimicrobial drugs and biocides are alike in many cases, and among the patterns of resistance development in the microbes, such similarities are also found. Reaching such multidrug and multi-biocide resistant microbes in the water bodies and other sectors of the environment may also cause serious effects on ecology, the environment, and the entire biosphere. Framing of strict legislative measures is required for the rational use of biocides by considering their spectrum of activity, effective concentration in different conditions, residue calculation, and after-use destruction. This review aims to explore the use, detection, and regulation of biocidal agents across different contexts, highlighting their application that can contribute to the concurrent development of biocidal resistance and overall antimicrobial resistance among microorganisms.

Given the significance of fish farming as a promising sector of Ukraine’s agriculture, and the Mykolaiv, Odesa, and Kherson regions are characterised by a significant number of natural and artificial water bodies, the study of aquatic bioresource catching indicators in the south is both important and timely. The research aimed to determine trends in aquatic bioresource catching in southern Ukraine during the period 2018-2023 and to analyse the factors influencing the extraction of aquatic bioresources. This article presents overall catch statistics, as well as catch data for inland waters of the south and aquaculture conditions over the past six years. It has been established that the catch of aquatic biological resources in southern Ukraine has been declining each year from 2018 to 2023. The negative trends in aquatic bioresource catching, both in aquaculture and natural water bodies, are linked to several factors. In particular, the decline in catches has been influenced by: COVID-19; the unstable military and political situation in Ukraine, associated with Russian military aggression; outdated material and technical base of fishing enterprises; lack of government subsidies and foreign investment in the sector; imperfections in the systems of control and regulation of the extraction of aquatic bioresources; and irrational use of the bioproductive potential of water bodies in southern Ukraine. Based on a scientific analysis of the dynamics of aquatic bioresource extraction in southern Ukraine and the identification of key factors contributing to the decline in catches, a set of measures has been developed to positively impact the fishing industry. These measures include: attracting foreign investment in fish farming; improving the quality of monitoring, regulation, and control over aquatic bioresource catching at local, regional, and state levels; restoring critical fish farming infrastructure damaged by Russian aggression; ensuring sustainable fisheries management; and introducing EU best practices into Ukrainian fish farming. The scientific results obtained from this research can be used in practice to ensure the sustainable development of fisheries in southern Ukraine

Given the significance of fish farming as a promising sector of Ukraine's agriculture, and the Mykolaiv, Odesa, and Kherson regions are characterised by a significant number of natural and artificial water bodies, the study of aquatic bioresource catching indicators in the south is both important and timely. The research aimed to determine trends in aquatic bioresource catching in southern Ukraine during the period 2018-2023 and to analyse the factors influencing the extraction of aquatic bioresources. This article presents overall catch statistics, as well as catch data for inland waters of the south and aquaculture conditions over the past six years. It has been established that the catch of aquatic biological resources in southern Ukraine has been declining each year from 2018 to 2023. The negative trends in aquatic bioresource catching, both in aquaculture and natural water bodies, are linked to several factors. In particular, the decline in catches has been influenced by: COVID-19; the unstable military and political situation in Ukraine, associated with Russian military aggression; outdated material and technical base of fishing enterprises; lack of government subsidies and foreign investment in the sector; imperfections in the systems of control and regulation of the extraction of aquatic bioresources; and irrational use of the bioproductive potential of water bodies in southern Ukraine. Based on a scientific analysis of the dynamics of aquatic bioresource extraction in southern Ukraine and the identification of key factors contributing to the decline in catches, a set of measures has been developed to positively impact the fishing industry. These measures include: attracting foreign investment in fish farming; improving the quality of monitoring, regulation, and control over aquatic bioresource catching at local, regional, and state levels; restoring critical fish farming infrastructure damaged by Russian aggression; ensuring sustainable fisheries management; and introducing EU best practices into Ukrainian fish farming. The scientific results obtained from this research can be used in practice to ensure the sustainable development of fisheries in southern Ukraine. [ABSTRACT FROM AUTHOR]

Objective(s): Drug prescription is one of the strategic issues in the field of health. Rational prescription of medicine and efforts towards appropriate, safe and efficient use of medicine are one of the main missions of health policy makers in the country. This study was conducted with the aim of reviewing the studies was done in the country in the field of drug prescription pattern. Methods: The present research was a scoping review using the Arsky and O'Malley protocol. The English and Persian databases examined in this study were Scopus, Web of Science, PubMed, Magiran and SID. Searched keywords were Prescription, Rational Use, Rational Utilization, Rational Consumption, Overconsumption, Overutilization, Utilization Management, Inappropriate Utilization, and Iran in English and Persian. Original research articles published in journals in English or Persian that estimated WHO prescribing indicators were included to the review. Studies published in other languages, books, theses, conference papers, review studies, articles whose full text was not available and articles published before 2010 were excluded from the study. Results: In the first stage 2846 citations were retrieved. After considering all inclusion and exclusion criteria 22 full articles were reviewed. About 70% of articles were published in English. 74% of studies focused on the prescription of a specific group of providers and 13% focused on drug administration in elderlies. The average number of drugs per prescription varied from 2 to 4.5 items in different studies. The percentage of prescriptions included antibiotics reported between 8.8 for elderlies’ home health care to 97.6 for dentists’ prescriptions. The prescriptions included injections also varied from 9.3 to 58.9 in medical interns and general practitioners in Kerman. Conclusion: The trend of drug prescription reflects the success of the country's policies toward rational use of drugs. However, to achievement the global standards, the implementation of policies to improve the prescription pattern in the country should be a priorities of health system.

Objective(s): Drug prescription is one of the strategic issues in the field of health. Rational prescription of medicine and efforts towards appropriate, safe and efficient use of medicine are one of the main missions of health policy makers in the country. This study was conducted with the aim of reviewing the studies was done in the country in the field of drug prescription pattern. Methods: The present research was a scoping review using the Arsky and O'Malley protocol. The English and Persian databases examined in this study were Scopus, Web of Science, PubMed, Magiran and SID. Searched keywords were Prescription, Rational Use, Rational Utilization, Rational Consumption, Overconsumption, Overutilization, Utilization Management, Inappropriate Utilization, and Iran in English and Persian. Original research articles published in journals in English or Persian that estimated WHO prescribing indicators were included to the review. Studies published in other languages, books, theses, conference papers, review studies, articles whose full text was not available and articles published before 2010 were excluded from the study. Results: In the first stage 2846 citations were retrieved. After considering all inclusion and exclusion criteria 22 full articles were reviewed. About 70% of articles were published in English. 74% of studies focused on the prescription of a specific group of providers and 13% focused on drug administration in elderlies. The average number of drugs per prescription varied from 2 to 4.5 items in different studies. The percentage of prescriptions included antibiotics reported between 8.8 for elder lies' home health care to 97.6 for dentists' prescriptions. The prescriptions included injections also varied from 9.3 to 58.9 in medical interns and general practitioners in Kerman. Conclusion: The trend of drug prescription reflects the success of the country's policies toward rational use of drugs. However, to achievement the global standards, the implementation of policies to improve the prescription pattern in the country should be a priorities of health system. [ABSTRACT FROM AUTHOR]

Abstract Background Irrational use of antibiotics in hospitals is one of the main health system problems. It leads to antibiotic resistance, adverse events, treatment failure, total treatment costs, and longer hospital stay. We aim to evaluate clindamycin use in critical care units in our hospital. It is a step to assess and then put strategies to improve the antibiotic use process. Methods This is a clindamycin use evaluation retrospective study. It was done in critical care units at Alexandria’s main university hospital. The clinical pharmacists reviewed 99 patients’ prescriptions over the last 4 months, recording patients' demographics, main diagnosis, comorbidities, type of infection, duplication of therapy, dose, the occurrence of diarrhea, serious drug interactions, clindamycin-defined daily dose per 1000 patients’ days), treatment duration and total cost of clindamycin. Results A total of 99 patients were included. Clindamycin was prescribed in appropriate indications in 57 patients (57/99 = 57.6%). Prescriptions with inappropriate indications were 42 (42/99 = 42.4%). Duplication of therapy with clindamycin was detected in 32 prescriptions (32.3%). Diarrhea was recorded in 4% of the cases. There were no severe drug interactions with clindamycin. Inappropriate indications were 320 defined Daily Dose (DDD) of total clindamycin consumption (765 DDD) and a cost of 29951.5 LE (42% of total cost). The prescribed dose of clindamycin was correct in all cases. Conclusion There is irrational clindamycin use in critical care units in some cases regarding indications and treatment duplication. Although the prescribed doses were correct. Clindamycin misuse increased total consumption and cost. Trial registration number NCT05223400 on 2 February 2022.

Self-medication is the use of drugs to treat self-diagnosed illnesses or symptoms, on one's own initiative, without the guidance of a healthcare professional. Poison centers play an important role in understanding the relationship between self-medication and poisoning. The objective of this study is to evaluate the clinical and epidemiological profile of patients exposed to and/or poisoned by different drugs through self-medication. This retrospective, cross-sectional, and descriptive study analyzed data from 2014 to 2020, provided by the Toxicological Information and Assistance Center of Santa Catarina, Brazil. Data were selected, tabulated, and analyzed by using descriptive statistics and group comparison with the chi-square test or Fisher's exact test. A P value <0.05 was considered statistically significant. There were 683 cases of self-medication identified. Most patients were female (62.8 percent) and between 20 and 29 years old (26.1 percent). A toxic dose of a substance was administered in only 22.8 percent of the cases, and five deaths were recorded. The most commonly used medications were anxiolytics (18 percent), followed by analgesics and antipyretics (15.4 percent). Paracetamol was the drug used in three of the five cases that resulted in deaths. This study demonstrates the prevalence of self-medication among women aged between 20 and 29 years old. Statistical analysis failed to show a relationship between a toxic dose and clinical manifestations. Anxiolytics, analgesics, and antipyretics are the most reported medications probably because healthcare professionals are mostly the ones who contact the center. Analgesics and antipyretics account for more than fifty percent of the deaths caused by self-medication in the present report. Some limitations such as secondary sources are related. We highlight the importance of health professionals in promoting the rational use of medicines, as well as poison centers in assisting the population and raising their awareness regarding the issue. [ABSTRACT FROM AUTHOR]

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All over the world, agriculture will have to adapt to new climatic conditions. Experts from the International Food Organization have concluded that after 2030, crop yields will decrease in many regions of the world due to climate change. For agriculture, the greatest danger is posed by such manifestations of climate change as rising temperatures, changing precipitation patterns, sea level rise (for coastal lowlands) and frequent droughts and floods, especially in areas prone to natural disasters. These changes are affecting agriculture, and the problem of ensuring food security is becoming more acute. This article discusses the problem of rational use of agricultural land in the Western region of Kazakhstan in the context of climate change. The main focus is on the need to adapt agriculture to new climatic conditions and the efficient use of available land resources. The paper presents the key aspects of this problem, analyzes possible solutions and offers recommendations for the sustainable development of agriculture in the region. [ABSTRACT FROM AUTHOR]

Objectives: This research was conducted to explore the patterns and behavior of panic purchasing, stockpiling, and use of drugs during COVID-19 in the Sylhet city, Bangladesh. Study design: The study adopted qualitative exploratory research design. Methods: 25 in-depth interviews with drug sellers and clients and 7 key informant interviews were conducted with pharmacists and medical representatives of pharmaceutical companies in Sylhet city in Bangladesh from October 2020 to March 2021. Thematic analysis was used to evaluate the primary data. Results: The findings revealed that individuals sought out, purchased, and stockpiled prescription-only drugs for self-medication purposes during the COVID-19 pandemic. News and rumor spread by social media, television, and everyday interactions concerning the severity of infections and the number of deaths caused an increase in self-medication as a preventive measure. The reason for this panic buying of drugs was identified as a fear of drug shortages, price hikes, the rise of infection, and the availability of medicines and home delivery services during the pandemic. Conclusion: The purchasing, stockpiling and use of drugs by pharmacies varied based on the person dispensing the drugs, the customer, and the COVID-19 pandemic situation. Furthermore, the role of social media in spreading rumor and (dis) misinformation about drug use, a greater tendency to self-medicate, and poor regulation, influenced the individual’s use of drugs. Therefore, the drug regulatory authorities and policymakers need to consider the real level of local drug use in order to encourage more rational use of drugs which will help to ensure that there is reliable access to safe, effective, and high-quality medicines and vaccines for all.

Background: Magnetic Resonance imaging (MRI) is a valuable diagnostic tool by its non-invasive/non-ionizing nature.Objective: This study aims to determine justification of MRI in hospitalized patients at a tertiary provincial referent medical center in a one-year period.Material and Methods: In the present retrospective and descriptive cross-sectional study, 438 admitted patients referred for MRI during 2017 were selected using systematic random sampling. The age, gender, investigated organ, the specialty of requesting physician, MRI with and without contrast, MRI diagnostic outcome were collected using checklists. Descriptive statistics and chi-square test were used for data analysis.Results: The mean age of the patients was 42±26 years-old and female represented 53% of enrolled patients. The most and less prevalent investigated organs were the cerebrum and the orbit. After excluding cancer diagnosis, cancer staging, and therapeutic follow-up exams, MRI request was oriented in 64.3% and 77.2% of positive results was concordant with aforementioned diagnostic orientation (P

Background: The World Health Organization (WHO) guidelines recommend the empiric treatment of infections before definitive treatment begins. However, ethical concerns limit the availability of clinical trials in neonates and paediatrics to fully ascertain the safety profile of antibiotics in these populations. Aim: This study aimed to quantify the use of antibiotics among neonates and paediatrics and commented on the use, rationale and appropriateness of antibiotics prescribed. Setting: A secondary level public sector hospital located in Durban, KwaZulu-Natal. Methods: Demographic and treatment information of neonates and paediatrics were collected retrospectively from January 2022 to June 2022. Data were obtained from patient files and extracted for analysis using Microsoft Excel®. Analytical and descriptive statistics were used to analyse patient demographics and treatment variables. Results: A total of 568 antibiotics, issued to 389 patients, were reviewed. Penicillins (40.1%), aminoglycosides (24.3%) and combination penicillin-beta-lactam inhibitors (23.3%) were identified as the most frequently prescribed antibiotics for inpatients. Most antibiotics prescribed to inpatients were for complications associated with pre-term birth (66.9%). Combination penicillin-beta-lactam inhibitors (34.7%), penicillins (29.5%) and cephalosporins (29.5%) were the most frequently prescribed antibiotics to outpatients. A correlation was found between the route of administration and the duration of therapy; the intravenous route (63.6%) was preferred over the oral route (36.4%) for administration. Conclusion: Many broad-spectrum antibiotics were prescribed, thus increasing the risk of resistance. Antibiotics were being prescribed according to the guidelines; however, there is still a need for therapeutic drug monitoring to ensure the continuation of rational drug use. Contribution: There was evidence of rational use of antibiotics in the public hospital (KwaZulu-Natal), in keeping with economic and availability factors.

Objectives The inappropriate use of antibiotics is one of the main factors in the development of antibiotic resistance. This study aimed at examining the public's knowledge and behaviour in Abu Dhabi and Dubai towards antibiotic use. Methods A cross-sectional survey was performed using a pretested self-administered online questionnaire on a sample of 208 randomly selected from Abu Dhabi and Dubai residents. Descriptive statistics and P values were used in data analysis. Key findings In our population, 63% knew that antibiotic usage is ineffective in treating viral infections. Half of our participants were unsure or misinformed that antibiotics could treat the common cold. On the other hand, 93% knew that the body can fight mild infections without antibiotics. The results also showed that almost 29% take antibiotics for pain and inflammation. Approximately, 72% of the population denied consuming leftover antibiotics. Also, 95.2% of the population confirmed they check the expiry date before using antibiotics, and 82.7% stop the antibiotic after completing the course prescribed by a physician. Conclusion This study revealed the gaps in knowledge and practice towards antibiotics among the general population. It also identified areas that need more interventions to promote the rational use of antibiotics, and thus reduce the risk of development of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Background: Magnetic Resonance imaging (MRI) is a valuable diagnostic tool by its non-invasive/non-ionizing nature. Objective: This study aims to determine justification of MRI in hospitalized patients at a tertiary provincial referent medical center in a one-year period. Material and Methods: In the present retrospective and descriptive crosssectional study, 438 admitted patients referred for MRI during 2017 were selected using systematic random sampling. The age, gender, investigated organ, the specialty of requesting physician, MRI with and without contrast, MRI diagnostic outcome were collected using checklists. Descriptive statistics and chi-square test were used for data analysis. Results: The mean age of the patients was 42±26 years-old and female represented 53% of enrolled patients. The most and less prevalent investigated organs were the cerebrum and the orbit. After excluding cancer diagnosis, cancer staging, and therapeutic follow-up exams, MRI request was oriented in 64.3% and 77.2% of positive results was concordant with aforementioned diagnostic orientation (P<0.001). Oriented diagnostic MRI requesting is influenced by age, medical specialists and, investigated organ (P<0.001). The positive MRI is influenced significantly by oriented MRI request, gender, medical specialists and investigated organ (P<0.001). The diagnosis concordance of MRI is influenced significantly by oriented MRI request, medical specialists and investigated organ (P<0.001). Conclusion: Appropriate implementation of medical imaging requires boosting employed rationality by the concerned physicians. The current suboptimal results to requesting MRI rationality should mandate supplementary educational programs as to incite the medical corpus more closely implementing the published medical practice guidelines. [ABSTRACT FROM AUTHOR]

Objective: Neurological disorders are a major cause of morbidity, mortality and disability. These adversely affect the quality of life among all age group patients. Majority of neurological disorders include Epilepsy, Headache, Cerebrovascular disorders with hemiparesis, Neuropathic pain, Extrapyramidal syndrome, Cervical myelopathy and Parkinson's disease. This study was done with aim to evaluate the prescription pattern of various drugs in different types of neurological disorders and to use the WHO / INRUD prescribing indicators to assess the rational drug prescribing. Materials and Methods: A Prescription-based, Observational prospective study was carried out in a tertiary care hospital at South India. The prescription data of patients attending the neurology outpatient department was analysed over a period of 2 months. Rational use of drugs was analysed by the INRUD Scale. Results: Out of these, 166 patients were male, whereas 134 patients were female. Most prevalent neurological disorders were Trigeminal neuralgia (25.66%), 9.97% of the patient population received injections, with 4% receiving Inj. Dexamethasone 8mg. Overall drug prescribing performance scoring was 3.55. Conclusion: Our study revealed good Prescribing pattern as shown by WHO scale-IRUD/INRUD. Further such studies with large sample size are needed so as to guide clinicians toward rationale drug. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the characteristics of intracranial infection (ICI) in patients after neurosurgery, and the influence of rational use of antibiotics. Methods: The medical records of 127 patients with neurosurgery-related ICI who were admitted into Jincheng People's Hospital, Jincheng, Shanxi, China from April 2019 to April 2022 were selected. The results of bacterial culture and drug susceptibility tests of cerebrospinal fluid were collected, and the profile of bacteria in the cerebrospinal fluid specimens of patients and the different bacterial compositions were analyzed. Results: A total of 148 strains of pathogenic bacteria were cultured and isolated from the cerebrospinal fluid samples of 127 patients, out of which 91 strains of Gram-positive bacteria accounted for 61.49 %, and 57 strains of Gram-negative bacteria accounted for 38.51 %. The Gram-positive bacteria were Staphylococcus aureus, coagulase-negative Staphylococcus, and hemolytic Staphylococcus, while the Gram-negative bacteria comprised the pathogenic bacteria Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The Gram-positive bacteria were more sensitive to rifampicin (91.21 %), vancomycin (95.60 %), and linezolid (97.80 %), while the Gram-negative bacteria were more sensitive to imipenem (84.21 %), meropenem (75.44 %) and amikacin (77.19 %). Conclusion: Gram-positive bacteria are the main pathogenic bacteria implicated in ICI after neurosurgery in patients. A further large-scale study is needed for better delineation of the disease presentation and prognosis. [ABSTRACT FROM AUTHOR]

Purpose is to substantiate foundations of sustainable management of mineral resources while implementing a circular economy model. Methods. The study has applied following research approaches: synthetic method (unification of the singled out aspects); induction method (analysis of a circular economy features); life cycle assessment (evaluation of the product influence on the environment from the viewpoint of each stage of its life cycle); circular economy toolkit (determination and evaluation of the periodicity of circular economy products and indicators); and circular economy indicator prototype (evaluation of the cyclic product efficiency). Findings. Circular economy is one of the key directions of a sustainable development policy as for conservation and protection of mineral resources; it is aimed at more efficient use and improvement of raw material extraction from industrial waste. Formation of a market infrastructure of the circular economy has been proposed based upon mining sector waste use to process it and reduce as well as to repurpose wasteless production and secondary processing of raw materials. The need has been substantiated to contribute to conservation of mineral resources for their sustainable use on the basis of the development of market infrastructure of a stable economy and mining sector waste use to process it and reduce as well as to repurpose wasteless production and secondary processing of raw materials. Originality. A concept for further development of the circular economy market infrastructure has been specified as a platform of production waste supply/demand to optimize the use and conservation of mineral resources on the principles of sustainable growth. It has been proposed to analyze assessment of business development along the lines of a circular economy while calculating parameters when manufacturing is applying primary mineral resources and industrial waste as a raw material for its further processing. Practical implications. The proposed approach of interaction between economic entities on the basis of a circular economy will provide rational use of mineral resources and contribute to the development of a sector of industrial waste processing. The abovementioned will help terminate decrease in the availability of mineral resources and form new milestones of social development on the principles of environmental friendliness and rationalism in the process of interaction with nature. [ABSTRACT FROM AUTHOR]

Background: Proton Pump Inhibitors (PPIs) are often prescribed inappropriately among hospitalized patients and same is often continued even after their discharge from the hospital. The inappropriate use of PPIs leads to an increased risk of adverse effects, drug interaction, and unnecessary hospital expenditure for such patients. Aim of this study was to determine the appropriateness of PPIs use among hospitalized patients. Methods: A cross sectional observational study was conducted on hospitalized patients in a tertiary care hospital in Northern India. The clinical records of adult patients hospitalized during April- May 2022 were assessed for the prescribing pattern and appropriateness of PPI use as per the National Institute of Health and Care Excellence (NICE) guidelines. Results: A total of 192 patient’s records were included in this study with the mean age 57 years and 61% of the study participants were males. Overall, 72% (138) of the study participants were prescribed PPIs by intravenous route and only in 28% (54) cases an oral route was preferred. Pantoprazole was the most commonly prescribed PPI in 112 (58%) patients and it was administered by intravenous route among 87 patients (78%) and by oral route in 25 (22%) patients. PPI use was appropriate in 54% of the cases and they were most commonly prescribed for ulcer prophylaxis. This study identified higher use of PPIs was seen in low risk patients for longer duration than indicated. Conclusion: PPIs are being prescribed inappropriately among hospitalized patient unrelated to their widely accepted clinical indications and are often continued unnecessarily once patient is discharged. These results suggest the need of regular audits on use of PPIs clubbed with educational initiatives to promote rational use of PPIs among hospitalized patients.

With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds—dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose, and duration. 3. Relying on education from the distant past and on previous experience. 4. The heterogeneity of (too many) guideline recommendations leads to confusion and over-prescribing. 5. Decreased access to guideline information in private practice. 6. Psychological factors such as pressure to prescribe, comfort prescribing and the weekend effect, and 7. Feeling removed from antimicrobial resistance and externalizing responsibility. Based on the existing knowledge, we propose a framework based on four key pillars for focused intervention: 1. Education. 2. Internalizing responsibility. 3. Recognizing recurring counter-productive practices, and 4. Addressing recurring counter-productive practices. This framework can be applied in different dental settings to ensure best practices for the successful implementation of rational antimicrobial prescribing.

Owing to the rising popularity and demand for immunoglobulins (IgG), obtaining supplies and rationalizing IgG use have become challenging. Herein, IgG consumption in Poland was analyzed through total IgG use and number of patients reported to the National Health Fund between 1 January 2016 and 31 December 2020. Total IgG used within 5 years increased by 27.48%, IgG use/1000 inhabitants/year was 23.13 g (2016) and 29.61 g (2020). In 2020, 35.5 % of IgG used was for neurological conditions, 25% for primary immunodeficiencies (PID), and 39.3% for all other indications. Within 5 years, 1,121,168.75 g IgG was used in PID; the use increased by 72%, from 783 in 2016 to 1153 patients in 2020. The proportion of patients who received subcutaneous immunoglobulin (SCIG) replacement therapy (IgRT) increased to 78% (2020). Within 5 years, 1,783,534.81 g IgG was used in neurological drug programs (+42.44%) and 2,327,513.88 g (+1.25%) outside neurological indications and outside PID. The annual IgG amount decreased in adult anesthesiology and intensive care (−46%), internal medicine (−55%), pneumonology (−50%), pediatric clinical immunology (−50%), and gynecology and obstetrics (−48%) and increased in dermatology (+178%), rheumatology (+103%), and clinical transplantation (+82%). IgG use significantly increased in Poland, mostly owing to PID. Subcutaneous IgG administration is currently the most common mode of IgRT in PID patients. An increase in SCIG administration may be expected for other indications. Implementing evidence-based clinical guidelines is key to prioritizing and rationalizing IgG use for immunomodulatory indications and secondary immune deficiencies. [ABSTRACT FROM AUTHOR]

Introduction: we compared the antimicrobial resistance profile of young infants' clinical isolates (from blood samples) of Staphylococcus epidermidis and haemolyticus with those colonizing mothers, clinical staff, and students. Also, screened for resistance to the watch and reserve classified groups, antibiotics not prescribed in the Ho Teaching Hospital (HTH), Ghana. Methods: a crosssectional study was conducted from March to June 2018 to determine the antimicrobial susceptibility of twenty-one antimicrobials for 123 isolates consisting of 54 S. epidermidis and 69 S. haemolyticus cultured from the participants. VITEK 2 was used for antimicrobial susceptibility testing. Staphylococcal species were identified using matrixassisted laser desorption/ionization-time of flight (MALDI-TOF). Statistical analysis was done with Grad-Pad prism. Results: for S. epidermidis, clinical staff isolates have the highest methicillin-resistant (65%), followed by young infants' (50%) and mothers' and students' twenty-five percent each. Both young infants and clinical staff's Staphylococcus haemolyticus isolates have 100% methicillin-resistant, while mothers' and students' ones have 82% and 63%, respectively. We have identified resistance to one watch (teicoplanin), two reserves (tigecycline and fosfomycin) antimicrobial groups, and mupirocin, an unclassified group. Conclusion: identifying coagulase-negative staphylococci (CoNS) resistance to watch and reserve groups of antimicrobials in a non-previously exposed hospital calls for further studies to determine molecular mechanisms of resistance to these antimicrobials. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) guidelines recommend the empiric treatment of infections before definitive treatment begins. However, ethical concerns limit the availability of clinical trials in neonates and paediatrics to fully ascertain the safety profile of antibiotics in these populations. Aim: This study aimed to quantify the use of antibiotics among neonates and paediatrics and commented on the use, rationale and appropriateness of antibiotics prescribed. Setting: A secondary level public sector hospital located in Durban, KwaZulu-Natal. Methods: Demographic and treatment information of neonates and paediatrics were collected retrospectively from January 2022 to June 2022. Data were obtained from patient files and extracted for analysis using Microsoft Excel ®. Analytical and descriptive statistics were used to analyse patient demographics and treatment variables. Results: A total of 568 antibiotics, issued to 389 patients, were reviewed. Penicillins (40.1%), aminoglycosides (24.3%) and combination penicillin-beta-lactam inhibitors (23.3%) were identified as the most frequently prescribed antibiotics for inpatients. Most antibiotics prescribed to inpatients were for complications associated with pre-term birth (66.9%). Combination penicillin-beta-lactam inhibitors (34.7%), penicillins (29.5%) and cephalosporins (29.5%) were the most frequently prescribed antibiotics to outpatients. A correlation was found between the route of administration and the duration of therapy; the intravenous route (63.6%) was preferred over the oral route (36.4%) for administration. Conclusion: Many broad-spectrum antibiotics were prescribed, thus increasing the risk of resistance. Antibiotics were being prescribed according to the guidelines; however, there is still a need for therapeutic drug monitoring to ensure the continuation of rational drug use. Contribution: There was evidence of rational use of antibiotics in the public hospital (KwaZulu- Natal), in keeping with economic and availability factors. [ABSTRACT FROM AUTHOR]

Abstract Background Pharmaceutical compounding ensures access of individuals with specific requirements to individualized therapy. However, there is an inconsistency of compounded medication quality. Therefore, advancing the rational use of compounded medication is essential for patient safety and medication effectiveness. Objective The presented study was aimed to investigate the healthcare practitioners’ knowledge, perception, and practice of extemporaneous compounding and its contribution to the prevalence of antimicrobial resistance. Method A descriptive cross-sectional survey using a structured questionnaire was conducted. The study participants were 300 healthcare practitioners working in Jimma University Medical Center, hospital pharmacies, and community pharmacies in Jimma and Mettu Town, Southwest Ethiopia. Results Most respondents were pharmacists (62.7%) and first-degree holders (48.3%). The majority of them had experience in administering (57.7%), preparing (38%), prescribing (21%), and repackaging and labeling (14%) compounded medications. Commonly they request compounded medications when prepackaged products (77.7%) and needed dosage regimens (72.3%) were not available in the market. However, most of them believed that compounded medications might lack quality (49%) and had poor patient compliance (40.7%). Moreover, they fear that inappropriate preparation processes (75%) and under-dose administration (59%) of compounded medication might contribute to the development and prevalence of antimicrobial resistance. Conclusion Most healthcare practitioners practice rational use of compounded medications and strongly agree that inappropriate compounding of antimicrobials contributes to antimicrobial resistance development.

BACKGROUND: The concept of listing essential medicines can lead to improved supply and access, more rational prescribing, and lower costs of drugs. However, these benefits hinge on the prescription of drugs from an Essential Medicines List (EML). Several studies have highlighted the problem of underutilization of EMLs by prescribers. Therefore, as part of prescription research by the Indian Council of Medical Research-Rational Use of Medicines Centres Network, we evaluated the extent of prescription of drugs not listed in the National List of Essential Medicines (NLEM). MATERIALS AND METHODS: Prescriptions of outpatients from participating centers were included after obtaining verbal/written informed consent as approved by the Ethics Committee, and evaluated for prescription of drugs from the NLEM 2015. RESULTS: Analysis of 4838 prescriptions from 13 tertiary health-care institutes revealed that 2677 (55.33%) prescriptions had at least one non-NLEM drug prescribed. In all, 5215 (31.12%) of the total 16,758 drugs prescribed were not in NLEM. Of these, 2722 (16.24%) were single drugs and 2493 (14.88%) were fixed-dose combinations (FDCs). These comprised 700 different drug products – 346 single drugs and 354 FDCs. The average number of non-NLEM drugs prescribed per prescription was 1.08, while the average number of all drugs prescribed was 3.35 per prescription. It was also found that some of the non-NLEM drugs prescribed had the potential to result in increased cost (for example, levocetirizine), increased adverse effects (dextromethorphan), and less effectiveness (losartan) when compared to their NLEM counterparts. Nonavailability of an essential drug (oral hydroxocobalamin) was another important finding of our study. CONCLUSION: This study highlights the extent and pattern of drugs prescribed from outside the NLEM at the tertiary health-care level and the need for training and enhanced awareness among prescribers for greater utilization of the NLEM. [ABSTRACT FROM AUTHOR]

The study examines the river basins of the Republics of Kazakhstan and Uzbekistan, in which many irrigation complexes have been allocated for the development of agricultural production. Each irrigation complex, in turn, serves a set of farms - the main links of agricultural production. Naturally, the task of irrigation development in the river basin is considered in a certain sequence (river basin - irrigation system - irrigated farm); which allows to link sectoral planning with territorial planning and to take into account the interests of the development of agricultural sectors, economic zones and districts. The purpose of the study is to create a new water resource management system based on the existing one, united by common water resources, which should meet water needs and ensure environmental well-being. The goal is based on the task of irrigation development, considers the acute shortage of water resources and the environmental degradation. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacovigilance plays an important role in the healthcare sector, in terms of health and economic burden. Studies on interns are limited and it is an aspect that requires further study. Aim: To evaluate the knowledge, attitude and perception of MBBS interns at a teaching hospital in southern India. Also to study the reasons for under-reporting of Adverse Drug Reactions (ADR). Materials and Methods: This questionnaire-based, cross-sectional study was conducted among the 112 MBBS interns at Konaseema Institute of Medical sciences and Research Foundation, Amalapuram, Andhra Pradesh, India, in December 2013. The interns were asked to complete 25 predesigned questionnaire based on the Knowledge, Attitude and Perception (KAP). The answered questionnaires were statistically analysed by using Microsoft Excel worksheet. Results: Out of total 112 MBBS interns, only 94 completed the questionnaire within the stipulated time. There were 41 males and 53 females, with a mean age of 25±2 years. The response rate was 83.9%. A 48 (51.1%) interns had come across Adverse Drug Reactions (ADR) cases during their practice, however, among them only 24 (50%) reported them. Difficulty to identify the causative drug was the major cause for under-reporting as per 23 (24.4%) interns. Majority (60.6%) were of the opinion that pharmacovigilance only covers drug-related side-effects, not other types of side-effects. Conclusion: Interns are the upcoming doctors, hence increased attention must be paid to their lack of pharmacovigilance knowledge in order to improve the clinical management and rational use of drugs. [ABSTRACT FROM AUTHOR]

Objective: Irrational and overzealous use of antibiotics in addition to multidrug resistance has increased at an alarming limits around the world. This study aimed to evaluate the knowledge and practices toward antibiotic use among students at Yarmouk University Material and Method: A cross-sectional descriptive survey using a structured electronic version of valid questionnaire was distributed among participants. Google form was prepared based on available questionnaire in literature, revised by a group of academic pharmacist to validate the questionnaire. Test-retest was performed for a small group and cronbach alpha was calculated. The form was distributed randomly among under- and postgraduate students at Yarmouk University via their mails. Results: A total of 1154 individuals who completed questionnaires were analyzed. The knowledge of antibiotic use and resistance was quite good; 72.7% reported correct responses with a mean score of 16 out of 22. High rates of antibiotic use were found with 92% of respondents used antibiotics in the past three months. Inappropriate practice toward antibiotic was common; 48% used it for incorrect indication (e.g., common cold, fever, and pain), 60% used for improper duration and 20% don’t take the correct doses. Conclusions: Interventions on enhancing awareness and understanding of rational antimicrobial use are highly recommended by promoting expert-driven behavioural change, effective communication, education and training. Furthermore, law restriction on antibiotic dispensing should be introduced. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) remains a serious global health problem. Spain is the fifth country in Europe with the highest consumption of antibiotics, due in part to ignorance of the good use of these drugs and the problem of AMR. To avoid a post-antibiotic era, adequate training on this problem is key to create social awareness. This study aimed to evaluate the impact that the SWICEU project, an academic program about antibiotic discovery, has had on the knowledge of AMR and rational use of antimicrobials in preuniversity students from seven schools in the province of Valencia during five academic years (2017–2021), as well as to evaluate the level of satisfaction of university and pre-university students who have participated in the project. For this study, a survey was carried out with multiple-choice questions with a single correct answer to evaluate the knowledge acquired by pre-university students before and after the project. A satisfaction survey was also designed with a Likert scale from the lowest to the highest level of satisfaction for the two groups of students after the project. Data on knowledge surveys indicated an increase in the mean number of correct answers after the sessions. In satisfaction surveys, we highlighted the issue that referred to the project’s recommendation. The data obtained confirm this project as a valuable activity, as it allows learning about AMR and the rational use of antibiotics in a pleasing and attractive way for young pre-university and university students. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Administration & Economics is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Recent research indicates irrational use of herbal medicine (HM) during pregnancy that can be harmful to the mother and development of baby. However, no study has been conducted to explore the use of HM among pregnant women in a conflict region. Methods: This was a cross-sectional research conducted in July and August in the year 2017, at three hospitals in Sana'a, Yemen. Postpartum women were interviewed via the structured instrument to collect data on patterns of HM used during pregnancy. Results: A total of three hundred postpartum women participated in the study, with 59.3% (178) of them using at least one modality of HM in the previous pregnancy. Cinnamon (Cinnamomum verum L), ginger (Zingiber officinale Z), barley (Hordeum vulgare P), and garlic (Allium sativum A) were the most commonly used HM. Statistical analysis showed that consumers of HM had a higher rate of caesarian section and complications during and after the delivery. Conclusion: Consumption of HM during pregnancy was high including contraindicated modalities such as cinnamon (C. verum L) and barley (H. vulgare P). The use of potentially harmful modalities and association with complications pose a threat to the well-being of mothers and newborns. Further studies in this area will be helpful to generate evidence for the rational use of HM during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacovigilance plays an important role in the healthcare sector, in terms of health and economic burden. Studies on interns are limited and it is an aspect that requires further study. Aim: To evaluate the knowledge, attitude and perception of pharmacovigilance awareness among MBBS interns at a teaching hospital in southern India. Also, to study the reasons for under-reporting of Adverse Drug Reactions (ADR). Materials and Methods: This questionnaire-based, cross-sectional study was conducted among the 112 MBBS interns at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India, in December 2013. The interns were asked to complete 25 predesigned questionnaire based on the Knowledge, Attitude and Perception (KAP). The answered questionnaires were statistically analysed by using Microsoft Excel worksheet. Results: Out of total 112 MBBS interns, only 94 completed the questionnaire within the stipulated time. There were 41 males and 53 females, with a mean age of 25±2 years. The response rate was 83.9%. A 48 (51.1%) interns had come across Adverse Drug Reactions (ADR) cases during their practice, however, among them only 24 (50%) reported them. Difficulty to identify the causative drug, was the major cause for under-reporting as per 23 (24.4%) interns. Majority (60.6%) were of the opinion that, pharmacovigilance only covers drug-related side-effects, not other types of side-effects. Conclusion: Interns are the upcoming doctors, hence, increased attention must be paid to their lack of pharmacovigilance knowledge, in order to improve the clinical management and rational use of drugs.

Antimicrobial resistance (AMR) remains a serious global health problem. Spain is the fifth country in Europe with the highest consumption of antibiotics, due in part to ignorance of the good use of these drugs and the problem of AMR. To avoid a post-antibiotic era, adequate training on this problem is key to create social awareness. This study aimed to evaluate the impact that the SWICEU project, an academic program about antibiotic discovery, has had on the knowledge of AMR and rational use of antimicrobials in pre-university students from seven schools in the province of Valencia during five academic years (2017–2021), as well as to evaluate the level of satisfaction of university and pre-university students who have participated in the project. For this study, a survey was carried out with multiple-choice questions with a single correct answer to evaluate the knowledge acquired by pre-university students before and after the project. A satisfaction survey was also designed with a Likert scale from the lowest to the highest level of satisfaction for the two groups of students after the project. Data on knowledge surveys indicated an increase in the mean number of correct answers after the sessions. In satisfaction surveys, we highlighted the issue that referred to the project’s recommendation. The data obtained confirm this project as a valuable activity, as it allows learning about AMR and the rational use of antibiotics in a pleasing and attractive way for young pre-university and university students.

Background: Recent research indicates irrational use of herbal medicine (HM) during pregnancy that can be harmful to the mother and development of baby. However, no study has been conducted to explore the use of HM among pregnant women in a conflict region.Methods: This was a cross-sectional research conducted in July and August in the year 2017, at three hospitals in Sana’a, Yemen. Postpartum women were interviewed via the structured instrument to collect data on patterns of HM used during pregnancy.Results: A total of three hundred postpartum women participated in the study, with 59.3% (178) of them using at least one modality of HM in the previous pregnancy. Cinnamon (Cinnamomum verum L), ginger (Zingiber officinale Z), barley (Hordeum vulgare P), and garlic (Allium sativum A) were the most commonly used HM. Statistical analysis showed that consumers of HM had a higher rate of caesarian section and complications during and after the delivery.Conclusion: Consumption of HM during pregnancy was high including contraindicated modalities such as cinnamon (C. verum L) and barley (H. vulgare P). The use of potentially harmful modalities and association with complications pose a threat to the well-being of mothers and newborns. Further studies in this area will be helpful to generate evidence for the rational use of HM during pregnancy.

Abstract Background The emerging threat of antibiotic resistance is growing exponentially and antibiotic stewardship programs are cornerstone to fight against this global threat. The study aimed to explore the knowledge, perspectives and practices of physicians regarding various aspects of antibiotic stewardship program including antibiotic stewardship activities, rational use of antibiotics, antibiotic resistance, prescribing practices and factors associated with these practices. Methods In this qualitative study, a total of 17 semi-structured, in-depth interviews with doctors of three tertiary care public sector hospitals in Bahawalpur and Rahim Yar Khan were conducted. The convenient sampling method was adopted to collect the data and the saturation point criterion was applied to determine the sample size. Thematic analysis approach was used to draw conclusions from the data. Results The analysis of data yielded five themes, 12 subthemes and 26 categories. The themes included, (i) perception about antibiotic use and antibiotic stewardship, (ii) antibiotic prescription practices, (iii) antibiotic resistance, (iv) limited strategies adopted by hospital administration to ensure quality and safe distribution of antibiotics, (v) implementation of antibiotic stewardship program: barriers, suggestion and future benefits. Doctors had misconceptions about the rational use of antibiotics. The perception regarding antibiotic stewardship programs was poor. Moreover, very few activities related to ASP existed. The participants gave many suggestions for successful implementation of ASP in order to reduce the burden of antibiotic resistance, including development of guidelines for the use of antibiotics, strict legislation regarding use of antibiotics, active participation of healthcare professionals and awareness program among general public about the use of antibiotics. Conclusion This study concluded that poor knowledge of doctors regarding ASP, non-existence of antibiogram of hospital and lack of rules for the safe use of antibiotics were the main driving factors associated with irrational antibiotic prescription practices and development of AR.

Copyright of Scire Salutis is the property of CBPC - Companhia Brasileira de Producao Cientifica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)