Background: Children asthma control complex due to the chronic nature of asthma and its interference with children’s quality of life, patient counseling about asthma nature and inhaler use are considered the cornerstone in asthma control. We evaluated various patient counseling techniques for optimizing the use of pressurized metered dose inhalers (pMDIs) to enhance asthma medication delivery and asthmatic state.

Methods: A random cohort of nonsmoking children with asthma aged 11-19 years was collected from an outpatient clinic; all diagnosed using Global Initiative for Asthma (GINA) diagnosis guidelines. The patient's asthma status and pMDI use were assessed during the initial structured interview, and three groups were randomly divided for different counseling techniques, as the following, traditional verbal counseling only was applied to Group 1, while Group 2 received advanced counseling just via two smartphone applications without verbal corrections for inhaler use errors and Group 3 received the advanced counseling using two smartphone applications alongside with verbal correction of the inhaler use mistakes. We monitored the three groups for two consecutive months using the forced expiratory volume in the one second to the forced vital capacity of the lungs ratio (FEV1/FVC) ratio, Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), and GINA control assessment Questionnaire.

Results: A total of 102 children with asthma n=102 were divided in to three counseling groups, each group is consisted of 34 patients, n=34. We found that, in term of FEV1/FVC 2^nd month interview, the advanced verbal counseling group was superior to the advanced alone counseling group p=0.016. In term of ACT 2^nd month interview, the advanced verbal counseling group was superior to the verbal only counseling group p=0.023. In term of ACQ 8^th week interview the advanced alone counseling group was superior to the verbal alone counseling group p=0.018. From the 2-month follow-up course using FEV1/FVC ratio, ACT, ACQ, and GINA control assessment questionnaires, the three counseling techniques significantly improved asthma control for all groups p<0.001.

Conclusion: The combination of smartphone applications based advanced counseling alongside with the verbal correction of the inhaler use errors resulted in a better children asthma control than using a single counseling approach.

Background:

A meta-analysis study was completed to measure how to forecast the effect of the decompression only compared to decompression with fusion on lumbar degenerative spondylolisthesis.

Methods:

Until October 2024, an inclusive literature study was accomplished, and 1865 related studies were reviewed. The 31 nominated studies encompassed 31678 participants with lumbar degenerative spondylolisthesis at the beginning of the study. The odds ratio (OR) and mean difference (MD) and 95% confidence intervals (CIs) were used to look at the outcome of the decompression only compared to decompression with fusion on lumbar degenerative spondylolisthesis dichotomous, or continuous methods with either a fixed or random model.

Results:

In individuals with lumbar degenerative spondylolisthesis, decompression had significantly lower visual analog scale back score (MD, -0.57; 95% CI,-0.91- -0.23, p=0.001), visual analog scale leg score (MD, -0.26; 95% CI, -.49- -0.03, p=0.03), Oswestry Disability Index score (MD, -2.42; 95% CI, -4.75- -0.08, p=0.04), operation time (MD, -82.60; 95% CI, -130.06- -35.14, p<0.001) intraoperative blood loss (MD, -261.93; 95% CI, -360.49- -163.36, p<0.001), and length of hospital stay (MD, -20.09; 95% CI, -29.55- -10.64, p<0.001) compared to decompression with fusion treatment. However, no significant difference was found between decompression and decompression with fusion treatment in European Quality of Life-5 Dimensions score (MD, -0.01; 95% CI, -0.04-0.01, p=0.28) Short-Form 36 physical component summary (MD, -0.73; 95% CI, -2.70-1.24, p=0.47), Short-Form 36 mental component summary score (MD, 0.08; 95% CI, -2.94-3.10, p=0.96), patient satisfaction (OR, 0.52; 95% CI, 0.25-1.09, p=0.08), overall complication rate (OR, 0.92; 95% CI, 0.68-1.26, p=0.61), and overall reoperation rate (OR, 1.34; 95% CI, 0.85-2.13, p=0.21) in individuals with lumbar degenerative spondylolisthesis.

Conclusions:

In individuals with lumbar degenerative spondylolisthesis, decompression had significantly lower visual analog scale back score, visual analog scale leg score, Oswestry Disability Index score, operation time, intraoperative blood loss and length of hospital stay, however, no significant difference was in European Quality of Life-5 Dimensions score Short-Form 36 physical component summary, Short-Form 36 mental component summary score, patient satisfaction overall complication rate and overall reoperation compared to decompression with fusion treatment. To validate this finding more studies are required, and care is essential to be implemented when interconnecting with its values, since many comparisons had law number of selected studies. 

Background

The purpose of the study was to appraise and compare the treatment of non-small cell lung cancer with the nursing application of chemotherapy and traditional Chinese medicine.

Method

Based on the inspection of the meta-analysis data, the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were derived by dichotomous random or fixed effect models. 26 papers with a total of 2290 subjects who were available between 2005 and 2021 were included in this meta-analysis.

Results

Traditional Chinese medicine had significantly higher quality of life (OR, 2.79; 95% CI, 1.87-4.16, p<0.001) and clinical efficacy (OR, 2.79; 95% CI, 2.24-3.47, p<0.001), and Karnofsky Performance Status score (OR, 3.03; 95% CI, 1.45-6.34, p=0.003), and lower leukopenia (OR, 0.21; 95% CI, 0.12-0.36, p<0.001), thrombocytopenia (OR, 0.19; 95% CI, 0.13-0.29, p<0.001), myelosuppression (OR, 0.24; 95% CI, 0.10-0.58, p=0.001), hemoglobin decrease (OR, 0.34; 95% CI, 0.12-0.93, p=0.04), nausea and vomiting (OR, 0.16; 95% CI, 0.11-0.22, p<0.001), diarrhea (OR, 0.22; 95% CI, 0.13-0.36, p<0.001), liver damage (OR, 0.17; 95% CI, 0.10-0.28, p<0.001), and kidney damage (OR, 0.30; 95% CI, 0.10-0.90, p=0.03) compared to control in subjects with non-small cell lung cancer.

Conclusions

The data that was looked at showed that using traditional Chinese medicine had significantly higher quality of life and clinical efficacy, and Karnofsky Performance Status score, and lower adverse effects, and hematological toxicity compared to control in subjects with non-small cell lung cancer. However, given that most of the studies comprised a small number as sample size, attention ought to be given to their values.

Abstracts of the First Conference of Pharm D Clinical Pharmacy Students Faculty of Pharmacy Beni-suef University

The basic mechanisms that support the nervous system's operation in both invertebrates and vertebrates are impulse transmission and the body's reaction to stimuli. These mechanisms let organisms' sense changes in their internal and external surroundings, analyze the information, and start the proper behavioral or physiological reactions. For homeostasis, survival, and adaptation, impulse transmission and response to stimuli must be accurate and efficient. When a stimulus is strong enough to surpass the excitation threshold, a brief, transient change in membrane potential known as an action potential is generated, signaling the beginning of neuronal impulse transmission. This electrochemical process is initiated by the passage of ions, namely sodium (Na⁺) and potassium (K⁺) ions, across the neuronal membrane via voltage-gated ion channels. Synaptic transmission is a crucial step in impulse propagation after this. An action potential that reaches the axon terminal releases neurotransmitters into the synaptic cleft. The kind of neurotransmitter and receptor involved determines whether these chemical messengers cause excitatory or inhibitory responses when they attach themselves to certain postsynaptic membrane receptors. Complex neural networks are formed by the communication that is made possible by this synaptic activity between neurons and threshold; the start of neuronal impulse transmission is indicated by the generation of an action potential, a short, fleeting shift in membrane potential. This communication tried to talk in more details about this topic.

Phytochemicals are chemical compounds naturally produced in plants during the food metabolism process. Phytochemicals also protect plants against hazards faced in the environment, such as moisture, drought, and extreme salt conditions. They also work on adapting plants to the surrounding environmental conditions and being responsible for giving plants their color. These compounds are represented in many types, including flavonoids, polyphenols, isoflavonoids, phytoestrogens, terpenoids, limonoids, phytosterols,anthocyanidins,glucosinolates, carotenoids, and fibers. Phytochemical are a good source of nutrition and obtaining daily needs. The inverse relationship between eating fruits and vegetables and the incidence of serious and chronic diseases such as cancer of all types and heart diseases was found.

Background

Spacers are commonly used especially for paediatric and elderly patients. However, there is a considerable discussion about their use and operation. The purpose of this study was to examine the performance of different types of spacers with Qvar breath actuated pressurize metered dose inhaler (pMDI) containing Beclometasone with fine particles.

Methods

The dose evaluation method for pMDIs in the British Pharmacopoeia (BP) was used to find out the total emitted dose (TED) and particle size distribution of Qvar pMDI. The study looked at pMDI alone and with three different spacers (Optimizer, Aerochamber Plus, and Aerochamber MAX) at a flow of 28.3 L/min and 4 L inhalation volume to mimic adults. At different times, from the first to the last actuation, the average amount of drug in each pMDI alone and connected to the three different spacers was evaluated.

Results

The pMDI by itself had the highest TED, which was significantly higher than all pMDI-spacer combinations (p < 0.05). The spacers also had higher fine particle dose, and fine particle fraction (p<5 µg) then pMDI alone. No significant different was observed in mass median aerodynamic diameter between the four tested combinations. No significant difference was observed between the three evaluated spacer.

Conclusions

These results show that there are improving effects on aerodynamic characterisation and the amount of drug available for inhalation when spacers are used as inhalational aids to pMDI. That support the GINA recommendation regarding the use of spacer with all patients using pMDI even the breath actuated pMDIs.

Background

An ocular ailment impacts the entirety of sensory functioning, and an undetected and untreated ocular ailment might result in visual impairment. The objective of this study was to create an automated system for detecting age-related macular degeneration (ARMD) using deep-learning (DL) method that combines optimal deep features selected using the arithmetic optimizer (AO).

Methods

The main stages of the proposed scheme include; image collection from the chosen dataset and resizing, feature extraction using the DL scheme, feature optimization with AO and serial features fusion, and bi-level data classification and five-fold cross validation. The performance of the developed DL system is verified using conventional-, optimal-, and fused-features and the importance of these methods are established based on the chosen performance metrics.

Results

This study is executed using 1200 numbers of optical coherence tomography images of Normal/ARMD class and the scheme helps in achieving accuracy of >90% and >91% with conventional- and optimal features. Further, the fused-features based classification provided an accuracy of >99% with the support vector machin.

Conclusions

The achieved results of this study confirm the importance of the developed procedure on the examination of retinal optical coherence tomography images.

Background: A meta-analysis study was undertaken to examine antibiotic resistance, specifically by assessing the effectiveness of pharmacist interventions in influencing the rate of antibiotic prescriptions compared to their impact on adherence to antibiotic prescribing guidelines.

Objective: Evaluating the effectiveness of pharmacist interventions in influencing the rate of antibiotic prescriptions, in contrast to their impact on adherence to antibiotic prescribing guidelines.

Method: A comprehensive literature review up to the year 2016 was conducted, examining a total of 215 relevant studies. Among these, 15 specific studies were chosen for inclusion, encompassing a population of 298,339 individuals who initially demonstrated antibiotic resistance. Within this group, 134,004 individuals were exposed to interventions involving pharmacist participation, while 164,335 served as controls. The calculation of odds ratios (OR) and 95% confidence intervals (CIs) was employed to assess antibiotic resistance in pharmacists involved in antibiotic prescribing rates as compared to those involved in antibiotic prescribing adherence rates. This analysis utilized dichotomous approaches and employed both fixed and random models.

Result: When pharmacists participated in interventions targeting antibiotic prescribing rates, a considerable reduction in antibiotic resistance was observed (Odds Ratio, 0.86; 95% Confidence Interval, 0.78-0.95, p<0.00001). However, these findings exhibited a significant degree of heterogeneity (I2 = 90%). Conversely, in interventions focusing on improving antibiotic prescribing adherence rates involving pharmacists, a substantial increase in antibiotic resistance was noted (Odds Ratio, 1.96; 95% Confidence Interval, 1.56-2.45, p<0.00001), with similarly high heterogeneity in the results (I2 = 91%). These outcomes were specifically evident in individuals grappling with antibiotic resistance issues.

Conclusion: Pharmacist-led interventions targeting antibiotic prescribing rates led to a noteworthy decrease in antibiotic resistance compared to scenarios without pharmacist involvement in such interventions. Nonetheless, it is crucial to approach the interpretation of these results with caution, given the limited sample size in certain studies incorporated into the meta-analysis.

Background

The study investigates the in-vitro aerodynamic particle size distribution of Symbicort^® Turbuhaler^®, a dry powder inhaler containing budesonide and formoterol, at different inhalation flows.

Methods

The primary objective was to assess the effect of inhalation flow on drug delivery by analyzing the fine particle dose (FPD) and mass median aerodynamic diameter (MMAD) using an Andersen Cascade Impactor at 28.3 L/min and 60 L/min inhalation flows.

Results

The results reveal a statistically significant impact of inhalation flow on drug deposition (p<0.05). A higher inhalation flow (60 L/min) led to an increase in FPD, a decrease in MMAD, and a higher fine particle fraction (FPF), indicating improved lung deposition. Additionally, throat deposition decreased with increasing flows, suggesting better de-aggregation and dispersion of drug particles. Despite these changes, the ratio of budesonide (R and S epimers) to formoterol remained constant, ensuring consistent pharmacological efficacy.

Conclusions

The findings highlight the importance of flow considerations in dry powder inhaler performance and suggest that higher inspiratory flows may enhance drug delivery efficiency. This study supports the need for variable flow testing in pharmacopoeial standards to optimize inhaler design and ensure effective drug administration for patients with asthma and chronic obstructive pulmonary disease.