Physicians' Perception About the Side Effects of COVID-19 Vaccine and Their Role in Vaccination Program.

INTRODUCTION: The Coronavirus disease 2019 (COVID-19) caused many problems in the health sector. Effective and safe vaccines are the only tool to combat the COVID-19 disease. Researchers and regulatory agencies have made efforts to develop such vaccines and healthcare professionals were prioritized for the vaccination program as first-line care providers. Considering this prioritization, we aimed to assess the physicians' perceptions regarding the side effects of the COVID-19 vaccine. METHODS: An interview-based study was conducted from May 5 May to November 5, 2021 (6 months) in a teaching hospital in the capital city of Islamabad, Pakistan. RESULTS: Among the 200 physicians who agreed to participate in the interview, 74% were male. A total of 94% did not experience any side effects after receiving the COVID-19 vaccine, regardless of the type of vaccine; 6% experienced side effects. Furthermore, 90% of physicians were afraid of side effects due to the high number of vaccine doses. CONCLUSION: Conclusively, physicians had a positive perception regarding the COVID-19 vaccine. Healthcare authorities and related departments must take precautions to ensure the effective and safe COVID-19 vaccine to change the perceptions of physicians who had a negative perception. This will not only reduce the reluctance among physicians regarding administering COVID-19 vaccine, but will also boost and facilitate the vaccination program for the general public as well.

Exploring the perception and readiness of Pharmacists towards telepharmacy implementation; a cross sectional analysis.

Background: Amid the turbulent nature of the COVID-19 pandemic, telepharmacy has shifted the paradigm of patient care by leveraging digital medicine. Government mandated lockdowns and norms of social distancing have further underscored the need for telepharmacy. Many developed and developing countries implemented such initiatives where pharmacists have provided tele-pharmacy services via telecommunications. However, the implementation and utilization of tele-pharmacy services are quite negligible in resource limited settings due to financial and administrative constraints. This study was aimed to ascertain the perception and readiness of pharmacists working in various sectors of a resource limiting country. Methodology: A cross sectional study was carried out in all provinces of Pakistan to explore the perceptions of pharmacists towards telepharmacy implementation through a 35-items study instrument. The collected data was analyzed descriptively and scored accordingly. The chi-square test was used for inferential analysis on pharmacist's perception regarding implementation of tele-pharmacy with their demographics. Results: Of 380 pharmacists, the mean age is 27.67 ± 3.67 years with a preponderance of male pharmacists (n = 238, 62.6%). The pharmacists (n = 321, 84.5%) perceived that telepharmacy implementation improves patient's quality of life and decreases patients' visits (n = 291, 76.6%). Overall, pharmacists (n = 227, 59.7%) had negative perception towards benefits of telepharmacy implementation, but pharmacists had positive perception towards eligibility (n = 258, 67.9%), regulatory issues (n = 271, 71.3%) and telepharmacy during pandemic and beyond (n = 312, 82.1%). In chi-square testing gender (p = 0.03) and age (p = 0.03) had a significant association with perception regarding regulatory issues. Among perception regarding telepharmacy during COVID-19 pandemic and beyond age had a significant association (p = 0.03). Among perception regarding eligibility job location of pharmacists had significant association (p = 0.04). Conclusion: The majority of pharmacists had a positive perception regarding the eligibility of patients and regulatory issues/legal framework regarding the implementation of tele-pharmacy, as well as its use during the COVID-19 pandemic and beyond. The implementation of tele-pharmacy can play a major role in providing timely and better patient care to remote patient areas and may help in the prevention and treatment of different infectious diseases.

A sustainable approach on biomining of low-grade bauxite by P. simplicissimum using molasses medium.

In order to find a sustainable and low-cost alternative route to the traditional recovery of aluminum, the filamentous fungus Penicillium simplicissimum was evaluated for aluminum recovery from low-grade bauxite ore. The oat-agar medium was carefully chosen as the foremost solid medium for fungal sporulation due to lower cost, ease in preparation, and high spore production in a short incubation time. To examine the acid production capability in submerged fermentation, P. simplicissimum was inoculated in a medium augmented with glucose and molasses as an energy source. High-performance liquid chromatography (HPLC) technique was used for the determination of the produced organic acids. Three different bioleaching approaches were evaluated using 1% bauxite pulp density. The culture containing P. simplicissimum spores grown in a medium supplemented with molasses leached 86.6% Al in the direct two steps on the fifth day, 56.5% in the direct one step on the fourth day, and 71.7% in the indirect bioleaching on the fourth day, while in the controlled sterile flasks, Al leaching was almost negligible. A maximal amount of Al was leached by the fungal strains using low-cost molasses as a substrate.

Formulation of instant disintegrating buccal films without using disintegrant: An in-vitro study.

The current study was conducted to fabricate Metoclopramide HCL (MCH) and Sumatriptan succinate (SS) instant release buccal films (IRBF) without using any super disintegrant. The solvent casting method was used for the preparation of IRBFs and prepared IRBFs were physicochemically evaluated. Spectrophotometric analysis was done to determine the lambda max followed by the linearity determination of both drugs. Different concentrations such as 100, 125, and 150mg of hydrophilic polymer (HPMC E5) were employed but the concentration of glycerol was variable. Comparatively better results were observed for the formulation with 150mg of HPMC E5 and 30% glycerol. Formulated IRBFs showed good tensile strength with a mean disintegration time of 12.4-28.4 seconds and rapid dissolution with more than 50% drug release within 2 minutes. It was concluded that the chosen combination of polymers was appropriate for the fabrication of MCH and SS buccal strips.

Enhanced bio-recovery of aluminum from low-grade bauxite using adapted fungal strains.

Filamentous fungi have been proved to have a pronounced capability to recover metals from mineral ores. However, the metal recovery yield is reduced due to toxic effects triggered by various heavy metals present in the ore. The current study highlights the fungal adaptations to the toxic effects of metals at higher pulp densities for the enhanced bio-recovery of aluminum from low-grade bauxite. In the previous studies, a drastic decrease in the aluminum dissolution was observed when the bauxite pulp density was increased from 1 to 10% (w/v) due to the high metal toxicity and low tolerance of Aspergillus niger and Penicillium simplicissium to heavy metals. These fungi were adapted in order to increase heavy metal tolerance of these fungal strains and also to get maximum Al dissolution. A novel approach was employed for the adaptation of fungal strains using a liquid growth medium containing 5% bauxite pulp density supplemented with molasses as an energy source. The mycelia of adapted strains were harvested and subsequently cultured in a low-cost oat-agar medium. Batch experiments were performed to compare the aluminum leaching efficiencies in the direct one-step and the direct two-step bioleaching processes. FE-SEM analysis revealed the direct destructive and corrosive action by the bauxite-tolerant strains due to the extension and penetration of the vegetative mycelium filaments into the bauxite matrix. XRD analysis of the bioleached bauxite samples showed a considerable decline in oxide minerals such as corundum and gibbsite. Results showed a high amount of total Al (≥ 98%) was successfully bioleached and solubilized from low-grade bauxite by the adapted fungal strains grown in the presence of 5% pulp density and molasses as a low-cost substrate. Graphical abstract.

The rational use of thromboprophylaxis therapy in hospitalized patients and the perspectives of health care providers in Northern Cyprus.

BACKGROUND: Despite the presence of effective strategies and standard guidelines for the prevention of deep vein thrombosis (DVT), a considerable proportion of patients at risk of developing thromboembolism did not receive prophylaxis during hospitalization, while others received it irrationally, thus led to unwanted side effects. AIM: This study aimed to evaluate the current thromboprophylaxis practice and management of hospitalized patients at risk of developing DVT, along with the assessment of health care providers (HCPs) knowledge, and attitudes regarding DVT prevention. METHODS: An observational study was conducted in the general wards of two leading tertiary university hospitals in Northern Cyprus in which patients from multiple clinics were enrolled to investigate the rational use of DVT prophylaxis using the Caprini risk assessment tool. Patients were also followed for possible complications two weeks post-hospitalization. A cross-sectional study followed to assess the knowledge and attitude of HCPs regarding DVT risks and prophylaxis. RESULTS: Of the 180 patients enrolled, 47.7% were identified as irrationally managed, 52.3% were identified as rationally managed, 77.8% of patients were identified as having a high level of risk. Notably, Four of thirteen patients who received more thromboprophylaxis developed minor complications. Additionally, 73.3% of nurses had not received DVT education. Furthermore, more than 50% of physicians and nurses achieved a low knowledge score for DVT risks and prophylaxis. CONCLUSIONS: A high degree of irrationality in the administration of thromboprophylaxis therapy to hospitalized patients was observed. The overall scores for HCPs indicated insufficient knowledge of DVT risk assessments and prophylaxis.

Successful Treatment of Severe Tardive Dyskinesia with Valbenazine, Including a Patient's Perspective.

BACKGROUND Tardive dyskinesia (TD) is a chronic involuntary movement disorder frequently induced by dopamine receptor blockers, particularly first-generation antipsychotics. Until recently, management of TD was restricted to lowering the dose of the current medication, switching to another medication, or using off-label treatments with insufficient evidence of efficacy. Valbenazine, a vesicular monoamine transporter-2 (VMAT2) inhibitor, became the first drug to be approved by the FDA specifically for the treatment of TD. CASE REPORT We describe the case of a 49-year-old African-American woman who was diagnosed with bipolar disorder at the age of 34 and treated with lithium carbonate (900 mg daily) and citalopram (10 mg daily). She also received low doses of second-generation antipsychotics for weeks at a time, but these were always discontinued due to severe sedation. Over a decade later, at the age of 45, she experienced rapid onset of severe TD symptoms. She enrolled in a phase III double-blind clinical trial and received valbenazine 80 mg, with encouraging results. CONCLUSIONS Once-daily dosing of valbenazine (80 mg) was effective and safe over a long period, even in this atypical case of severe and rapid-onset TD.

Adsorptive desulphurization study of liquid fuels using Tin (Sn) impregnated activated charcoal.

Keeping in view the growing concern regarding desulphurization of petroleum products, the present study was under taken to investigate the efficiency of tin impregnated activated charcoal (Sn-AC) as a potential adsorbent for the desulphurization of model and real commercial straight run kerosene and diesel oil samples. The adsorbent Sn-AC was prepared by wet impregnation process in the laboratory and characterized by SEM, EDX and surface area analysis. Initial experiments were carried out using model oil, which was prepared by dissolving dibenzothiophene (DBT) in cyclohexane, the optimum conditions for desulfurization were found to be, 60°C temperature, 1h contact time and adsorbent dosage of 0.8g, under which about 99.4% of DBT removal was attained. Under optimized conditions the desulfurization of real oil i.e., kerosene and diesel oil was also investigated. Kinetic studies revealed that DBT adsorption followed pseudo second order kinetics and the data best fits in the Langmuir adsorption isotherm as compared to Freundlich adsorption isotherm model. The adsorbent could be easily regenerated simply by washing with toluene for a multiple cycles and reused without losing its efficiency.