Community Pharmacists' Knowledge and Attitude Towards Opioid Pain Medication Use in Bahir Dar City, North-West Ethiopia.

Background: Opioid use is a major global public health problem, affecting 16 million individuals worldwide. According to a 2023 WHO report, out of the 600,000 substance-related deaths worldwide, 80% were attributed to opioid use. Pharmacists play a vital role in reducing unnecessary opioid exposure while facilitating access to non-opioid alternatives. To do so, pharmacists should have sufficient knowledge regarding opioid-containing medications and a positive attitude about opioid use problems. Objective: This study aimed to evaluate community pharmacists' knowledge of opioid-containing medications and their attitude toward opioid use problems. Materials and methods: A cross-sectional study was conducted using a self-administered, structured questionnaire distributed to 105 community pharmacists from July 1-30, 2023 in Bahir Dar City, Ethiopia. The tool included demographic information and questions designed to assess participants' knowledge and attitudes. Results: Out of the 105 pharmacists included in this study, majority were males (54.3%), nearly half held a bachelor's degree (49.5%), and slightly above one-third had over a decade experience (39%). Regarding knowledge and attitude towards opioids, 62 individuals (59%) exhibited good knowledge, and 64 (61%) demonstrated less stigma toward opioid usage. Factors affecting knowledge include: education level (AOR (95% CI): 8.43 (1.76-40.35) and 9.93 (1.04-85.33) for bachelors and postgraduates respectively and age 1.45 (1.20-1.77)]. Meanwhile, experience [AOR (95% CI): 4.64(1.20-17.90) and 4.29 (1.23-15.05)] for 5-9 years and ≥10 years respectively and education level [AOR (95% CI): 4.08 (1.40-11.93) for bachelors and 6.40 (1.42-28.96)] for postgraduates were linked to attitude. Conclusion: A gap in knowledge and more stigmatizing behavior was observed among community pharmacists. These findings imply the importance of tailored educational interventions to address knowledge gaps and promote positive attitudes toward opioid usage among community pharmacists. Therefore, it is imperative to deliver up-to-date information on opioids, emphasizing their high addiction potential, to ensure pharmacists are well-equipped with the latest information.

Willingness to Embrace COVID-19 Vaccination Amongst Residents in a Low-Income Nation: Insights From a Cross-Sectional Study on a Limited Cohort.

The global pandemic had a significant impact on countries around the world, both politically and socioeconomically. It is crucial that swift decisions and actions need to be taken to prevent negative outcomes. The development of vaccines has emerged as a potential necessity for countries worldwide. Ethiopia began vaccinating health professionals and high-risk individuals in March 2021, according to a report from the World Health Organization citing the Ethiopian Federal Ministry of Health. This study aimed to assess the determinants of willingness to receive the COVID-19 vaccine among Debre Markos city administration residents. A community-based cross-sectional study design was employed to recruit 845 individuals as a sample. Descriptive statistics and logistic regression were used as statistical analysis techniques. Among the total 845 samples, the overall response rate was 98.34%. Two hundred forty-two participants showed their willingness to receive vaccines. Age (AOR = 2.56; 95%CI = [1.87-3.23]), sex (Female) (AOR = 3.45; 95% CI = [2.07-5.26]), having children (AOR = 1.21; 95% CI = [1.02-1.90]), and Chronic Disease (AOR = 2.98; 95% CI = [1.67-3.50]) were significantly and positively associated with willingness to receive COVID 19 vaccines at 95% CI. Although most of the participants were aware of the possibility of COVID-19 to cause fever; and its transmission, only a small percentage of the total participants showed their willingness to receive the vaccine if it was available to them. Elderly and individuals with chronic diseases need to get a priority of taking those vaccinations.

3D printed drug loaded nanomaterials for wound healing applications.

Wounds are a stern healthcare concern in the growth of chronic disease conditions as they can increase healthcare costs and complicate internal and external health. Advancements in the current and newer management systems for wound healing should be in place to counter the health burden of wounds. Researchers discovered that two-dimensional (2D) media lacks appropriate real-life detection of cellular matter as these have highly complicated and diverse structures, compositions, and interactions. Hence, innovation towards three-dimensional (3D) media is called to conquer the high-level assessment and characterization in vivo using new technologies. The application of modern wound dressings prepared from a degenerated natural tissue, biodegradable biopolymer, synthetic polymer, or a composite of these materials in wound healing is currently an area of innovation in tissue regeneration medicine. Moreover, the integration of 3D printing and nanomaterial science is a promising approach with the potential for individualized, flexible, and precise technology for wound care approaches. This review encompasses the outcomes of various investigations on recent advances in 3D-printed drug-loaded natural, synthetic, and composite nanomaterials for wound healing. The challenges associated with their fabrication, clinical application progress, and future perspectives are also addressed.

How Combined Macrolide Nanomaterials are Effective Against Resistant Pathogens? A Comprehensive Review of the Literature.

Macrolide drugs are among the broad-spectrum antibiotics that are considered as "miracle drugs" against infectious diseases that lead to higher morbidity and mortality rates. Nevertheless, their effectiveness is currently at risk owing to the presence of devastating, antimicrobial-resistant microbes. In view of this challenge, nanotechnology-driven innovations are currently being anticipated for promising approaches to overcome antimicrobial resistance. Nowadays, various nanostructures are being developed for the delivery of antimicrobials to counter drug-resistant microbial strains through different mechanisms. Metallic nanoparticle-based delivery of macrolides, particularly using silver and gold nanoparticles (AgNPs & AuNPs), demonstrated a promising outcome with worthy stability, oxidation resistance, and biocompatibility. Similarly, macrolide-conjugated magnetic NPs resulted in an augmented antimicrobial activity and reduced bacterial cell viability against resistant microbes. Liposomal delivery of macrolides also showed favorable synergistic antimicrobial activities in vitro against resistant strains. Loading macrolide drugs into various polymeric nanomaterials resulted in an enhanced zone of inhibition. Intercalated nanomaterials also conveyed an outstanding macrolide delivery characteristic with efficient targeting and controlled drug release against infectious microbes. This review abridges several nano-based delivery approaches for macrolide drugs along with their recent achievements, challenges, and future perspectives.

Physicochemical Characterization and Evaluation of Ficus vasta Gum as a Binder in Tablet Formulation.

Binders are ingredients used in tablet granulation process for tablet cohesiveness which confirms that the tablet remains intact after compression. Natural gums have been employed as disintegrants, emulsifying agents, suspending agents, and binders in tablets. Even though Ficus vasta gum is claimed as a possible pharmaceutical excipient by some phytochemical studies, literature is scanty on its efficacy as a tablet binder. The purpose of this study was to isolate, characterize, and comparatively evaluate Ficus vasta gum as a potential binder in tablet formulation. Gum was extracted from Ficus vasta tree, characterized for physicochemical properties, and applied as a binder in paracetamol granule and tablet formulation. Granules were prepared using 4%, 6%, 8%, and 10% w/w concentration of the gum and standard binders (polyvinylpyrrolidone K-30 and Starch@1500) by wet granulation. The formulated tablets were then evaluated for tablet quality parameters, and comparison between the test and standard binders was done by ANOVA. The dried crude gum yielded 50.63% (w/w) of a brownish yellow purified gum. The angle of repose, Carr's index, and the Hausner ratio all complied with the pharmacopoeial recommendations. The gum is compatible with the model drug, paracetamol. The paracetamol granules prepared with Ficus gum binder demonstrated an optimum size range and size distribution with substantial flow and compressibility properties. Ficus gum binder demonstrated significantly higher disintegration time and strength properties than that of similar concentrations of Starch@1500 but lower than polyvinylpyrrolidone (p < 0.05). Ficus gum has better binding properties than starch but lower than polyvinylpyrrolidone. Hence, Ficus vasta gum can be used as an alternative tablet binder in tablet manufacturing.

Concern on Skin Lightening Product Safety: Level of Awareness and Associated Factors Among Female Users in Bahir Dar City, Ethiopia.

Background: Most skin lightening products are composed of some toxic chemicals such as mercury and hydroquinone which are classified under critical ingredients which need evaluation. Consumption without sufficient awareness may lead to toxicities endangering skin health. Objective: The aim of this study was to assess the level of awareness towards the side effects of skin lightening products and associated factors among females in Bahir Dar city, Ethiopia. Methods: An institutional-based cross-sectional study design was conducted in Bahir Dar city from June 28 to August 28, 2022 among females that had been using skin whitening. Samples of 362 females were selected by using multistage sampling technique from selected drug retail outlets. The data was coded, cleaned, and analyzed by using SPSS version 26. The variables were analyzed through multiple regression in order to identify the associated factors towards the level of awareness on the side effects of skin lightening products. Results: Only 42.7% of the respondents had a favorable level of awareness. The highly influencing factors for using skin lightening products were peer pressure (39.9%) and social media (37.4%). Nearly half of the users experienced side effects. Only 8.9% of the respondents know the active ingredients of the products. Level of education was found to have significant association with level of awareness (AOR = 7.66, 95% CI: (1.23, 47.59); P = 0.029). Conclusion: Only less than half of women have favorable awareness towards skin lightening products they use. The significant association between educational level and level of awareness should be considered as an alternative intervention in addition to regulatory restrictions.

Post COVID-19 Vaccination Side Effects and Associated Factors Among Vaccinated Clients in Bahir Dar City, Ethiopia.

Introduction: The lack of local side effect profiles for vaccines could hinder vaccination uptake. Since all COVID-19 vaccines are brand-new medications, it is crucial to keep track of any safety related concern. Objective: This study is aimed to investigate post-vaccination side effects of COVID-19 vaccines and associated factors in Bahir Dar city. Method: An institutional-based cross-sectional study was conducted among vaccinated clients. A simple random and a systematic random sampling method were used to select the health facilities and the participants, respectively. Bi-variable and multivariable binary logistic regression analyses were executed with odds ratio at 95% confidence intervals at p < .05. Results: A total of 72(17.4%) participants reported at least one side effect following vaccination. The proportion prevalence was higher after the first dose than that of the second dose and the difference was also found to be statistically significant. In the multivariable logistic regression analysis female participants (AOR = 3.39, 95% CI = 1.53, 7.52), participants with a history of regular medication use (AOR = 3.34, 95% CI = 1.52, 7.33), participants aged 55 and above (AOR = 2.93, 95% CI = 1.23, 7.01), and participants who had taken only the first dose (AOR = 14.81, 95% CI = 6.40, 34.31) were more likely to develop side effects for COVID 19 vaccination compared to their counterparts. Conclusion: A significant number (17.4%) of participants reported at least one side effect following vaccination. Sex, medication, occupation, age, and type of vaccination dose were factors statistically associated with the reported side effects.

Self-Medication Prevalence and Factors Associated with Knowledge and Attitude Towards Self-Medication Among Undergraduate Health Science Students at GAMBY Medical and Business College, Bahir Dar, Ethiopia.

Background: Reports indicate that health science students are among the frontline of self-medication practitioners. The main objective of this study was to evaluate the self-medication (SM) practice and associated factors with knowledge and attitude of undergraduate health science students at GAMBY Medical and Business College, Bahir Dar, Ethiopia. Methods: An institutional-based cross-sectional quantitative study was conducted using a self-administered questionnaire from May to July, 2022. A stratified random sampling method was applied to collect the data. The collected data were checked, and exported into SPSS 26. Descriptive statistics and regression analysis were performed to determine the results and the associated factors. Variables with p < 0.05 were regarded as significant. Results: 301 students (31 medicine, 163 pharmacy, and 107 medical laboratory students) responded (99% response rate). 68.1% of the respondents had practiced SM at least once within the last six months. 58.8% had good knowledge, while 55.5% have a positive attitude towards SM. Headache (33.7%) and cough (29.8%) were the primary disease conditions for SM. Analgesics (37.1%) and antimicrobials (29.8%) are most frequently self-consumed agents. Being a medicine student (AOR = 3.872; 95% CI: (1.263-11.866); p = 0.018), not having health insurance (AOR = 2.431; 95% CI: (1.383-4.274); p = 0.002), and not having a known medical illness (AOR = 2.241; 95% CI: (1.226-4.127); p = 0.010) were independently associated with good knowledge. While, living in an urban area was significantly associated with a positive attitude (AOR = 3.593; 95% CI: (1.404-9.197); p = 0.004). Conclusion: The SM rate in GAMBY is significantly higher. Besides, not more than half the students had acceptable knowledge and attitude towards SM. The college and the surrounding regulatory authorities should consider ways of controlling and recapitalizing SM practices by the students.

Balantidium coli; Rare and Accidental Finding in the Urine of Pregnant Woman: Case Report.

Background: Balantidium coli is a ciliated protozoan parasite, which causes intestinal and extraintestinal infections in humans. It is transmitted feco-orally by ingesting infective cysts with food and water. Urinary balantidiasis may occur through contamination (direct spread from the anal area), secondarily to rectovaginal fistula and following immune suppression. Data about cases of urinary balantidiasis are rare in the world. Currently, there are no documented reports of urinary balantidiasis in Ethiopia. As our understanding, there are only eleven documented reports of urinary balantidiasis globally. However, cases of urinary balantidiasis among pregnant women have not been documented yet. The aim of this report is to alarm health professionals for considering the occurrence of such rare cases and conduct diagnosis. Case Presentation: A 24-year old pregnant woman was admitted due to severe preeclampsia and preterm delivery at Debre Tabor Comprehensive Specialized Hospital, gynecology ward. Her urine was presented to inpatient laboratory for routine urinalysis. We detected unusual and ciliated parasite from her urine sediment characterized by its active and rotary motility through its cilia and possessing macro- and micro-nuclei, several food vacuoles and ingested red blood cells inside the cytoplasm. Hematuria, many white blood cells and epithelial cells were also detected from the urine sediment, which suggests genito-urinary tract infection due to this parasite. This rare parasite finding was confirmed to be B. coli. Conclusion: The route of transmission and extraintestinal existence from this woman's urine was unclear. It might be due to feco-oral transmission and spread to the genitourinary tract through direct anal contact. Moreover, it might be associated with immune suppression as she is pregnant woman.

Different Nanotechnology Approaches for Ciprofloxacin Delivery Against Multidrug-Resistant Microbes.

The percentages of organisms exhibiting antimicrobial resistance, especially resistance to multiple antibiotics, are incessantly increasing. Studies investigated that many bacteria are being resistant to ciprofloxacin. This review addresses the current knowledge on nano-based ciprofloxacin delivery approaches to improve its effectiveness and overcome the resistance issues. Ciprofloxacin delivery can be modified by encapsulating with or incorporating in different polymeric nanoparticles such as chitosan, PLGA, albumin, arginine, and other organic and inorganic nanostructure systems. Most of these nano-approaches are promising as an alternative strategy to improve the therapeutic effectiveness of ciprofloxacin in the future.

Multidisciplinary Effort and Integrative Preparedness: A Lesson for the Foreseen Multivariate COVID-19 Pandemic Flare-Up.

It has been a year and a half since the world suffered the horrific COVID-19 pandemic which has still continued becoming a prominent headache for the whole world. Recently, we are facing the second and third wave of multivariate outbreaks with great intensity of transmission which renders huge disaster. Presently, new strains of the virus are emerging that are predicted to be resistant for the current vaccines and other management approaches. It needs collaborative and coordinated role at professional, facility, regional, and global levels to ameliorate the pandemic by monitoring the existing and emerging variants. This review addressed the multidisciplinary roles in patient screening and detection, emergency management, moderate and critical care, vaccination, complication prevention, comorbidity management, psychological therapy, and digital health care. The inevitable roles of academicians, researchers, private health sectors, policy makers, regulatory bodies, and partners are also discussed.

A Cost Effectiveness Analysis of Rivaroxaban Compared to Warfarin for Deep Vein Thrombosis (DVT) Treatment in Ethiopia.

BACKGROUND: Deep vein thrombosis and pulmonary embolism are known by the collective name venous thromboembolism. Deep vein thrombosis is the third most common cardiovascular disorder in the world. The disease is also prevalent in Africa including Ethiopia, besides lack of studies that show epidemiology of the disease. OBJECTIVE: To assess cost effectiveness of rivaroxaban compared to warfarin-based therapy for deep vein thrombosis patients in Ethiopia. METHODS: A Markov model was built to compare cost and effectiveness of rivaroxaban 15mg bid for three weeks and 20mg per day for the rest to adjusted dose of warfarin for one year using a restricted societal perspective. The population in this analysis was a hypothetical cohort of deep vein thrombosis patients 40 years old with no contraindication, comorbidity and concomitant therapy. The patients were followed yearly for 24 years up to their average life expectancy. RESULTS: Rivaroxaban therapy resulted in higher quality adjusted life years with a value of 16.78, while warfarin-based treatment resulted in 16.34 quality adjusted life years. Total lifetime costs were $988.58 for rivaroxaban and $932.92 for unfractionated heparin/warfarin. Therefore, rivaroxaban resulted in a gain of 0.443 quality adjusted life years at an additional cost of $55.661. The incremental cost effectiveness ratios for rivaroxaban compared with warfarin was $125.683 per quality adjusted life year saved which is less than willingness to pay threshold of $783 per quality adjusted life year saved. Warfarin resulted in a net monetary benefit of $11,859.72, while that of rivaroxaban is $12,150.82, meaning rivaroxaban is cost-effective. Sensitivity analyses found that the model was sensitive to utility of no deep vein thrombosis, effectiveness of rivaroxaban and cost of rivaroxaban respectively. CONCLUSION: This study showed that rivaroxaban is a cost effective alternative and substituting rivaroxaban for warfarin is acceptable to willingness to pay threshold.

Could Nanotechnology Help to End the Fight Against COVID-19? Review of Current Findings, Challenges and Future Perspectives.

A serious viral infectious disease was introduced to the globe by the end of 2019 that was seen primarily from China, but spread worldwide in a few months to be a pandemic. Since then, accurate prevention, early detection, and effective treatment strategies are not yet outlined. There is no approved drug to counter its worldwide transmission. However, integration of nanostructured delivery systems with the current management strategies has promised a pronounced opportunity to tackle the pandemic. This review addressed the various promising nanotechnology-based approaches for the diagnosis, prevention, and treatment of the pandemic. The pharmaceutical, pharmacoeconomic, and regulatory aspects of these systems with currently achieved or predicted beneficial outcomes, challenges, and future perspectives are also highlighted.