Sustained release local anesthetics for pain management: relevance and formulation approaches.

This review attempted to ascertain the rationale for the formulation of sustained-release local anesthetics and summarize the various formulation approaches designed to date to achieve sustained and localized local analgesic effects. The incidence of pain, which is the concern of patients as well as health care professionals, is increasing due to accidents, surgical procedures, and other diseases. Local anesthetics can be used for the management of moderate to severe acute and chronic pain. They also allow regional analgesia, in situations where the cause and source of the pain are limited to a particular site or region, without the need for loss of consciousness or systemic administration of other analgesics thereby decreasing the risk of potential toxicities. Though they have an interesting antipain efficacy, the short duration of action of local anesthetics makes the need for their multiple injections or opioid adjuvants mandatory. To overcome this problem, different formulations are being designed that help achieve prolonged analgesia with a single dose of administration. Combination with adjuvants, liposomal formulations, lipid-based nanoparticles, thermo-responsive nanogels, microspheres, microcapsules, complexation with multivalent counterions and HP-ß-CD, lipid-based nanoparticles, and bio-adhesive films, and polymeric matrices are among the approaches. Further safety studies are required to ensure the safe and effective utilization of sustained-release local anesthetics. Moreover, the release kinetics of the various formulations should be adequately established.

Commentary: Nanoparticle-Based Chemotherapy Delivery and Potential Health Risks: Prospects for Effective Clinical Translation.

With recent advancements, chemotherapy is one of the most prevalent regimens for cancer treatment. However, the heterogeneity of tumor biology and healthy cell-damaging potential of chemotherapy remain challenges. As a solution, nanoparticle-based delivery is advancing. Besides its promising potential, effective clinical translation and commercialization of nanoparticle-based chemotherapy should get attention to ensure the absence of potential health risks. Specifically, the permeability potential of nanoparticles across biological barriers can lead to drug accumulation in vital organs and produce harm. Therefore, for effective design and clinical application of next-generation nanomedicine, pharmaceutical formulation scientists should conduct intensive studies. They involve studying the properties of drug-loaded nanoparticles in the microenvironment of the target site and the impact of interspecies differences using quantitative and mechanistic studies. It creates a comprehensive understanding of the specific properties of nanoparticles and their interaction potential with biological systems. This commentary justifies the requirement for comprehensive knowledge of the above-mentioned criteria and tests for the success of nanomedicine for chemotherapy delivery.

Extent and barriers to providing effective pharmaceutical compounding services in hospital and community pharmacies of a low-income country: Case of Southwest Ethiopia.

Background and objective: In low- and middle-income countries, pharmaceutical compounding is vital to provide high-quality healthcare service. Accordingly, this study aimed to investigate the extent status of practice and barriers to compounding services in hospital and community pharmacies of Southwest Ethiopia. Methods: A healthcare institution-based cross-sectional study was conducted from 15 September 2021 to 25 January 2022. Data were collected from 104 pharmacists using a self-administered questionnaire. The responding pharmacists were selected by purposive sampling technique. Finally, descriptive statistical methods were used for data analysis with the help of IBM SPSS Statistics V21.0. Results: A total of 104 pharmacists (27 hospital pharmacists and 77 community pharmacists) responded (response rate: 0.945). Besides providing other routine essential pharmacy services, around 93.3% of contacted pharmacies have a history of practicing compounding services. The most common practices were granule or powder reconstitution to suspensions or solutions (98.97%) and crushing tablets into smaller forms (92.8%). Commonly, compounding was requested and practiced for preparing pediatrics (97.9%) and geriatrics (96.9%) doses from adult doses, unavailable dosage forms (88.7%), and solving therapeutic gaps (86.6%). All compounding pharmacies participated in compounding antimicrobial medications. They often cited lacking skills or training (76.3%) and insufficient equipment and supplies needed for compounding (99%) as the main barriers. Conclusion and recommendation: With many facilitators, challenges, and limitations, medication compounding services remain one of the core healthcare services. Areas needing improvement include strengthening comprehensive and continuous professional development for pharmacists on compounding standards.

Knowledge and attitudes toward euthanasia among final year pharmacy and law students: a cross-sectional study.

BACKGROUND: Euthanasia is the last resort for those living with untreatable and terminable diseases which cause pain and suffering. However, the concept of euthanasia resulted in many dilemmas and controversy around life extension and death. OBJECTIVE: The aim of this study was to evaluate the knowledge and attitudes of final year pharmacy and law students concerning euthanasia. METHODS: A descriptive cross-sectional study was carried out among all final year law and pharmacy undergraduate students. The data were collected using self-administered structured questionnaire and analyzed by SPSS version 22. Multivariate logistic regression was used to assess the influence of socio-demographic characteristics of participant's on acceptance of euthanasia. RESULT: 72 (61.5%) of the students were declared that euthanasia is administration of lethal drugs to a patient at the explicit request of that patient. Majority 87 (74.4%) of the students knew that euthanasia is active shortening of the dying process. Most participants 95(81.2%) awared that there is no legalized euthanasia in Ethiopia. On the other hand, 47(40.2%) believed the patient has the right to choose to end his/her own life. Around 45% had the view that euthanasia should be legalized in some circumstances. Only 27.3% (n = 32) of the respondents endorsed legalization of euthanasia in Ethiopia. 35 (29.9%) said euthanasia should be performed. The acceptance of euthanasia was greater for pharmacy students compared to law students [adjusted odds ratio (AOR) = 3.490; 95% CI 1.346-9.049; p = 0.010] and lower for Muslim students compared to Orthodox students (AOR = 0.186; 95% CI 0.044-0.783; p = 0.022). CONCLUSION: The final year law and pharmacy students were aware of euthanasia. However, majority of students did not reveal favorable attitude toward euthanasia and its acceptance was low. Participants' field of study and religion were significantly affect acceptance of euthanasia As the current study limited to pharmacy and law students, the authors suggest that future studies should involve various segments of societies to investigate more about euthanasia in Ethiopia.

An analysis of COVID-19 information sources.

BACKGROUND: The COVID-19 pandemic has brought new situations that require the effective delivery of health information across the world and it's important to offer clear, consistent, and credible information on the pandemic to mitigate and control the outbreak. AIM: To assess COVID-19 information source, need and trust among the rural community of southwest Ethiopia. METHODS: A community-based cross-sectional study design was conducted among 634 rural communities of southwest Ethiopia. The data were collected by interviewing individuals from selected households and analyzed by SPSS version 26. A multivariable logistic regression model was used to assess factors affecting information needs. RESULTS: Radio 484 (76.3%) was mostly used as a source of information for COVID-19, and government 404 (63.7%) and health professionals 345 (57.7%) were trusted. However, only 10 (1.6%) of the participants acquired information from health professionals. Around 395 (62.3%) of the participants needed additional information on COVID-19. Around 230 (58.2%) and 186 (47.1%) of the participants required additional information on cause and sign and symptoms, respectively. Age of < 45 years old (AOR: 2.11, 95% CI: 1.43, 3.12, P < 0.001), and absence of formal education (AOR: 2.00, 95% CI: 1.35, 2.95, P: 0.001) were factors positively affecting the information needs of the participants on COVID-19. Church goers (AOR: 3.24; 95% CI: 2.03, 5.19; P < 0.001), television (AOR: 2.39; 95% CI: 1.63, 3.49; P < 0.001) and social media users (AOR: 4.52; 95% CI: 2.26, 9.04; P < 0.001) as source of information required additional information on COVID-19, and the participants that trusted social media (AOR: 2.52; 95% CI: 1.64, 3.87; P < 0.001) and friends/relatives (AOR: 2.95: 95% CI: 1.51, 5.76; P < 0.001) were also required additional information on COVID-19. CONCLUSIONS: The popular sources of COVID-19-related information were radio and television. The participants trusted the government and health professionals on COVID-19. However, less than 2% of the participants had information from health professionals. The majority of the participants wanted to learn more about COVID-19. The areas the participants required additional information include cause and signs and symptoms. Age, educational status, trust in social media, trust in friends, using the church, television and social media as a source were factors associated with information needs.

Generic substitution for prescribed brand medicines in Ethiopia: knowledge, attitude and practice among pharmacy professionals in community drug retail outlets.

BACKGROUND: Generic substitution is a good approach to reduce pharmaceutical expenses without compromising healthcare quality. Yet, the practice of generic substitution has been contentious due to concerns on quality and efficacy. OBJECTIVE: This study was aimed to assess knowledge, attitude and practice among pharmacy professionals toward generic substitution in community drug retail outlets in Jimma town, Southwest Ethiopia. METHODS: A descriptive cross-sectional study was conducted among pharmacy professionals working in community drug retail outlets. Data was collected using a self-administered questionnaire. Knowledge was tested using a 3-point response format consisting of "Yes," "No" and "I am not sure." Attitude was evaluated using the 5-point Likert scale ranging from 1(strong agreement) to 5 (strong disagreement). The practice was examined as never, seldom, sometimes, often, and always with scores ranging from 0 to 4. The influences of socio-demographic factors on knowledge, attitude, and practice were tested using the Mann-Whitney U and Kruskal-Wallis tests as appropriate. P ≤ 0.05 was considered statistically significant. RESULTS: The mean knowledge score of participants regarding generic medicines was 5.75 ± 1.79. Only 32 respondents (30.2%) of the participants were knowledgeable about the generic substitution. 54 (50.9%) of respondents had positive attitude toward generic substitution and 52 (49.1%) had practiced generic substitution. The year of experience had a significant effect on knowledge (X2 = 9.14, p = 0.01) and practice (X2 = 4.71, p = 0.03) of generic substitution. CONCLUSIONS: Our study found that pharmacy professionals working in community drug retail outlets in Jimma town had lack of knowledge about generic substitution. Conversely, an enormous amount of participants had positive attitude toward generic substitution and nearly half of them had practiced generic substitution. The year of experience had a significant effect on knowledge and practice of generic substitution.

Investigating the knowledge, perception, and practice of healthcare practitioners toward rational use of compounded medications and its contribution to antimicrobial resistance: a cross-sectional study.

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.

Medication counselling practices amid COVID -19 pandemic and associated factors in drug retail outlets of Jimma town, Southwest Ethiopia: cross-sectional study.

Background: Patients' good understanding and awareness of drug information received at the drug retail outlet is paramount to gaining expected outcomes. In the COVID-19 pandemic, the routine counselling practice faced multifactorial challenges. Objectives: The study aimed to assess medication counseling practice and associated factors in drug retail outlets of Jimma town, southwest Ethiopia. Methods: A facility-based cross-sectional study was conducted using an interviewer administered questionnaire. The data were analysed by using SPSS version 23. A multivariable logistic regression model was used to identify factors associated with medication counselling practice. Results: A total of 180 pharmacy professionals were enrolled in the study, about half (51.1%) of the participants reported good medication counselling provision for their patients. In A multivariable logistic regression analysis, reduced pharmacist's level of communication (AOR=0.008; CI: 0.001-0.292; p= 0.009) and shortage of personal protective equipment (AOR=0.021; CI: 0.002-0.226; p=0.002) due Covid-19 were factors associated with poor medication counselling practice. Conclusion: Reduced level of communication and shortage of personal protective equipment due to Covid-19 were factors associated with poor medication counselling practice. In general, Jimma town health offices and Oromia Region Health bureau should struggle in association with other stakeholders to improve the identified bottleneck of pharmacist's counselling practice.

Traditional Medicine Practice in the Context of COVID-19 Pandemic: Community Claim in Jimma Zone, Oromia, Ethiopia.

PURPOSE: To assess traditional medicine practice claims by the community for the prevention and treatment of COVID-19. METHODS: A community-based cross-sectional study design was conducted among 422 households of Jimma Zone, and the data were collected by interviewing individuals from the selected households. The medicinal plants were recorded on Microsoft excel 2010 with their parts used, dosage form, route of administration and source of plants and tabulated in the table. Descriptive statistics were used to describe and organize the data. The Relative Frequency of Citation (RFC) was calculated for each traditional medicine to identify the top 10 medicinal products. RESULTS: Around 46% of participants used traditional medicines for the prevention and treatment of COVID-19. The study recorded 32 herbal and non-herbal medicinal products. Garlic (RFC: 0.166), ginger (RFC: 0.133), lemon (RFC: 0.133), garden cress (RFC: 0.069) and "Damakase" (RFC: 0.031) were the frequently used herbal medicines. Seeds (47.22%) and leaves (30.56%) were the most used parts of medicinal plants. Most preparation of medicinal plants (90.63%) was administered through the oral route. The majority of medicinal plants were from home gardens. CONCLUSIONS AND RECOMMENDATIONS: Around half of the participants practiced traditional medicines for COVID-19. Garlic, ginger, lemon, garden cress and "Damakase" were the frequently used herbal products. Seeds and leaves were regularly used parts. The oral route is the most used route of administration. The majority of medicinal plants were from home gardens. This quantity of traditional medicine practice is probably challenging to control the pandemic. However, it might open possibilities for pharmaceutical industries and researchers to look into the effectiveness and safety of claimed medicinal products. Therefore, all responsible bodies are advocated to behave accordingly.

Knowledge, Attitude and Self-Reported Performance and Challenges of Hand Hygiene Using Alcohol-Based Hand Sanitizers Among Healthcare Workers During COVID-19 Pandemic at a Tertiary Hospital: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVE: Understanding and consistent hand hygiene practice by alcohol-based hand sanitizer is a cardinal step to stay safe from the coronavirus disease (COVID-19) pandemic. This study aimed to assess the self-reported level of knowledge, attitude, practice, and challenges to practice hand hygiene by alcohol-based hand sanitizers among healthcare workers during the COVID-19 pandemic in Jimma Medical Center, Ethiopia. METHODS: Between April and June 2020, a questionnaire-based descriptive cross-sectional study was conducted using 96 study participants. Data were analyzed using SPSS version 21 and described. RESULTS: All of the study participants (96) were at the forefront of the fight against COVID-19. Most of the study participants were nurses (27) and pharmacists (21). Their mean age was 28.69±4.048 years. All of them were practicing different COVID-19 prevention methods. In this study, 95.8% of the respondents used alcohol-based hand sanitizers. The majority of the respondents were knowledgeable (93.8%), had a favorable attitude (74%), and good hand hygiene practices (76%) by alcohol-based hand sanitizers. However, 84.5% of the respondents were confronted with challenges during alcohol-based hand sanitizer use due to it is unavailable 66 (68.8%), expensive 50 (52.1%), forgetting 11 (11.5%), experiencing health-associated risks (skin irritation (28.1%), skin dryness (62.5%), ocular irritation (11.5%)), etc. CONCLUSION: The majority of respondents had good knowledge, attitude, and practices of alcohol-based hand sanitizer. But there were some items of their evaluation with relatively low scores that revealed some room for improvements. Additionally, the respondents reported various challenges. Therefore, to achieve and sustain changes, the hand hygiene promotion strategic plan needs a great concern.