Knowledge, Attitude and Practice of Disposal of Unused, Unwanted and Expired Medicines among Healthcare Professionals

Background Unused, unwanted and expired medicines stored at home pose threats to both health systems and environments. Healthcare professionals (HCPs) should be aware of the proper disposal methods of such medicines. Objective To assess the knowledge, attitude and practice of disposal of unused, unwanted and expired medicines among healthcare professionals. Method A web-based cross-sectional descriptive study was conducted among faculties and junior residents at B.P. Koirala Institute of Health Sciences, Dharan, Nepal using a semi-structured proforma. The data were collected through Google Form. Descriptive statistics were calculated. Chi-square test and Student's t test were used for analysis using statistical package for the social sciences at p value of 0.05. Result A total of 294 healthcare professionals with mean age 35.37± 6.630 years were participated out of which 231 (78.6%) were male and 151 (51.4%) were faculties. Mean knowledge score was higher in faculties (2.37±1.111) than the Junior residents (2.33±1.155) [F(1,293)=0.102, p=0.750]. Junior residents (140 out of 143, 97.9%) had a better attitude than faculties (141 out of 151, 93.3%) regarding the disposal of medicines [χ2 (1)=3.558, p=0.059]. Junior residents (36 out of 143, 25.1%) also had a better practice than faculties (24 out of 151, 15.8%) regarding the disposal of medicines [χ2 (1)=3.895, p=0.048]. Conclusion Majority of the Healthcare professionals had positive attitude but poor knowledge and practice regarding disposal of expired and unused medicines. There was a high practice of keeping medicines at home by healthcare professionals. The findings would be useful for planning strategies to minimize unused medicines and foster the appropriate disposal practice.

Impaired very low density lipoprotein and triglyceride removal in broad beta disease: comparison with endogenous hypertriglyceridemia

The removal rate of apoprotein-B (apo B) in very low density lipoprotein (VLDL) was decreased in individuals with broad beta disease when compared with endogenous hypertriglyceridemia. Following the injection of 125I-VLDL isolated from individuals with endogenous hypertriglyceridemia, both VLDL apo B fractional catabolic rate (0.058 +/- 0.029 hr-1) and VLDL apo-B turnover rate (0.300 +/- 0.070 mg/kg/hr) were lower in broad beta disease than in endogenous hypertriglyceridemia (fractional catabolic rate 0.112 +/- 0.046, p less than .05; turnover rate 0.640 +/- 0.199, p less than .005) despite equivalent plasma concentrations of VLDL-apo-B. Furthermore, conversion of VLDL apo-B to LDL was impaired in broad beta disease relative to endogenous hypertriglyceridemia. Differences in the kinetics of lipoprotein lipase-related triglyceride removal during a maximal heparin infusion were also demonstrated between these two disorders. These differences suggest an abnormality in the interaction of lipoprotein lipase with the lipoproteins of unusual composition in broad beta disease. This is further supported by the normalization of lipoprotein composition in broad beta disease by estrogen therapy, with a simultaneous change in the kinetics of lipoprotein lipase-related triglyceride removal towards those seen in endogenous hypertriglyceridemia.

Effect of choline deficiency on utilization of labeled precursors of choline and turnover of choline in the liver of mature Japanese quail

Studies were conducted to determine the effect of choline deficiency on utilization of various labeled precursors of choline and rate of choline biosynthesis in mature Japanese quail. A deficiency of dietary choline did not change the in vivo incorporation of 14C-label from (1,2-14C) ETHANOLAMINE, N, N-dimethyl (1,2-14C) ethanolamine, and L-(methyl-14C) methionine into liver phosphatidylcholine (PC) or total phospholipids. Incorporation of radioactivity from (14C) serine into liver PC was increased, but the difference was not significant (PGREATER THAN3.35). In vitro studies confirmed these observations as there were no differences in liver microsomal methyltransferase activities, expressed as the incorporation of methyl-14C from labeled S-adenosylmethionine into microsomal PC from quail fed a purified diet with with or without choline. Rats appeared to incorporate an increased amount of 14C into PC when fed a diet devoid of choline, but the differences were not significant. There were differences in methyltransferase activities among species, and quail had the lowest activity. A slower turnover of choline was found in quail liver (t1/2=7.5 hours) as compared with that of hen liver (t1/2=2.0 hours). The methyltransferase responsible for the first methylation of phosphatidyl-ethanolamine from quail liver appears to differ from most other biosynthetic enzymes in that it occurs in liver and catalyzes the reaction at a slow rate but cannot adapt to exogenous choline supply to meet the requirements for normal bodily functions in quail.