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.

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.

Availability of Essential Antidotes and the Role of Community Pharmacists in the Management of Acute Poisoning: A Cross-Sectional Study in Ethiopia

Background

Morbidity and mortality related to acute poisoning is a major public health issue in both developing and developed countries. Community pharmacists have a crucial role in ensuring drug availability, increasing drug safety, counseling patients, overdose risk reduction and management, and provision of appropriate drug information. This study aimed to assess the availability of necessary antidotes in community pharmacies in Gondar and Bahir-Dar cities, Ethiopia, and the role of community pharmacists in the management of acute poisoning.

Methods

A cross-sectional survey was conducted in Gondar and Bahir-Dar cities. A self-administered, structured questionnaire was used for data collection and Statistical Package for Social Sciences (SPSS) version 24.0 was used for data analysis. Chi-square analysis was computed to identify the associated factors with a confidence interval of 95% and a P value less than .05 was used as a cut-point for statistical significance.

Results

Out of 101 community pharmacies invited to participate in the study, 80 of them completed the survey with a response rate of 79.2%. The overall mean antidote availability score was .59 (SD = .837), which falls within the definition of Poor availability. None of the pharmacies had kept all of the antidotes, and the maximum number of an antidote kept by a single pharmacy was 7 out of nineteen essential antidotes surveyed. The most commonly reported reason for the unavailability of essential antidotes was stock was not ordered (56.3%) followed by stock ordered but not delivered from suppliers (wholesalers) (20.0%). More than 3 fourth of the respondents (83.8%) had poor knowledge about the antidotes for the common poisonings.

Conclusion

There was a significantly very low availability of essential antidotes in the community pharmacies. Strategies should be implemented to improve pharmacist’s knowledge about antidotes, and management of poisoning emergencies through on-job training and provision of reference materials.

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.

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.

Targeted Drug Delivery - From Magic Bullet to Nanomedicine: Principles, Challenges, and Future Perspectives

Nanomedicine is an advanced version of Paul Ehrlich's "magic bullet" concept. Targeted drug delivery is a system of specifying the drug moiety directly into its targeted body area (organ, cellular, and subcellular level of specific tissue) to overcome the aspecific toxic effect of conventional drug delivery, thereby reducing the amount of drug required for therapeutic efficacy. To achieve this objective, the magic bullet concept was developed and pushed scientists to investigate for more than a century, leading to the envisioning of different nanometer-sized devices - today's nanomedicine. Different carrier systems are being used and investigated, which include colloidal (vesicular and multiparticulate) carriers, polymers, and cellular/subcellular systems. This review addresses the need for and advantages of targeting, with its basic principles, strategies, and carrier systems. Recent advances, challenges, and future perspectives are also highlighted.

Impact of COVID-19 on Pharmaceutical Care Services and the Role of Community Pharmacists: A Multi-Center Cross-Sectional Study in Ethiopia

Objectives

The current study aimed at assessing the impact of COVID-19 on pharmaceutical care services and the role of community pharmacists.

Methods

A cross-sectional study was conducted from May 1st to June 7, 2020, on community pharmacies in Bahir Dar and Gondar cities, Ethiopia. Descriptive statistics and Chi-square test were conducted. A P-value of less than 0.05 was considered to declare statistical significance at a 95% Confidence interval (CI).

Results

A total of 101 community pharmacies were approached (one pharmacist per pharmacy), and 80 of them had completed the survey. From the total pharmacies, 78.8% of them had encountered a shortage of pharmaceutical products. Chi-square test revealed that there was a significant difference (P = 0.036) in the shortage of personal protection equipment between Gondar and Bahir Dar cities. Face mask 55 (77.4%) followed by hand glove 15 (21.1%) were the most commonly reported personal protective equipment's in short supply.

Conclusion

Strategies should be in place to improve the availability and affordability of various essential pharmaceuticals to mitigate the spread of the disease and prevent other complications.

Health professional's exposure, attitude, and acceptance of drug promotion by industry representatives: A cross-sectional study in Ethiopia

Interactions between pharmaceutical companies and health care providers have long been an area of interest from ethical as well as scientific grounds. The information provided by those companies must be scientifically accurate and fair. The current study aimed to investigate the exposure, attitude, and training background of medical doctors and pharmacy professionals regarding drug promotional activities, and assess their acceptance of promotional gifts provided by pharmaceutical sales representatives. A cross-sectional study was conducted on medical doctors and pharmacy professionals working at Bahir Dar and Gondar cities, Amhara regional state, Ethiopia. Data were collected using a self-administered structured questionnaire and Statistical Package for Social Science (SPSS) version 26 was used for analysis. A Chi-square test was computed to investigate the presence of an association between the dependent and independent variables. A p-value of less than 0.05 was considered to declare significance at a 95% Confidence Interval (CI). A total of 105 health professionals, 81 pharmacy professionals, and 24 medical doctors have participated in the study. Above two-thirds of the respondents (69.5%) agreed that most talks sponsored by drug companies were helpful and educational. On the other hand, 39% of the respondents agreed and 47.6% disagreed that receiving gifts from pharmaceutical representatives will increase the chance that they will eventually sell or recommend the drug company's products. The majority of the study participants (81%) preferred drug samples and stationery as appropriate gifts by pharmaceutical sales representatives. Significant gaps were found regarding the training of health professionals about the ethics of drug marketing and how to deal with pharmaceutical representatives. Policies aiming at restricting health care provider's contacts with pharmaceutical companies during residency training along with incorporating gift restriction policies could bring significant improvements.

Role of community pharmacists in educating asthmatic patients: A multi-centered cross-sectional study in Ethiopia

Background:

Effective asthma management requires a multidisciplinary approach that includes; the physician, the patient, and the patient’s family.

Objectives:

The current study aimed to assess the roles played by community pharmacists toward asthma control together with the barriers hindering their practice and possible strategies to overcome those barriers.

Methods:

A multi-centered cross-sectional study was conducted. Data was collected using a structured, self-administered questionnaire adapted from previously conducted studies and customized to fit with the current study setup. The collected data was cleaned, coded, and entered into Statistical Package for Social Sciences (SPSS) version 21 for analysis. Descriptive analysis of the collected data was conducted and the results were presented using frequency tables and graphs.

Results:

A total of 122 community pharmacy professionals; 63 from Gondar, 26 from Bahir Dar, 15 from Debre Markos, 14 from Woldia, and 4 from Debre birhan participated in the study. About 96 (78.7%) of the participants reported that they teach their patients the basic facts about asthma. More than two-thirds of the participants 85 (69.7%) also reported that they were able to identify and manage the triggering factors of asthma for their patients. Lack of pharmacist time was reported by 78 (63.9%) of the study participants as a major reason for the inadequacy of the counseling service provided.

Conclusion:

It appears evident that there is a need for continuing professional education and pharmacists to receive additional training to improve their ability to go beyond identifying a problem and suggesting therapeutic options.

Health Professionals Oral Health Knowledge and Practice: Unleashing the Hidden Challenges

Objective

Dental disease is one of the major prevalent preventable public health challenges that resulted in a significant burden on children and adults. The aim of the current study was to identify oral health-related knowledge and practice among Bahir Dar community health care providers and the perceived barriers to oral health care services.

Methods

A cross-sectional study was conducted. A self-administered, structured questionnaire was used for data collection, and SPSS version 20 was used for data analysis. A chi-square test was used to determine the association between study variables, and a P-value of less than 0.05 was considered to declare statistical significance.

Results

A total of 281 interviews were conducted. Doctors had the highest mean knowledge score value of 4.67 followed by dentists with a mean score of 4.5. The majority of the study participants (59.4%) reported that they use a toothbrush and fluoride toothpaste for brushing their teeth, and a statistically significant difference was observed between different types of health professionals. The majority of the study participants (80.1 and 70.8%) reported limited finances and lack of adequate health/dental insurance as a barrier to oral health care services, respectively.

Conclusion

Oral health-related knowledge of health professionals in Bahir Dar city is low. Oral health topics must be incorporated into the health care professionals training programs and continuing medical education. Health professionals should master basic oral health-related knowledge, and they should practice basic oral health care practices to become role models for their patients.

Antibacterial Potential of Aloe weloensis (Aloeacea) Leaf Latex against Gram-Positive and Gram-Negative Bacteria Strains

OBJECTIVE

To evaluate the antibacterial effects of the leaf latex of Aloe weloensis against infectious bacterial strains.

METHODS

The leaf latex of A. weloensis at different concentrations (400, 500, and 600 mg/ml) was evaluated for antibacterial activities using the disc diffusion method against some Gram-negative species such as Escherichia coli (ATCC 14700) and Pseudomonas aeruginosa (ATCC 35619) and Gram-positive such as Staphylococcus aureus (ATCC 50080) and Enterococcus fecalis (ATCC 4623).

RESULTS

The tested concentrations of the latex ranging between 400 and 600 mg·mL-1 showed significant antibacterial activity against bacterial strain. The highest dose (600 mg/ml) of A. weloensis leaf latex revealed the maximum activity (25.93 ± 0.066 inhibition zone) followed by the dose 500 mg/ml against S. aureus. The lowest antibacterial activity was observed by the concentration 400 mg/ml (5.03 ± 0.03) against E. coli.

CONCLUSION

The results of the present investigation suggest that the leaf latex of A. weloensis can be used as potential leads to discover new drugs to control some bacterial infections.