Client satisfaction to methadone maintenance treatment program in Myanmar

Background To tackle the long-standing opioid misuse problem, Myanmar introduced the methadone maintenance treatment (MMT) program in 2006, starting with 260 clients. Since then, the program has been expanded across different geographical sites in the country. This study was done in 2017 to explore the treatment satisfaction of the clients towards the MMT program. Method A total of 210 clients with a minimum of six-month treatment history enrolled in five MMT program sites across Myanmar were recruited through stratified random sampling. Administering the Verona Service Satisfaction Scale for Methadone-Treatment (VSSS-MT), this study assessed the satisfactory responses under three categories viz., 1) clinic staff professional skills; 2) basic drug intervention; 3) specific intervention (individual rehabilitation and psychotherapy). Results The majority (89%, n = 186) of the respondents were satisfied with the current MMT program. Specifically, 89.5% (n = 187) were satisfied with the clinic staff professional skills category, 91.9% (n = 192) with the basic program intervention and 74.6% (n = 156) with specific interventions. Among the respondents, treatment satisfaction with the MMT program was higher (p < 0.05) in those (i) with a higher quality of life score in physical, psychological, social and environmental categories, ii) who were satisfied with their current marital and leisure status, and those iii) who consumed alcohol. Results from stepwise binary logistic regression showed alcohol consumption and physical health status had a significant association with MMT treatment satisfaction. Conclusion Treatment satisfaction of the clients, in general is high. However, the lower percentage of satisfied clients (74.6%) for the specific interventions category compared with 89.5 and 91.9% respectively for staff and basic drug management categories highlights the need for improvement in this category for overall enhancement of the MMT program.

Disinfection of environmental objects against coccidia oocysts in broiler chickens

The purpose of the research is developing a method for disinfection of environmental objects against coccidia oocysts in broiler chickens.Materials and methods. At the VNIIP – FSC VIEV vivarium, a bioassay test was performed to experimentally infect 60 chickens aged 14 days which were divided into six equivalent groups of 10 birds each and kept isolated in cages. Chickens from the first, second and third groups were administered orally, using a micropipette, 1 ml of an Eimeria oocyst suspension treated with 4, 5 and 6% solutions of the combined eimeriocide agent. Chickens from the fourth group were administered 1 ml of Eimeria oocyst suspension treated with 4% phenol solution (base drug). Chickens from the fifth group received 1 ml of a buffered solution and were used as a noninfected control. Chickens from the sixth group received 1 ml of suspension containing 2000 oocysts/mL and were used as an infected control. The efficacy of disinfection with eimeriocide and the basic drug was determined based on the percentage of decrease in the recovery of Eimeria oocysts after being exposed to drugs as compared to chickens of the infected control. The efficacy of 5% eimeriocide against poultry coccidia oocysts in a production test was determined empirically with the set of oocysts on control sites as compared with the basic drug on a poultry farm in the Moscow Region.Results and discussion. The intense-effectiveness of 4% eimeriocide against coccidia oocysts was 99.31%, and the 5 and 6% combined agent showed 100% efficacy. The basic drug, 4% phenol showed 74.65% intense-effectiveness. The results obtained in the production test of 5% eimeriocide at a dose of 0.5 l per 1 m2 with a 2 hour-exposure indicate its high efficacy for disinfection against coccidia oocysts in broiler chickens. The intense-effectiveness was 97.25% versus 59.03% efficacy of the base drug, phenol.

The drug Argovit for treatment of piglets when intestinal infections

The drug Argovit developed in the LLC Vector-Vita Research and Production Center has antimicrobial and astringent properties, easily fits into the technology of housing farm animals and poultry in cases of uncomplicated colibacteriosis and is effective in isolated use, it is cheaper than other drugs, which makes it attractive in the modern market of biological products. The purpose of the research was to study the effectiveness of the drug Argovit for the treatment and prevention of gastrointestinal diseases of piglets in comparison with the basic drug Baitril used in the farm. Piglets of the experimental group (n=20) with the syndrome of gastrointestinal diseases have been treated with 1,0 % aqueous solution of the drug Argovit at a dose of 2 ml/kg of live weight 2 times a day until clinical recovery. The drug contributed to a lighter course and reduced the duration of the disease by half, while the livability of piglets reached 90,0 %. There was also a weakening of inflammatory processes in the body of piglets of both groups, which was characterized by the decrease in the level of leukocytes in piglets of the experimental group during treatment from 12,9±0,75 to 10,1±0,89×10⁹/l, and in the control group from 11,3±1,20 to 9,0±0,04×10⁹/l. The platelet content in animals at the beginning of the experiment was slightly higher than the lower limit of the norm in the experimental group by 1,8 %, in the control group by 4,7 %. At the same time, the restoration of homeostasis and the decrease in the level of protein in the blood serum have been observed. It has been found that the use of the drug Argovit to piglets during the suckling period and after weaning improves the morphological and biochemical parameters of blood due to the protective forces of protein by 4,7 %, reduces the phenomena of diarrhea, and as a result increases their livability.

Patient Drug Database: Construction of Database for Patient Leading Drug Side Effects Exploration Using Patient Generated Health Data

Objectives: This study focuses on building a database for patient-led search on drug side effects using basic drug information, drug analysis results information, patient information, and patient-generated health data (PGHD).Methods: After collecting data from the Health Insurance Review and Assessment Institute, the Korean Pharmaceutical Information Center, the Ministry of Food and Drug Safety, and the Korean Pharmaceutical Association, basic drug information was created. By utilizing the Korea Average Event Reporting System (KAERS) side effect report data provided by the Korea Drug Safety Administration and MetaLAB, a drug side effect detection algorithm applied on the Konyang university hospital’s real data, we designed and built a database using Oracle DB, which contains a table of patient information and PGHD. For drug information, a total of 49,553 drugs were mapped, and drug analysis results used KAERS and MetaLAB.Results: Based on the collected drug information, a total of 15 tables containing basic drug information (7 tables), drug analysis results (2 tables), patient information (1 table), and patient generation information (5 tables) were created using EDI codes, following mapping and normalization. Basic drug information included 49,553 EDI and 2,099 ATC codes. Drug analysis results included 2,046 KAERS ATC codes, 1,701 WHOART-ARRN (PT) that the result of 33 WHOART-SEQ (IT), 15,861 MetaLABEDI codes, and 101ATC codes. TheADR results were constructed using 62 DRUG_IDs and 73 MedDRA_PTI_IDs.Conclusions: The Patient Drug Database (PD2B) in this study was employed to allow patients to voluntarily report on their perception and drug side effects through application tools, which can provide quick measures against drug side effects and assist in the discovery of new ones.

Bioequivalence of Oral Drug Products in the Healthy and Special Populations: Assessment and Prediction Using a Newly Developed In Vitro System “BE Checker”

In order to assess and predict the bioequivalence (BE) of oral drug products, a new in vitro system “BE checker” was developed, which reproduced the environmental changes in the gastrointestinal (GI) tract by changing the pH, composition, and volume of the medium in a single chamber. The dissolution and membrane permeation profiles of drugs from marketed products were observed in the BE checker under various conditions reflecting the inter-patient variations of the GI physiology. As variable factors, initial gastric pH, gastric emptying time, and GI agitation strength were varied in vitro. Dipyridamole, a basic drug, showed rapid and supersaturated dissolution when the paddle speed in the donor chamber was 200 rpm, which corresponds to the high agitation strength in the stomach. In contrast, supersaturated dissolution disappeared, and the permeated amount decreased under the conditions with a slow paddle speed (100 and 50 rpm) and short gastric emptying time (10 min). In those conditions, disintegration of the formulation was delayed, and the subsequent dissolution of dipyridamole was not completed before the fluid pH was changed to neutral. Similar results were obtained when the initial gastric pH was increased to 3.0, 5.0, and 6.5. To investigate that those factors also affect the BE of oral drug products, dissolution and permeation of naftopidil from its ordinary and orally disintegrating (OD) tablets were observed in the BE checker. Both products showed the similar dissolution profiles when the paddle speed and gastric emptying time were set to 100 rpm and 10 or 20 min, respectively. However, at a low paddle speed (50 rpm), the dissolution of naftopidil from ordinary tablets was slower than that from the OD tablets, and the permeation profiles became dissimilar. These results indicated the possibility of the bioinequivalence of some oral formulations in special patients whose GI physiologies are different from those in the healthy subjects. The BE checker can be a highly capable in vitro tool to assess the BE of oral drug products in various populations.

Research Progress on the Mechanism of Natural Product Ingredients in the Treatment of Uveitis

As the spectrum of ophthalmic diseases keeps changing, uveitis has gradually become one of the major blinding eye diseases in the world. Although the efficacy and safety of adalimumab and other biological agents in the treatment of uveitis have been proved in clinical studies, no biological agents have been approved for the treatment of uveitis by Chinese National Medical Products Administration (NMPA). The quality of life and prognosis of uveitis patients are affected by the adverse reactions of currently available immunosuppressive drugs. In recent years, it has become a research hotspot to select effective components for uveitis treatment from natural drugs. Based on the classification of chemical structure, the therapeutic effect and mechanism of natural drug components on uveitis were discussed in detail, in order to provide reference for basic drug development and clinical research.

Improving the therapy of generalized forms of Meningococcal infection in children using extracorporeal hemocorrection

Invasive meningococcal infection is a significant cause of death, reaching 80% in septic shock. The Pediatric Research and Clinical Center for Infectious Diseases (PRCCID) has developed an algorithm for the treatment of children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome, which includes basic drug therapy with polymyxin hemoperfusion in combination with extended methods of extracorporeal hemocorrection.Purpose: to evaluate the effectiveness of extracorporeal hemocorrection operations in children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome.Materials and research methods: to the intensive care unit of the PRCCID for the analyzed period 2006—2020 34 children were hospitalized with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome. Two groups were formed: Group 1 — children admitted to the PRCCID in the period 2014—2020 (n = 23), who underwent polymyxin hemoperfusion simultaneously with extended methods of extracorporeal hemocorrection, group 2 — children hospitalized in 2006—201 3 (n = 1 1), methods of extracorporeal hemocorrection were not performed. The Mann-Whitney U-test and ANOVA were used to evaluate the results.Results and discussion: the use of extracorporeal hemocorrection operations in the complex therapy of invasive forms of meningococcal infection with refractory septic shock and multiple organ failure syndrome in children provides stabilization of central hemodynamics, reduces clinical and laboratory inflammatory reactions, helps to reduce the dose of vasopressor drugs and parameters of respiratory support, and also increases patient survival rate by 82.6%.

PARKINSON'S DISEASE MEDICAL REHABILITATION METHODS

Parkinson's disease ranks first among the neurodegenerative pathology. The approach to the treatment of Parkinson's disease must be comprehensive. Medical rehabilitation methods include not only basic drug therapy, surgical methods of treatment, but also methods of physiotherapy, reflexology, physiotherapy, speech therapy and psychotherapy. When prescribing physical factors in patients at different stages of the disease, it is possible to recommend those methods that will have a more pronounced effect on the clinical symptoms of Parkinson's disease. From physical factors, balneotherapy, thermal mud therapy, impulse currents, electrophoresis, electrostatic field, microwave therapy, phototherapy, barotherapy are prescribed. The use of transcerebral Electrotherapy methods and computer-stabilographic programs in complex treatment based on biofeedback by statokinesogram will reduce the severity of the main symptoms of the disease. Key words: medical rehabilitation, physiotherapy, Parkinson's disease

Metformin and Lactic Acidosis in Diabetic Patients

Metformin is the basic drug in the clinical treatment of Diabetes, often used in the treatment of Type 2 Diabetes Mellitus (T2DM).Its effect has been fully verified in the clinical treatment of T2DM. However, in the treatment of T2DM with metformin, there is still a certain probability of related lactic acidosis, and the fatality rate is high. Therefore, is the use of metformin drug treatment a direct risk factor for lactic acidosis in diabetic patients? This paper will review the hypoglycemic mechanism of metformin and related studies on lactic acidosis, so as to further explore the relationship between metformin and lactic acidosis in diabetic patients, and provide help and reference for metformin drugs in the clinical treatment of T2DM.