Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 124 125 Saeed Mohammad Soleymani Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hadi Esmaily Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2023 09 11 2023 09 12 Access to Megadoses of Vitamin D, Insufficient Knowledge of People and Poor Practice of Community Pharmacists, Made a Vicious Circle in the Direction to D Hypervitaminosis in Iran. https://jpc.tums.ac.ir/index.php/jpc/article/view/613

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 126 134 Prashant Mishra Department of Pharmacology, Armed Forces Medical College, Pune, India. Harmanjot Dhillon Department of Pharmacology, Armed Forces Medical College, Pune, India. Sandeep Vihan Department of Pharmacology, All India Institute of Medical Sciences, Gorakhpur, India. Shashikant Bhargava Department of Pharmacology, All India Institute of Medical Sciences, Gorakhpur 2023 07 20 2023 08 30 Background: Due to emergence of antimicrobial-resistant healthcare associated infections (HAIs), the implementation of antimicrobial stewardship programs (AMSP) is the need of hour at institutional and national levels. We conducted an assessment of the current status of infrastructure, manpower, and education and training (E&T) in relation to Antimicrobial Stewardship (AMS) in the tertiary care hospitals of India. Methods: Healthcare professionals from 30 tertiary care hospitals in North-western India (public & private) were invited to participate in online survey from Nov 2022 to Apr 2023 by sending a pre-designed questionnaire about the current existing antimicrobial stewardship (AMS) practices at their hospitals through email. The answers received on various parameters of AMS were analyzed using descriptive statistics. Results: 72 healthcare professionals from 30 hospitals responded to the survey. 63% of the respondents had received education and training (E&T) on AMS during undergraduate or postgraduate training. 65% had not received any E&T at induction to the hospital. The positive responses were 36%, 47% and 33% for leadership support, accountability and availability of drug expertise in form of pharmacologist/pharmacist respectively. A policy to support optimal antibiotic use was present in 25% of respondents. Broad interventions to improve antibiotic use were scored as 28%, 7% and 6% for antibiotic time out, pre-authorization and prospective audit with feedback respectively. Conclusion: The findings reveal the enablers and barriers to implementation of antimicrobial stewardship and highlighted the need for establishing a framework for stricter implementation and monitoring of antimicrobial stewardship in Indian tertiary care hospitals. Few key areas which require immediate attention are: need for government level endorsement and leadership support of antimicrobial stewardship (AMS) activities; lack of AMS programs in hospitals; and lack of undergraduate/ postgraduate/at induction education and training in AMS for staff. https://jpc.tums.ac.ir/index.php/jpc/article/view/601

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 135 144 Adeleh Jeddi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Amir Hooshang Mohammadpour Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Milad Iranshahy Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Ali Moradi Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Batool Zarei Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. 2023 06 30 2023 09 17 Background: Licorice is proposed as a treatment option for coronavirus disease-19 (COVID-19) by inhibiting the virus binding, penetration and replication; it also modulates various cellular signaling pathways. In this double-blind randomized-controlled trial, efficacy of Licorice hydroalcoholic extract oral formulation has been evaluated in patients with mild–moderate COVID-19in an outpatient clinic. Methods: A total of 40 mild to moderate outpatient Covid-19cases were randomly assigned into either Licorice or placebo groups (n=20 in each). Patients in Licorice group were given 700 mg capsules of hydroalcoholic extract of Licorice, trice a day for 2 weeks, while controls were given placebo capsules that were filled with Avicel (microcrystalline cellulose). Blood samples were collected from all participants before starting the medication and on days three, seven, and 14 for laboratory parameters including quantitative C-reactive protein (CRP), WBCs, lymphocytes, and neutrophils counts. The clinical symptoms were also recorded. Results: Our results showed that Licorice extract significantly decreased the frequency of cough on day seven (P=0.004) and the frequency of dyspnea on day three (P=0.02). No significant differences were found in the frequency of nausea, diarrhea, body pain, sore throat, runny nose, dizziness, lethargy, and loss of taste or smell between the two groups. Patients in Licorice group showed significantly higher oxygen saturations on days three, seven, and 14. Other laboratory parameters did not show any changes between the two groups. Conclusion: licorice extract improved some clinical symptoms such as cough and dyspnea while only increased the oxygen saturation. Further studies with larger sample sizes at different stages of Covid-19are suggested. https://jpc.tums.ac.ir/index.php/jpc/article/view/598

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 145 150 Amirhosein Ghahremanian Department of Clinical Pharmacy, 13‑Aban Drug and Poison Information Center, Tehran University of Medical Sciences, Tehran, Iran Hasti Photography Department of Clinical Pharmacy, 13‑Aban Drug and Poison Information Center, Tehran University of Medical Sciences, Tehran, Iran Sona Ghasemi Department of Clinical Pharmacy, 13‑Aban Drug and Poison Information Center, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Heidari Department of Clinical Pharmacy, 13‑Aban Drug and Poison Information Center, Tehran University of Medical Sciences, Tehran, Iran Elliyeh ghadrdan Department of Clinical Pharmacy. Faculty of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran. 3Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran 2023 05 20 2023 09 03 Background: One of the FDA-approved treatments for COVID-19 is remdesivir. In this study, we investigated adverse drug events (ADEs) of remdesivir in COVID-19 patients who contacted 13-Aban pharmacy's drug and poison information center (DPIC). Methods: In this study, data of patients receiving remdesivir who contacted the 13-Aban pharmacy's DPIC between April 2021 and May 2022 were extracted. For the evaluation of potential ADEs, we reviewed all contacts related to remdesivir recipients. Results: Out of 223 patients enrolled, 108 (48.40%) developed 120 ADEs. Elevated liver transaminase levels (26.67%) were the most common ADE, followed by weakness (7.5%), nausea, and vomiting (7.5%). The causality assessment of ADE using the Naranjo scale revealed that 41.67% were probable and 58.33% were possible. Conclusion: Based on the results of this study, hepatic dysfunction was the most prevalent ADE among remdesivir recipients; thus, in order to ensure safe use of remdesivir, patients should be closely monitored for this ADE. https://jpc.tums.ac.ir/index.php/jpc/article/view/590

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 151 157 EN Kamyab Andarzbakhsh Department of Clinical Pharmacy, School of Pharmacy, Tehran Medical sciences, Islamic Azad University, Tehran, Iran. Niayesh Mohebbi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran. Amir Rezazadeh Department of Clinical Pharmacy, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran. Kheirollah Gholami Department of Clinical Pharmacy, School of Pharmacy, Tehran Medical sciences, Islamic Azad University, Tehran, Iran. Ramin Abrishami Department of Clinical Pharmacy, School of Pharmacy, Tehran Medical sciences, Islamic Azad University, Tehran, Iran. 2023 06 18 2023 08 28 Background: Critically ill patients treated in the intensive care unit (ICU) are at risk of drug-related problems (DRPs), clinical pharmacists are specifically trained in pharmacotherapy evaluations with the abilities to identify and manage drug-related complications. This study aims to identify areas where clinical pharmacists can be effective in the ICU. The primary outcomes of this study were determining the clinical aspect of clinical pharmacists in the ICU, type, and number of clinical pharmacist interventions. Methods: This was a prospective, interventional study in a teaching hospital in Iran. A clinical pharmacist was dedicated to implement comprehensive medication management (CMM); All Pharmacotherapy Problems were categorized. Results: During the monitoring of 162 patients by the clinical pharmacist, 1524 interventions were conducted. The most frequent pharmacotherapy-related problems identified were drug selection (33.3%), dose adjustment (17.3%), and fluid and electrolyte management (12.9%). Conclusion: Clinical pharmacists’ interventions could reduce the rate of DRPs by pharmacotherapy evaluation and may have important role in many aspects of patient’s management. https://jpc.tums.ac.ir/index.php/jpc/article/view/595

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 158 164 Foroud Shahbazi Department of Clinical Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. Fatemeh Heydarpour Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. Matin Badrbani Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mohammad Azizi Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Amir Kamari Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mostafa Bahremand Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Lida Shojaei Department of Clinical Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2023 07 29 2023 09 25 Background: Coronary endarterectomy is an adjunctive treatment to coronary artery bypass grafting (CABG) in patients with multiple coronary involvements. The aim of the present study was to compare the efficacy and safety of the rivaroxaban versus warfarin in patients undergoing CABG endarterectomy in a prospective observational study. Methods: All the patients who had undergone CABG endarterectomy and had received rivaroxaban or warfarin during the period from January2019 until August 2020 were included in the study. Need for salvage CABG, major bleeding, and thromboembolic events were considered as primary outcomes. The secondary outcomes included all-cause mortality and minor bleeding. The patients all were followed for at least six months after their hospital discharge. Results: Out of the 73 patients recruited during the 18 months, 45 received rivaroxaban and the remaining people received warfarin along with at least one antiplatelet. During the follow-up, no salvage CABG was performed. The minor bleeding was comparable between the two groups (31.96 versus 13.27; p=0.21). There was no significant difference between warfarin and rivaroxaban in terms of major bleeding and thromboembolic events (p=0.38 and >0.99, respectively). The all-cause mortality rate was similar between the two groups (p>0.99). Conclusion: In this preliminary real-word study, rivaroxaban was comparable to warfarin in terms of efficacy and safety in the patients undergoing CABG endarterectomy. Further larger studies are needed to clarify safety and efficacy of such approach. https://jpc.tums.ac.ir/index.php/jpc/article/view/605

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 165 172 Azzam Abdulsattar Mosa Department of Chemistry, Collage of Science, University of Duhok, Duhok, Iraq. Ghorbat Saleh Ali Department of Biology, Collage of Science, University of Duhok, Duhok, Iraq. Zeliha Selamoglu Nigde Ömer Halisdemir University 2023 03 28 2023 06 20 Acute myeloid leukemia (AML) is a heterogeneous disease with multiple mutations in hematopoietic stem cells characterized by abnormality increases in immature or dysfunctional white blood cells. The precise mechanisms of AML development have not been clear but there are many factors increase to developing leukemia such as familial history of leukemia, elderly, life style, genetics and some chronic disease like diabetic. Multiple mutilations happen in the hematopoietic stem cells, acquire some form of genetic instability lead to improve expression of some protein kinase and transduction protein following that increase ROS formation, which is associated with increased DNA damage. Nowadays, the use antioxidant drugs are growingly accepted in universal due to their safety and efficiency to dimini locale="en_US">Department of Engineering Sciences, Faculty of Advanced Technologies, University of Mohaghegh Ardabili, Namin, Iran. AND BioScience and Biotechnology Research center (BBRC), Sabalan University of Advanced Technologies, Namin, Iran. Muhammad Akram Department of Eastern Medicine, Government College University, Faisalabad, Pakistan. Muhammad Muddasar Saeed Department of Eastern Medicine, Government College University, Faisalabad, Pakistan. Asadollah Asadi Department of Biology, Faculty of Science, University of Mohaghegh Ardabili, Ardabil, Iran. Mahan Kajkolah Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran. 2020 04 20 2020 05 05 Neurodegenerative disorders could be a most important health issue within the 21st century. In the recent past; there has been a growing interest in medicinal plants. Chemical fruits and vegetables are said to decrease the possibility of many chief ailments, together with cardiovascular and cancer disorders as well as neurodegenerative ailments. Hence, who eat more fruits and vegetables may be less threaten for developing certain diseases caused by neurological dysfunction. The present review provides an overview of the about 14 most important plants used for neurological disorders and explores their neurological protection for the development of new pharmacological potential drugs. The data sources including the publications on Google Scholar, PubMed, and Science Direct. Publications searched with no particular time restriction in order to get a holistic and comprehensive view of the research done on this topic so far. Therefore, we present a systematic approach for herbal medicine as neuroprotective agent. From ancient time the herbal medicines are used to cure neurological symptoms. While the exact pharmacology of these herbs has not yet been set on, some of them have anti-inflammatory or antioxidant properties on different peripheral systems. The significant variety of medicinal plants makes it an essential source of healthy compounds compared to current therapeutic agents. In this review, the importance of phytochemicals for the function of neurological protection and other related disorders, in particular, the process mechanism and therapeutic prospective will be emphasize. https://jpc.tums.ac.ir/index.php/jpc/article/view/342

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 88 89 EN Zohre Labbani-Motlagh Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Simin Dashti-Khavidaki Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2020 04 02 2020 04 13 No abstract  No abstract   https://jpc.tums.ac.ir/index.php/jpc/article/view/335

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 90 92 EN Fatma Hammami Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Makram Koubaa Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Sahar Ben Kahla Cardiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Amal Chakroun Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Khaoula Rekik Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Fatma Smaoui Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Mounir Ben Jemaa Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia 2020 02 13