#pharmacoepidemiology

[dreamscapescribe]

“Hence, drugs reflect not only the prevalence of some health problems, but also how humans experience health and cope with suffering.” — Hartzema

[cluelesspharma]

PUBLIC HEALTH HELP

Hey everyone, wondering if anyone has any good sources for public health? Specifically for pharmacy or pharmacists? Stuff like epidemiology, pharmacoepidemiology etc Books, sites, articles, videos.. anything!

please share!

🙏

[benzo-collage]

2020 - Addiction Therapy

This post focuses on a German-language article in the medical journal Suchttherapie (= addiction therapy), released by the Thieme Group. The author D. Wolter titled it, "Verordnungshäufigkeit, Missbrauch und Abhängigkeit von Benzodiazepinen, Z-Substanzen und Opioidanalgetika" (= Prevalence of Use, Abuse and Dependence: Benzodiazepines, Z-drugs and Prescription Opioids).

According to the abstract, the prescription of benzodiazepines has been declining in most Western industrialized countries, while prescriptions for Z-substances (Z-Drugs) initially increased but have also decreased in recent years, particularly in Germany. There are significant regional differences in the prevalence of these medications, with a considerable portion of prescriptions being private. Reliable population-based data on the abuse and dependency of BZDs, Z-Drugs, and opioids is lacking, as studies only provide indications of possible related disorders. Abuse of these substances is less common in older age (ibid. Abstract).

[jppres]

Drug utilization in patients with SARS-CoV-2 in an intensive care unit

Image: Flickr Article published in J. Pharm. Pharmacogn. Res., vol. 10, no. 6, pp. 977-985, November-December 2022. DOI: https://doi.org/10.56499/jppres22.1460_10.6.977 Miguel Sevilla Méndez1, Ana M. Téllez López2, Giovanni Gómez Barragán3, Ivette Reyes Hernández2, Claudia Velázquez González2, Isis B. Bermúdez Camps2* 1Departamento de Servicios Farmacéuticos y la Unidad de Cuidados Intensivos…

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[irispublisherspharmacy]

Iris Publishers-Journal of Archives of Pharmacy & Pharmacology Research-Do Folk Medicinal Practices of Bangladesh Have any Scientific Value? an Appraisal of Phytotherapeutic Practices of a Rural Folk Medicinal Practitioner

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Abstract

Folk medicine is generally considered as phytotherapy practiced by an individual or a group of individuals, who do not need to obtain any institutional training or approval to practice, and who can practice on a regular basis or as a hobby. In Bangladesh, folk medicinal practitioners (FMPs) are a varied lot using a bewildering variety of plants to treat almost every ailment suffered by human beings. It is the general opinion of allopathic doctors and the affluent section of the Bangladeshi population that FMPs practice nothing but quackery and their main objective is to deceive people. It was the objective of the present study to document the phytotherapeutic practices of a village FMP of Bangladesh and to search through the scientific literature to determine whether the plants used by the FMP had any scientific validation behind their uses. Our Results and Discussions clearly demonstrate that folk medicinal plants have substantial scientific validations, which possibly has come through practice of folk medicine and honing of such practices over thousands of years and transmission of acquired knowledge to successive generations initially orally and then through written methods.

Keywords: Folk medicine; Scientific validation; Phytotherapy; Kushtia; Bangladesh

Introduction

Folk medicine (FM) is practiced by part-time or full-time folk medicinal practitioners (FMPs) in Bangladesh, utilizing for the most part plant-based remedies as their modus operandi for treatment of practically all ailments suffered by the Bangladesh people. FM is not unique to Bangladesh; it is present in practically every country of the world under different names or guises like home remedies, herbal remedies, etc. With time, FM can even take on a more formal form in which cases they are known as Ayurveda and Siddha (in India), Unani (in Greece) or Kampo (in Japan). People of Thailand are said to use herbal remedies since the Sukothai period (1238- 1377) [1]. However, the use of plants as medicines dates back to much earlier times. Radiocarbon dating shows that plants were cultivated in ancient Babylon (present Iraq) more than 60,000 years ago [2]. It is possibly safe to say that human beings have suffered from ailments since their very advent and have tried to cure such ailments possibly from the earliest human ancestors about 6-7 million years ago – the Australopithecines [3]. It is to be taken into account that the great apes and other animal species instinctively partake of some plants for medicinal purposes [4], and the earliest hominids could have easily caught onto this ‘cure’ system.

Ethnomedicine is still somewhat a new concept in Bangladesh even though the country possibly has more than a hundred tribes and over 5500 plant species. With the emergence of new diseases, drug-resistant vectors, and adverse effects of allopathic medicines, even modern doctors and scientists are giving FM a second look. There is a desperate need for new drugs to treat diseases like malaria and antibiotic-resistant microorganisms; plant kingdom, which has always been a source for new drugs [5], can also be the sources for novel drugs at present and in the future. In this instance, FMs can play a key role in guiding scientists to plants with strong potential as sources of novel and efficacious drugs, for from constant practice they can be the most knowledgeable persons on therapeutic properties of plants. Another possible advantage of FMs and tribal medicinal practitioners (TMPs, really tribal FMs) is that due to regional diversity or simply knowledge-based diversity, there can be huge variations between the selections of plants to treat the same disease from one FM to another, even though both FMs may be practicing quite close to one another [6-35]. This opens up alternate sources of discovering possible new drugs with less or no adverse effects. FM is generally dismissed by the allopathic doctors and the affluent section of the population as ‘quackery’. Our objective was to select at random a FMP, and see whether the FMP’s therapeutic uses of plants are supported by available scientific reports on the pharmacological activities of the plant and reported phytochemicals in the plant with appropriate therapeutic benefits. As such we chose a rural FMP for such FMPs, if any, may be more prone to such ‘quackery’.

Methods

The FMP was named Shahidul Islam, male, middle-aged, that is around 45 years of age. He practiced in the villages of Daulatpur Upazila (sub-district) in Kushtia district, Bangladesh. The subdistrict had a total number of 246 villages with an area of 468.76 square kilometer and a population density of 946 per square kilometer. Kushtia district is located in between 23°42’ and 24°12’ north latitudes and in between 88°42’ and 89°22’ east longitudes with an area of 1621.15 sq km. The practice of the FMP was to travel in the various villages searching for prospective patients and also practicing from home at Gobrapara village, Kushtia district. Prior informed consent was initially obtained from the FMP. The FMP was informed the reason for our visit and consent obtained to disseminate any information provided including his name both nationally and internationally. Actual interviews were conducted in the Bengali language, which was spoken fluently by the FMP as well as the interviewers, the language being the mother tongue of FMP, villagers and the interviewers. The interviews were conducted with the help of a semi-structured questionnaire and the guided field-walk method of Martin [36] and Maundu [37]. In this method the FMP took the interviewers to spots from where he collected medicinal plants for therapeutic purposes. (In Bangladesh every village will have fallow land, secluded spots, small water bodies, or a strip of forest from where FMPs and folk herbalists collect their medicinal plants.) The FMP showed the interviewers a number of plants and described their therapeutic uses. All plant specimens shown by him were collected on the spot, pressed, dried and brought back to Dhaka for identification by a competent botanist. Voucher specimens were deposited with the Medicinal Plant Collection Wing of the University of Development Alternative. Secondary information on the pharmacological properties and phytochemicals of the plants used by the FMP were obtained from papers in PubMed, SCOPUS and Google Scholar abstracted journals.

Results and Discussion

The FMP used a total of twelve plants in monoherbal and polyherbal formulations to treat fever, loss of appetite, rheumatism, snake bite, female hormonal disorders, gastritis, anemia, neck pain, nerve sprain, sleep paralysis, ear infection and as a galactagogue. The results are shown in Table 1. Female hormonal disorders are taken in rural Bangladesh to mean either infertility or menstrual problems. Nerve sprain is pain in any portion of the body due to sudden twisting of that body part; in most cases, it indicates neck pain caused from not using proper support for the head and neck during sleeping. Sleep paralysis is inability to speak or move after waking up or while falling asleep; it can be temporary or last longer if it happens from extreme fear, which in rural areas happens when a person imagines to have seen something evil from the spirit world in dream or while waking up suddenly during sleeping. Andrographis paniculata was used by the FMP to treat fever and loss of appetite. The latter can be an individual problem or arising out from fever. The plant contains the anti-pyretic compound, andrographolide, which has been shown to reduce fever in Brewer’s yeast induced pyrexia in rats [38]. Improvement of appetite has been seen with infective hepatitis patients following treatment with the plant [39]. Lasia spinosa and Zingiber officinale have been reported to possess analgesic and anti-inflammatory properties [40,41]; the reports validate the use of the FMP of these two plants to treat rheumatism. The leaves of Carica papaya have lactagogue effect [42]; the FMP used the fruits of the plant (Table 1).

Table 1: Medicinal plants and formulations of the FMP from Kushtia district, Bangladesh.

Crataeva religiosa has medicinal uses in traditional medicinal system of India to treat snake bite [43]. Commelina benghalensis is used to treat infertility in women in many parts of tropical Asia [44]. The fruits of black pepper can be beneficial during gastritis; the fruits also stimulate digestive enzymes, which in turn can lead to amelioration of anemia by stimulating more food consumption; the active ingredient is known to be piperine [45]. Mature fresh leaves of Vitex negundo have analgesic and anti-inflammatory properties [46], so the leaves can be used for neck pain or sprain. The same applies to Cissus quadrangularis, Paederia foetida and Datura metel [47-49]. Thus the three plants in combination can be useful against neck pain and nerve sprain. However, their effectiveness against sleep paralysis needs to be scientifically determined. The analgesic and anti-inflammatory properties of C. quadrangularis can also make it an effective plant to be used against any pain and inflammation associated with ear infection. Overall, it can be seen from published scientific reports that the various plants used by the FMP are more or less scientifically validated in their therapeutic uses based on their reported pharmacological activities and phytochemical contents. FMPs and FM cannot then be describes as mere ‘quackery’, although there may be isolated cases of fraudulent practices.

Conclusion

Our findings suggest that the phytotherapeutic methods of the present FMP were quite consistent with available scientific reports on the pharmacological properties and phytochemical contents of the plants used by the FMP. As such, folk medicine can form the basis for herbal cures and the plants used in folk medicine can prove to be valuable sources of new drugs.

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[afreelancers-aide-memoire]

Q47

Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed?

A- Attributable risk

B- Odds ratio

C- Positive predictive value

D- Relative risk

[tokyorecruiter]

Post Marketing Surveillance Manager

Provide scientific support across Japan product’s post-marketing surveillance and pharmacoepidemiologic studies, including the planning, implementing and evaluating

Propose and carry out various components of epidemiology deliverables for Japan Post Marketing Studies, in coordination with Global Epidemiology, including:

Post-marketing surveillance strategy, including product portfolio review and…

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[afreelancers-aide-memoire]

Incidence  & Prevalence

Prevalence

It is the proportion of a population who have a specific characteristic in a given time period, regardless of when they first developed the characteristic

Incidence

It is a measure of the number of new cases of a characteristic that develop in a population in a specified time period

Ref:

1.https://www.hsph.harvard.edu/obesity-prevention-source/prevalence-incidence/

2.https://www.nimh.nih.gov/health/statistics/what-is-prevalence.shtml

3.https://www.bmj.com/about-bmj/resources-readers/publications/epidemiology-uninitiated/1-what-epidemiology