ABSTRACT
Background: Identifying and quantifying potentially inappropriate prescribing (PIP) practices remains a time-consuming and challenging task, particularly among the pediatric population. In recent years, several valuable tools have been developed and validated for assessing PIP. This study aimed to determine the prevalence of PIP and related risk factors in pediatric patients at a tertiary care hospital in Oman. Materials and Methods: A retrospective study was conducted by reviewing the medical records of pediatric patients (<18 years) from 1 October to 31 December 2019. Potentially inappropriate medication (PIM) and potential prescribing omission (PPO) were assessed using an internationally validated pediatric omission of prescriptions and inappropriate prescriptions (POPI) tool. Results: A total of 685 patients were included; 57.5% were male, and 30.5% had at least one comorbidity. Polypharmacy was identified in 70.2% of these patients, with a median of 2 (1−3) medications. PIM was observed in 20.4% of the cohort, with the highest in ENT-pulmonary disease (30.5%), followed by dermatological disorders (28.6%). PPO was identified in 6.9% of the patients with digestive and neuropsychiatric disorders, with the highest rate of 54% and 24%, respectively. Age (p = 0.006), number of medications (p = 0.034), and prescriber rank (p = 0.006) were identified as significant predictors of PIM, whereas age (p = 0.044) was the only significant predictor for PPO. Conclusions: The rates of PIM and PPO were high in this study population. In light of these findings, educational and interventional activities and programs are needed.
ABSTRACT
Bone injuries represent a major challenge in the medical field. The commonly used treatments for bone regeneration rely on the use of bone grafts that are usually associated with complications such as donor site morbidity, disease transmission, high cost, and lack of availability. Bone tissue engineering has become a golden solution for the repair of bone injuries by regenerating the damaged biological tissues using biocompatible scaffolds. However, most of the tissue engineered scaffolds do not possess the combined properties of high elasticity, appropriate stiffness, biocompatibility, osteoinductivity, and antimicrobial properties. In this study, we engineered bioactive and antimicrobial nanocomposites that can promote bone formation while simultaneously provide a barrier against bacterial infections commonly associated with bone implants. We used PEGylated polyglycerol sebacate as nanocomposites base, which was functionalized with Laponite nanosilicates, a synthetic nanoclay, and an antimicrobial peptide (AMP). The successful synthesis of the PEGylated polyglycerol sebacate and Laponite incorporation within the nanocomposites were confirmed through nuclear magnetic resonance (NMR) and Fourier transform infrared spectroscopy (FTIR). The scaffolds had an elastic modulus and ultimate tensile strength within a range of 3.8-4.7 MPa and 1.5-3 MPa, respectively. Furthermore, the scaffolds loaded with antimicrobial peptide exhibited a significant antimicrobial activity against both Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria. The in vitro cytocompatibility tests showed >90% viability of preosteoblast (W-20-17) cells. Moreover, in vitro differentiation assays demonstrated the scaffolds' ability to promote osteogenic differentiation of W-20-17. Collectively, the nanocomposites containing Laponite and antimicrobial peptide were proven to have osteoinductive and antimicrobial activity, making them desirable for bone tissue engineering applications.
ABSTRACT
Stents used for cardiovascular applications are composed of three main elements; a metal, polymer coating and the specific drug component. Nickel-based metals and polymer coatings currently used in the stent market have increased the recurrence of in-stent restenosis and stent failure due to inflammation. In this study, a Ti-8Mn alloy was used to fabricate a nanostructured surface that can be used for drug eluting stents to overcome the hypersensitivity of metals that are currently used in stent making as well as introducing a new built-in nano-drug reservoir instead of polymer coatings. Two different systems were studied: titanium dioxide nanotubes (NTs) and Ti-8Mn oxides NTs. The materials were characterized using field emission electron microscope (FESEM), energy dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), roughness, wettability and surface energy measurements. Nanoindentation was used to evaluate the mechanical properties of the nanotubes as well as their stability. In-vitro cytotoxicity and cell proliferation assays were used to study the effect of the nanotubes on cell viability. Computational insights were also used to test the blood compatibility using band gap model analysis, comparing the band gap of the materials under investigation with that of the fibrinogen, in order to study the possibility of charge transfer that affects the blood clotting mechanism. In addition, the drug loading capacity of the materials was studied using acetyl salicylic acid as a drug model.
