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Quality has been a concern of the World Health Organization since its inception and is defined as fitness for use. Since our ancestors began trading several millennia ago, Falsified Pharmaceutical Products has been a recurring problem and still threatens economic stability and public health. Its definition various from country to country and according to World Health Organization, 2017, it is 'a product that is deliberately and fraudulently mislabelled with respect to identity and/or source'. The implementation of anti-falsified nanomaterial technologies is the prominent preventive measure to track and/or detect Falsified Pharmaceutical Products. Software and hardware companies had made encouraging progress towards implementing Radio Frequency Identification devices for ensuring the authenticity of pharmaceutical products. The purpose of the review was to critically appraise Radio Frequency Identification devices technology for the purpose of track and trace Falsified Pharmaceutical Products circulating in the market. Different search engines such as Google Scholar, Science Direct and PubMed were applied and mesh terms and keywords were searched. Different guides and related books were investigated in addition to the articles. Radio Frequency Identification devices technology is a compact electronic device that contains a small chip and reader with antenna that enables wireless transmission of identity of pharmaceutical products. The authenticated Radio Frequency Identification devices model is used for pharmaceutical products' authentication from origin of pharmaceutical industry to the pharmacy at any point along the chain of the distribution. Popular pharmaceutical products, such as OxyContin and Sildenafil Citrate, which are particular targets of falsification have mandated the use of Radio Frequency Identification devices technology.

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BACKGROUND: The COVID-19 pandemic significantly increased the demand for remote healthcare services delivery, including remote access to medications. This study explored the practices and challenges associated with remote provision of pharmaceutical products and services in Kampala, Uganda. METHODS: A cross-sectional study was conducted from July to September 2022, enrolling 174 out of 198 sampled retail pharmacies. Data was collected using a pre-tested questionnaire on remote service provision, platforms used, products offered, delivery methods, and challenges faced. RESULTS: Over 58% of pharmacies provided remote services, primarily through social media (especially WhatsApp) and phone calls. OTCs and POMs were the most commonly dispensed products remotely. Key challenges identified included high internet costs, labor shortages, poor internet quality, and a lack of specific regulations for remote provision of pharmaceutical products and services. CONCLUSION: The proportion of retail pharmacies providing pharmaceutical products and services remotely is significant in Kampala, but they face challenges that need to be addressed. Regulations are crucial to ensure responsible dispensing practices and rational medicine use. Addressing internet affordability and quality, staffing issues, and delivery logistics is essential for sustainable and effective remote pharmaceutical products and services.

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Biological methods do not effectively remove pharmaceutical products (PPs) and antibiotic resistance genes (ARGs) from wastewater at low temperatures, leading to environmental pollution. Therefore, anaerobic-aerobic-coupled upflow bioelectrochemical reactors (AO-UBERs) were designed to improve the removal of PPs at low temperatures (10 ± 2 °C). The result shows that diclofenac (DIC) and ibuprofen (IBU) removals in the system with aerobic anodic and anaerobic cathodic chambers were 91.7% and 94.7%, higher than that in the control system (12.2 ± 1.5%, 36.5 ± 5.9%), and aerobic zone favors DIC and IBU removal; fluoroquinolone antibiotics (FQs) removals in the system with aerobic cathodic and anaerobic anodic chambers were 17.5-22.4% higher than that in the control system (9.1-22.4%), and anaerobic zone favors FQs removal. Analysis of microbial community structure and ARGs showed that different electrotrophic microbes (Flavobacterium, Acinetobacter, and Delftia) with cold-resistant ability to degrade PPs were enriched in different electrode combinations, and the aerobic cathodic chambers could remove certain ARGs. These results showed that AO-UBERs under intermittent electrical stimulation mode are an alternative method for the effective removal of PPs and ARGs at low temperatures.

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Pharmaceutical manufacturing utilizes solvents at different stages of production. Some of the harmful solvent residuals may be retained in the final product; therefore, they need to be monitored for quality control and to meet the regulation requirement. Here, a novel method capable of rapidly analyzing residual solvents in pharmaceutical products was developed using a compact-portable gas chromatography with a photoionization detector (GC-PID). The method consists of modified Tedlar® bag sampling, online pre-concentration, separation of volatiles by miniaturized GC, and micro-PID detection. The method detection limits of selected residual solvents were in the range of 26.00 - 52.03 pg/mL which is much lower than the pharmaceutical compliance concentration limits. Limits of detection > 520 pg of analyte per grams of sample was also determined for the over-the-counter drugs. The method performance showed rapid speed (5 min), linear calibration (r2 < 0.99), and repeatable retention time (RSD < 0.4 %). Direct analysis of residual solvents in solid samples was conducted without the need for complex sample preparation. The method validation using over-the-counter pharmaceutical products yielded excellent accuracy (recovery > 91.2 %) and precision (RSD < 6.5 %) for the selected residual solvents, including 1,4-dioxane, benzene, chlorobenzene, cyclohexane, xylenes, and toluene. This portable and rapid method could be deployed during the pharmaceutical drug manufacturing processes for quality control.

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The COVID-19 pandemic has led to an unprecedented increase in pharmaceutical drug consumption and plastic waste disposal from personal protective equipment. Most drugs consumed during the COVID-19 pandemic were used to treat other human and animal diseases. Hence, their nearly ubiquitous presence in the soil and the sharp increase in the last 3 years led us to investigate their potential impact on the environment. Similarly, the compulsory use of face masks has led to an enormous amount of plastic waste. Our study aims to investigate the combined effects of COVID-19 drugs and microplastics from FFP2 face masks on important soil processes using soil microcosm experiments. We used three null models (additive, multiplicative, and dominative models) to indicate potential interactions among different pharmaceutical drugs and mask MP. We found that the multiple-factor treatments tend to affect soil respiration and FDA hydrolysis more strongly than the individual treatments. We also found that mask microplastics when combined with pharmaceuticals caused greater negative effects on soil. Additionally, null model predictions show that combinations of high concentrations of pharmaceuticals and mask MP have antagonistic interactions on soil enzyme activities, while the joint effects of low concentrations of pharmaceuticals (with or without MP) on soil enzyme activities are mostly explained by null model predictions. Our study underscores the need for more attention on the environmental side effects of pharmaceutical contamination and their potential interactions with other anthropogenic global change factors.

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BACKGROUND: Increased costs in the health sector have put considerable strain on the public budgets allocated to pharmaceutical purchases. Faced with such pressures amplified by financial crises and pandemics, national purchasing authorities are presented with a puzzle: how to procure pharmaceuticals of the highest quality for the lowest price. The literature explored a range of impactful factors using data on producer and reference prices, but largely foregone the use of data on individual purchases by diverse public buyers. METHODS: Leveraging the availability of open data in public procurement from official government portals, the article examines the relationship between unit prices and a host of predictors that account for policies that can be amended nationally or locally. The study uses traditional linear regression (OLS) and a machine learning model, random forest, to identify the best models for predicting pharmaceutical unit prices. To explore the association between a wide variety of predictors and unit prices, the study relies on more than 200,000 purchases in more than 800 standardized pharmaceutical product categories from 10 countries and territories. RESULTS: The results show significant price variation of standardized products between and within countries. Although both models present substantial potential for predicting unit prices, the random forest model, which can incorporate non-linear relationships, leads to higher explained variance (R2 = 0.85) and lower prediction error (RMSE = 0.81). CONCLUSIONS: The results demonstrate the potential of i) tapping into large quantities of purchase-level data in the health care sector and ii) using machine learning models for explaining and predicting pharmaceutical prices. The explanatory models identify data-driven policy interventions for decision-makers seeking to improve value for money.

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BACKGROUND: Smuggling health goods given the importance and critical nature of health services should be undeniably addressed and controlled by all countries. This issue is especially more widespread in developing countries with more damaging consequences. This paper therefore aims to identify and analyze the challenges of preventing smuggling of health goods in Iran. METHOD: Within this qualitative study, we conducted face-to-face, semi-structured interviews with 30 purposefully recruited key informants and stakeholders in the detection, prevention, and combating of health goods smuggling. Each interview was analyzed thematically, using an inductive approach to generate codes, then categorized and presented in the form of main themes and sub-themes. Maxqda 11 assisted in coding, analysis, and data management. RESULTS: Three main themes emerged representing the challenges of prevention of smuggling in Iran in the areas of anti-smuggling policy development, including categories of inefficient policy and plan, and failure to reach agenda; policy implementation; categorized into actors, resources and instruments, and implementation guarantee; and finally monitoring and evaluation; including, procedures and practices, and the role of surveyors. CONCLUSION: Prevention of smuggling health goods proves to be a highly complex, challenging, and multi-faceted practice. Therefore, strengthening policy-making, regulatory frameworks, and facilitation functions about smuggling, counterfeiting, and corruption should be promoted in parallel.

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A novel electrochemical sensor based on LaNiO3/g-C3N4@RGH nanocomposite material was developed to simultaneously determine Ribociclib (RIBO) and Alpelisib (ALPE). Ribociclib and Alpelisib are vital anticancer medications used in the treatment of advanced breast cancer. The sensor exhibited excellent electrocatalytic activity towards the oxidation of RIBO and ALPE, enabling their simultaneous detection. The fabricated sensor was characterized using various techniques, including energy dispersive X-ray (EDX), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XR), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS), which confirmed the successful synthesis of the LaNiO3/g-C3N4@RGH composite material. Electrochemical characterization revealed enhanced conductivity and lower resistance of the modified electrode compared to the bare electrode. The developed sensor exhibited high repeatability, reproducibility, stability, and selectivity toward RIBO detection. Furthermore, the sensor displayed high sensitivity with low detection limits of 0.88 nM for RIBO and 6.1 nM for ALPE, and linear ranges of 0.05-6.2 µM and 0.5-6.5 µM, respectively. The proposed electrochemical sensor offers a promising approach for simultaneously determining RIBO and ALPE in pharmaceutical formulations and biological samples with recovery data of 98.7-102.0 %, providing a valuable tool for anticancer drug analysis and clinical research.

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Background: Despite the fact that synthetic preservatives and antioxidants have strong antibacterial and antioxidant activity, they are frequently associated with negative health consequences. Currently, there is an increasing interest in pharmaceutical products that are excellent in quality and free of synthetic preservatives. Methods: As a result, the purpose of this research is to assess the antibacterial and antioxidant activities of olive leaf extract, oleuropein, and thymol in various pharmaceutical products. Furthermore, the efficacy of these natural extracts to substitute synthetic preservatives (methyl-propylparaben and benzalkonium chloride) and antioxidants (butylhydroxytoluene) will be investigated. Results: The results revealed that oleuropein, olive leaf extract, and a blend of oleuropein and thyme oil may be utilized as preservatives at concentrations of (0.6 % w/v), (0.4 % w/v), and (0.4 %/0.1 % v/v), respectively. The results demonstrated that thyme oil and oleuropein have synergistic efficacy against the studied microorganisms. By assessing antibacterial activity, and physical properties, the results demonstrated that pharmaceutical formulations containing natural preservatives were stable and effective for three months under accelerated settings (40 °C/75 % RH). Conclusion: Natural compounds such as oleuropein, olive leaf extract, and thyme oil have shown antibacterial effectiveness equivalent to synthetic preservatives in selected pharmaceutical products. Furthermore, there was synergy in antimicrobial activity between thyme oil and oleuropein and this facilitates the use of these compounds at different levels.

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A highly sensitive electrochemical sensor is reported that employs a modified electrode for the precise measurement of cabotegravir, a potent anti-HIV drug. Cyclic voltammetry (CV), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS) were utilized for this purpose. Electrode modification involved the immobilization of Cr2AlC MAX phase/g-C3N4 onto a glassy carbon electrode (GCE) to enhance its electrocatalytic activity and selectivity for cabotegravir detection. Under the optimal experimental conditions, the working potential (vs. Ag/AgCl) was to 0.93 V. The developed sensor exhibited a good linear relationship in the range 0.05 µM to 9.34 µM with a low limit of detection of 4.33 nM, signifying its exceptional sensitivity. Additionally, it demonstrated successful cabotegravir detection in pharmaceutical formulations and biological samples, achieving an RSD below 3.0%. The recoveries fell within the range 97.7 to 102%, confirming the sensor's potential for real-sample applications. This innovative electrochemical sensor represents a significant advancement, providing a simple, reliable, and sensitive tool for the accurate measurement of cabotegravir. Its potential applications include optimizing drug dosages, monitoring treatment responses, and supporting the development of cabotegravir-based pharmaceutical products, thereby contributing to advancements in HIV therapy and prevention strategies.

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Wastewater-based epidemiology (WBE) has been already proposed by several authors for estimating the consumption of drugs, mainly the illicit ones. However, not much information is available about the actual reliability of this tool given the absence of comparison with the actual consumption. This work aims to evaluate the reliability of the WBE as a tool for estimating the consumption of pharmaceuticals in urban area. Measured consumption back-calculated with a WBE approach was compared with prescription of pharmaceutical products as "control." Moreover, seasonal influence on (i) pharmaceutical consumption, (ii) load of pharmaceutical products in the sewer system, and (iii) reliability of WBE was evaluated. Ciprofloxacin, sulfamethoxazole, metoprolol, carbamazepine, and citalopram were estimated by WBE with a difference respect to the "control" value lower than 0.2 order of magnitude while only trimethoprim and sotalol exceeded the 0.5 order of magnitude of difference but below the 1 order of magnitude. Sedatives were the best represented by WBE (on average 0.15 order of magnitude of difference compared to prescription data). However, further studies are suggested to fully estimate the influence of the type of APs on the reliability of the WBE. Seasonal patterns were found for the load of ciprofloxacin in the sewer and for the consumption of sulfamethoxazole and trimethoprim by population but seasonal changes did not have a significant impact (p > 0.05) on the reliability of WBE. Despite some gaps remained to optimize the reliability of the tool, WBE can be considered a valid method to estimate the consumption of prescribed drugs from the analysis of the sewer system.

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The rapid growth of various industries has led to a significant, alarming increase in recalcitrant pollutants in the environment. Hazardous dyes, heavy metals, pesticides, pharmaceutical products, and other associated polycyclic aromatic hydrocarbons (such as acenaphthene, fluorene, fluoranthene, phenanthrene, and pyrene) have posed a significant threat to the surroundings due to their refractory nature. Although activated carbon has been reported to be an adsorbent for removing contaminants from wastewater, it has its limitations. Hence, this review provides an elaborate account of converting agricultural waste into biochar with nanotextured surfaces that can serve as low-cost adsorbents with promising pollutant-removing properties. A detailed mechanism rationalized that this strategy involves the conversion of agrowaste to promising adsorbents that can be reduced, reused, and recycled. The potential of biowaste-derived biochar can be exploited for developing biofuel for renewable energy and also for improving soil fertility. This strategy can provide a solution to control greenhouse gas emissions by preventing the open burning of agricultural residues in fields. Furthermore, this serves a dual purpose for environmental remediation as well as effective management of agricultural waste rich in both organic and inorganic components that are generated during various agricultural operations. In this manner, this review provides recent advances in the use of agrowaste-generated biochar for cleaning the environment.

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BACKGROUND: The improper disposal of pharmaceutical preparations substantially threatens human health and environmental safety. Pharmacists are responsible for properly disposing of unwanted medications and educating patients about how to do so themselves. This study aimed to assess community pharmacists' knowledge, determine their views on how to dispose of unwanted pharmaceuticals, and assess the extent to which they realize that it is their responsibility to guide patients toward the safe disposal of expired medications. METHODS: A descriptive cross-sectional study was conducted between December 2021 and April 2022 among 400 practicing pharmacists who were chosen to participate by random cluster sampling. Community pharmacists' practices, awareness, and beliefs about disposing of unused drugs were evaluated. The Statistical Package for Social Sciences (IBM-SPSS) version 21 was used for data entry and analysis. RESULTS: Of 400 pharmacists, 348 stated that they did not participate in courses on the safe disposal of unwanted medications. Disposal of drugs in the garbage, an unsafe method, was very frequently recommended by pharmacists to patients, especially regarding inhalers, antibiotics, hormonal drugs, and solid and semisolid drugs. However, many pharmacists advised patients to return their hormonal, category B, and category C drugs to the pharmacy. A total of 61.3% of pharmacists agreed and 26% strongly agreed that unsafe disposal of drugs negatively affects the environment. A total of 54.3% of the participants agreed that improper disposal of antibiotics might be a reason for increased antimicrobial resistance, and 54.5% of them agreed that improper disposal of hormonal drugs might contribute to the development of certain cancers. A total of 80.3% of the participants perceived that most unwanted drugs in pharmacies were those returned from patients. A total of 97.3% of the participants supported establishing a drug disposal system, with 77.5% choosing to have the district health board responsible for funding this system. A total of 48.5% of the participants indicated that a lack of education and awareness on the issue of getting rid of unused drugs constitutes a challenge to the safe disposal of medicines, and 66% of them said that a lack of law enforcement constitutes another challenge. A total of 95.5% of the participants agreed or strongly agreed that good training for health sector workers and organizing workshops to develop knowledge on this subject would improve practices. A total of 93.3% supported distributing educational brochures, and 92.8% supported placing special containers in every pharmacy to collect unwanted drugs. CONCLUSIONS: Most pharmacists in our study returned drugs to manufacturing companies and stores, and few followed the correct methods of incineration and return of drugs to the Ministry of Health. Current data emphasize the issue of improper disposal of medicine in Palestine and the need for improved education among healthcare workers.

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The present study aimed to strategically design a Molecularly Imprinted Polymer (MIP) with selective extraction capabilities for volatile compounds found in pork. These specific volatile compounds, such as 3-methyl-1-butanol, 1-nonanal, octanal, hexanal, 2-pentyl-furan, 1-penten-3-one, N-morpholinomethyl-isopropyl-sulfide, methyl butyrate, and (E,E)-2,4-decadienal, are primarily responsible for the distinctive aroma and flavor characteristics associated with pork. Molecular dynamics simulations were employed to investigate the stability of the pre-polymerization system, simulating the interactions between the volatile compounds as templates, 4-hydroxyethyl methacrylate (HEMA) as monomers, and ethylene glycol dimethacrylate (EGDMA) as crosslinkers. Computational simulations revealed that the optimal mole ratio of 1:4:20 for templates, monomers, and crosslinkers resulted in the most favorable functional radial distribution and exhibited the strongest interactions. To validate the computational findings, additional analyses were performed utilizing Molecular Mechanics Poisson-Boltzmann Surface Area (MM-PBSA), radial distribution function (RDF), and hydrogen bond (HBond) occupancy. The calculated binding free energy demonstrated that all template molecules were capable to bind with both the monomers and crosslinkers, including 1-penten-3-one and N-morpholinomethyl-isopropyl-sulfide displaying the strongest interactions, with values of -12,674 kJ/mol and -11,646 kJ/mol, respectively. The congruence between the results obtained from the molecular simulation analyses highlights the crucial role of molecular dynamics simulations in the study and development of MIP for the analysis of marker compounds present in pork.Communicated by Ramaswamy H. Sarma.

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One of the main characteristics of health systems and pharmaceutical supply chains is their significant costs in the public sector, which has forced governments and companies active in this field to find ways to reduce costs. In this paper, the deterioration of imported pharmaceutical items is investigated as one of the challenges of the supply chain of pharmaceutical firms. Specifically, the micro, small medium enterprise (MSME), and a collaborative strategy to reduce its costs is presented. The technical solution of the cooperative strategy is the formation of a partnership alliance between the foreign patent holder of brand drugs and a domestic manufacturer through an exclusive license contract in the local country. This leads to a significant reduction of costs in the distribution network of the pharmaceutical supply chain. On the other hand, supply chain management techniques in the cooperative strategy provide the necessary motivation for its practical implementation by splitting fair profits between producers and other members, namely local government, distributors, and pharmacies. For these purposes, a cooperative game theory-based contract is utilized to set the parameters of the license agreement, and then a profit-sharing mechanism is introduced that splits the benefits of cooperation among the supply chain members based on their afforded costs. The most important contribution of the current research is to propose an integrated framework that combines the logistics network models, valuation methods, and profit split mechanisms that embody more facts from real-world problems than separate models in this regard in previous studies. Moreover, results of the proposed strategy in the supply chain of a drug for thalassemia patients in Iran indicate the effectiveness of the proposed strategy in reducing costs and deterioration. Further, it is shown that the higher the ordering costs of the imported drugs, the lower the market share of the patent holder, and the lower the financing expenses of the cooperative alliance, the more efficient is the proposed strategy.

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tris-[(4,7-diphenyl-1,10-phenanthroline)ruthenium(II)] dichloride (Ru(DPP)3Cl2), a fluorescent sensor which is sensitive to the amount of oxygen in the sample, was applied using the fluorescent optical respirometry (FOR) technique. The oxygen in the samples quenches the fluorescence. The fluorescence intensity depends on the metabolic rate of the viable microorganisms. The effect of DMSO and plant extracts on bacteria was determined by FOR. It was shown that the MIC values obtained by FOR were consistent with the results of the MIC determinations using the method of serial dilutions; at the same time, the effects of concentrations lower than the growth-inhibitory concentrations on microbial cells were demonstrated. The FOR method enables the detection of multiplying bacteria in sterile and non-sterile pharmaceutical preparations in real time, which significantly shortens the time required to obtain results and allows the introduction of repair processes in the production. This method also allows for quick, unambiguous detection and the counting of the viable cells of aerobic microorganisms in non-sterile pharmaceuticals.

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Both sterile and non-sterile pharmaceutical products, which include antiseptics, have been recalled due to Burkholderia cepacia complex (BCC) contamination. Therefore, minimizing the frequency of outbreaks may be conducive to the development of a quick and sensitive approach that can distinguish between live and dead loads of BCC. We have assessed an exo probe-based recombinase polymerase amplification (RPA) with 10 µM propidium monoazide (PMAxx) for selective detection of live/dead BCC cells in various concentrations of antiseptics (i.e., chlorhexidine gluconate (CHX) and benzalkonium chloride (BZK) solutions) after 24 h. The optimized assay conducted using a set of primer-probes targeting gbpT was performed at 40 °C for 20 min and shows a detection limit of 10 pg/µL of genomic DNA from B. cenocepacia J2315, equivalent to 104 colony-forming units (CFU/mL). The specificity of a newly designed primer and probe was 80% (20 negatives out of 25). The readings for total cells (i.e., without PMAxx) from 200 µg/mL CHX using PMAxx-RPA exo assay was 310 relative fluorescence units (RFU), compared to 129 RFU with PMAxx (i.e., live cells). Furthermore, in 50-500 µg/mL BZK-treated cells, a difference in the detection rate was observed between the PMAxx-RPA exo assay in live cells (130.4-459.3 RFU) and total cells (207.82-684.5 RFU). This study shows that the PMAxx-RPA exo assay appears to be a valid tool for the simple, rapid and presumptive detection of live BCC cells in antiseptics, thereby ensuring the quality and safety of pharmaceutical products.

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The current healthcare system is widely based on the concept of "one size fit for all", which emphasizes treating a disease by prescribing the same drug to all patients with equivalent doses and dosing frequency. This medical treatment scenario has shown varied responses with either no or weak pharmacological effects and exaggerated adverse reactions preceded by more patient complications. The hitches to the concept of "one size fits all" have devoted the attention of many researchers to unlocking the concept of personalized medicine (PM). PM delivers customized therapy with the highest safety margin for an individual patient's needs. PM has the potential to revolutionize the current healthcare system and pave the way to alter drug choices and doses according to a patient's clinical responses, providing physicians with the best treatment outcomes. The 3D printing techniques is a solid-form fabrication method whereby successive layers of materials based on computer-aided designs were deposited to form 3D structures. The 3D printed formulation achieves PM goals by delivering the desired dose according to patient needs and drug release profile to achieve a patient's personal therapeutic and nutritional needs. This pre-designed drug release profile attains optimum absorption and distribution, exhibiting maximum efficacy and safety profiles. This review aims to focus on the role of the 3D printing technique as a promising tool to design PM in metabolic syndrome (MS).

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La principal misión de la Farmacia Militar es el mantenimiento de la fuerza operativa desplegada en misiones. Con este fin tras el estudio del Petitorio de las Fuerzas Armadas Españolas (FFAA), se decidió modernizar los comprimidos tradicionales de loperamida a la forma farmacéutica de comprimidos bucodispersables. Este cambio, así como el proceso tecnológico de fabricación ha sido posible gracias a los avances en equipamientos de fabricación y control además de los modernos excipientes. Los farmacéuticos militares actualizan a una forma farmacéutica fácil de emplear por el combatiente en todas las situaciones del despliegue, incluidas las iniciales en las que el acceso al agua está comprometido. La fabricación por compresión directa y el empleo de superdisgregantes permite ahorros en el tiempo y coste de producción, gracias a su inmediata liberación de la forma farmacéutica aumenta la eficacia y rapidez de efectos del medicamento. Por estos motivos la actualización constante al estado de la ciencia, permite en los despliegues tácticos la total disponibilidad de la fuerza operativa sin bajas transitorias de especialistas difícilmente reemplazables y de su cohesión en los modernos grupode combate. (AU)

The main mission of the Military Pharmacy is the maintenance of the operational force deployed in missions. To this end, after the study of the Request of the Spanish Armed Forces (FFAA), it was decided to modernize the traditional loperamide tablets to the pharmaceutical form of orodispersible tablets. This change, as well as the technological manufacturing process, has been possible thanks to advances in manufacturing and control equipment and modern excipients. Military pharmacists upgrade to a combatant-friendly dosage form in all deployment situations, including initial ones where access to water is engaged. The manufacture by direct compression and the use of superdisintegrants allows savings in production time and cost and, thanks to its immediate release from the pharmaceutical form, increases the efficacy and rapidity of the drug's effects. For these reasons, constant updating to the state of the science allows for the total availability of the operational force in tactical deployments without temporary casualties of specialists that are difficult to replace and their cohesion in modern combat groups. (AU)

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BACKGROUND: Despite the prominent evidence of cold chain monitoring in the health system to reduce wastage and maintain product potency, there are still inefficiencies in the storage and transportation of cold chain products. This study assessed medicine cold chain storage conformity in health facilities in the Eastern Province of Rwanda. METHODS: A cross-sectional and prospective with quantitative and qualitative approaches study was approved, and 44 health facilities (public, faith-based and private) were selected using both convenience, stratified, and purposive sampling techniques. Temperature data loggers were mounted in refrigerators to measure the Mean Kinetic Temperature (MKT). RESULTS: The overall performance of cold chain storage conformity of refrigerators assessed was 54 (73.0%). The conformity found in refrigerators of pharmacy stock in public health facilities was 22 (56.0%), in vaccination program was 25 (100.0%), and in private retail pharmacies was 7 (70.0%). The MKT measured fit the required cold chain storage at this rate. Most refrigerators used in pharmacy stock (27.0%) were aged between 8 and 10 years, while those used in vaccination programs were less than 4 years. Regular calibration of refrigerator and temperature monitoring device (TMD) was 39.0% and 24.0%, respectively. Most respondents, 44 (80.0%), knew the proper cold chain storage. However, few identified the impact of storing cold chain products with vaccines at 16 (29.1%). The transportation of cold chain products from two central medical stores assessed showed inefficiencies as only one of them uses temperature data loggers during transportations of the products mentioned above. CONCLUSIONS: The medicines cold chain storage conformity investigated in seven districts of the Eastern Province in Rwanda was better than reported previously in other LMICs. However, cold chain storage for pharmacy stock often did not meet the requirements. The observed drawback represented a serious risk to public health. Calibrating cold chain equipment, regular maintenance, and commissioning new cold chain equipment should be done to improve cold chain storage.