Практическое задание
Write a conclusion based on the information provided.
1) Background
The use of substandard and degraded medicines is a major public health problem in developing countries. Improper packaging and storage conditions can reduce the quality of amoxicillin–clavulanic acid preparations at community pharmacies.
Methods
We obtained amoxicillin-clavulanic acid tablets from consumer outlets. We examined packaging condition, printed information, and other sources of information. We tested the samples for quantity, content uniformity, and dissolution.
Results
We collected 59 samples from 48 outlets. A total of 32 (54.2%) samples were substandard: 8 (13.6%), 10 (16.9%), and 20 (33.9%) samples failed quantity, content uniformity, and dissolution tests, respectively.
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2) Background
Arterial hypertension is more prevalent and associated with more complications in African-American adults than in white adults. Various types of drugs are used to treat hypertension. Blacks and whites may respond differently to different types of drugs. We examined the response to angiotensin-converting enzyme (ACE) inhibitors in blacks and whites.
Methods
After a systematic search for clinical trials of ACE-inhibitors among hypertensive adults that compared blood pressure response between whites and blacks, we did a meta-analysis to determine the difference in systolic and diastolic blood pressure response. We investigated possible sources of heterogeneity or bias through meta-regressions, funnel plots, and one-study-removed analyses.
Results
The meta-analysis of 13 trials with 17 patient groups found ACE inhibitors reduced systolic and diastolic blood pressure less in blacks than in whites (here the numbers show this a clinically significant difference). In the meta-regression, the only significant source of heterogeneity was ACE-inhibitor dosage. There was little evidence of publication bias.
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3) Background
Aquilaria crassna has long been used to treat infections in traditional Thai medicine. We examined the antibacterial activity of Aquilaria crassna leaf extract against Staphylococcus epidermidis and its underlying mechanism. We also tested the extract’s antioxidant activity and toxicity.
Methods
We used the Kirby-Bauer test to determine antibacterial activity. We determined the minimum inhibitory concentration (MIC) by the dilution method. We defined the minimum bactericidal concentration (MBC) as the lowest concentration producing no growth of microbes in the subcultures. We used scanning electron microscopy to observe morphological changes in the bacteria and phase contrast microscopic analysis to evaluate the inhibitory effect on biofilm formation. We used transmission electron microscopy to assess bacterial cell wall integrity. We used FRAP, ABTS, and DPPH scavenging methods to determine antioxidant activity. Tests for acute toxicity were conducted in mice in accordance with the OECD’s guidelines.
Results
Staphylococcus epidermidis was susceptible to the extract with the MIC and MBC of 6 and 12 mg/ml, respectively. The extract caused swelling and distortion of bacterial cells and inhibited bacterial biofilm formation. The bacterial cell wall ruptured after being treated with the extract for 24 h. The extract had considerable antioxidant activity. Mice showed no signs of acute toxicity at doses of 2,000 mg/kg or 15,000 mg/kg body weight.
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