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Amphotericin B (AmB) is a highly hydrophobic drug with significant leishmanicidal activity whose use is limited by its poor water solubility and adverse effects. Polymer-drug conjugates are proposed as a delivery system designed to overcome those limitations while improving drug bioavailability, safety, and activity. Here, AmB was covalently linked to periodate-oxidized hyaluronic acid (HA) (oxidation degree of 30.1 ± 5.6%) via a Schiff base (HA-AmB imine). The conjugate presents high water solubility and self-assembles into particles with a mean size of 88.2 ± 17.6 nm, a negative charge (-28.3 ± 0.9 mV), and a drug content of 17.8 ± 1.4%. Spectroscopic studies revealed the presence of AmB in aggregate and super-aggregated forms in the conjugate, which could explain the significant reduction of the

IntroductionThere is limited data on the awareness and use of synthetic cannabinoids (SCs) in high-risk population in Serbia, despite SCs becoming more and more common at illicit drug market.AimThis pilot study aimed to examine the awareness and prevalence of use of SCs in patients with an opioid-use disorder and to identify patient characteristics and other factors associated with SCs use.Patients and methodsThis cross-sectional study was conducted at the Clinic for Psychiatry, Clinical Center Vojvodina, Serbia, the largest tertiary health care institution in this region of the country. All patients hospitalized due to the treatment of opioid dependence during November and December 2017 were included (response rate 100%), and filled-out an anonymous questionnaire specifically developed for the purpose of this study. Differences between patients reporting SCs use and those who did not were compared using chi-square test with values of p ResultsOut of 64 patients (median age 36.37 years), one third (32.81%) reported using SCs. Socio-demographic characteristics of the subjects were not associated with SCs use. There were differences in the most common sources of information reported between the SCs users and non-users. Majority of SCs users (76.0%) were informed about SCs through friends, compared with just 26.0% of non-users (p = 0.011 and 15.6% vs. 12.5%, p = 0.015), respectively. Higher share of SCs users used multiple psychoactive substances (38.1% vs. 16.3%), and this difference was statistically significant (p = 0.047). The most commonly reported adverse effect of SCs among users included dry mouth (81.0%), trouble thinking clearly (52.4%) and panic attacks (52.4%).ConclusionUnderstanding the awareness and use of SCs among high-risk drug users, as well as associated factors can help improve substance-use disorder treatment in our setting. Educational activities targeting public are urgently needed to raise awareness on SCs, considering that social contacts are the main sources of information on SC for this vulnerable population. Users of SCs have also reported using other psychoactive substances more often, and this calls for a holistic approach addressing multiple factors to improve substance-use treatment in our setting.

IntroductionOne of the most common oral diseases affecting children is early childhood caries (ECC). The link between oxidative stress and ECC has been proven in numerous clinical studies. Technical and biological variability were so high in most of the studies that none of the markers have yet been proven suitable for routine clinical use. This study aimed to evaluate the antioxidant status and the levels of leptin and adiponectin in saliva of children with severe early childhood caries (S-ECC).MethodsMorning unstimulated saliva samples were collected from children (n = 40, 0–6 years old) for the evaluation of oxidative stress which were measured by total antioxidant capacity (TAC), and by the ferric reducing antioxidant power (FRAP) assays, as well as to assess the salivary levels of leptin and adiponectin. FRAP, TAC, leptin and adiponectin concentrations were evaluated in S-ECC group (n = 31) and caries free group CF (n = 9). All results were analyzed based on age and sex.ResultsOverall median salivary leptin and adiponectin levels were 5.59 pg/mL and 24.86 ng/mL, respectively. Significantly lower leptin levels were observed in saliva of caries free children (4.66 pg/mL) than in the S-ECC group (6.64 pg/mL, p < 0.01). No significant difference was observed for adiponectin levels (S-ECC and CF, 25.31 and 23.2 ng/mL, respectively, p = 0.961). TAC and FRAP values of saliva had similar values in children with S-ECC and caries free children. TAC and FRAP values also remained stable with the age of the children, without significant differences with respect to sex.ConclusionThe increased concentrations of leptin in saliva of children with S-ECC suggests that leptin may play a role in inflammatory and immune responses in the development of early childhood caries.

Introduction: Primary dysmenorrhea is a common disorder in women, with a significant impact on quality of life. Aim: The objective of this academic study was to investigate the severity of dysmenorrhea in female students of the Faculty of Medicine in Novi Sad, to estimate the self-medication prevalence of primary dysmenorrhea, to identify the most commonly used conventional, herbal, homeopathic remedies and manner of their usage, as well as non-pharmacological measures in the treatment of primary dysmenorrhea. Material and Methods: This study was performed on a random sample of 100 respondents from different departments of the Faculty of Medicine in Novi Sad, from December 1st to December 15th, 2016. The data were obtained by using a standardized questionnaire. Results: The sample included 59 female medical students and 41 female students of the other study groups. Most of the respondents had medium expressed symptoms due to dysmenorrhea (48.0%). The most common symptoms were cramps and pain in the lower abdomen, anxiety, and appetite changes. 11% of respondents were absent from classes at the university minimum one day of each menstrual cycle, because of dysmenorrhea. 66% of respondents used drugs due to symptoms of dysmenorrhea. The most commonly used group of drugs were non-steroid anti-inflammatory drugs (75.76%), primarily ibuprofen (53.03%), and diclofenac (10.61%). Self-medication prevalence was 48.48%. Conclusion: According to the results of this study, dysmenorrhea symptoms significantly impact the quality of life.

The global prevalence of dyslipidemia (elevated plasma levels of total cholesterol, LDL-Cholesterol, triglycerides, and lower plasma levels of HDL-Cholesterol) is constantly on the rise. Lately, carob pulp has been recognized as an effective natural product for the treatment of dyslipidemia. The two main components of the carob pulp, polyphenols, and insoluble fiber are believed to have beneficial effects on lipid metabolism. Studies on humans and animals confirmed its lipid-lowering effects. Several mechanisms have been proposed to explain this phenomenon, namely by affecting three organ systems: 1) gastrointestinal tract, 2) liver and 3) adipose tissue. Also, carob products have antioxidative, anti-inflammatory, and vascular-protective activity.

The global prevalence of dyslipidemia (elevated plasma levels of total cholesterol, LDL-Cholesterol, triglycerides, and lower plasma levels of HDL-Cholesterol) is constantly on the rise. Lately, carob pulp has been recognized as an effective natural product for the treatment of dyslipidemia. The two main components of the carob pulp, polyphenols, and insoluble fiber are believed to have beneficial effects on lipid metabolism. Studies on humans and animals confirmed its lipid-lowering effects. Several mechanisms have been proposed to explain this phenomenon, namely by affecting three organ systems: 1) gastrointestinal tract, 2) liver and 3) adipose tissue. Also, carob products have antioxidative, anti-inflammatory, and vascular-protective activity.

This study has been aimed at evaluating knowledge, attitudes and behaviour of university students regarding the usage of antibiotics focusing on differences between medical and nonmedical students. This cross-sectional questionnaire-based study was performed on 800 students of the University of Novi Sad, Serbia. The identified predictors of adequate antibiotic knowledge were enrolled in medical program, higher grade average and appropriate use of antibiotics during last infection. Multivariate regression identified following predictors of self-medication: being medical student (B = 0.715; p

Proper collection and disposal of pharmaceutical waste from households can reduce the negative influence of medicines on the environment. The aim of this paper is to examine the current methods of disposal of unused medicines from households, as well as the willingness of Serbian residents to participate and bear the costs of an organized collection program. Moreover, this research aims to define factors contributing to an individual's willingness to participate and pay for a medicine collection program. The survey included randomly selected patients older than 18 years visiting private pharmacies in the four largest Serbian cities. The questionnaire included information regarding the presence of unwanted medicines within the household, general medicine disposal practices, the likelihood to participate in a medicine take-back program, willingness to pay for a medicine disposal program (per prescription and per visit), importance to the environment, and demographic variables from participants. Approximately 80% of surveyed respondents are very or somewhat likely to participate, however less than half of the respondents are willing to pay for the collection of their unused medicines. The factors that influenced willingness to participate are environmental awareness and income, while the factors affecting willingness to pay, are previously received advice about proper disposal, education level, number of unwanted medicines in the household and gender. The majority of Serbian people dispose unused medicines improperly, mostly into household garbage. Well-organized and easily accessible collection programs are essential in order to enable the general public to return unused medicines for proper disposal.

Introduction: Hypertension is a significant risk factor for stroke, myocardial infarction, and heart failure. Maintaining adequate blood pressure helps preventing cardiovascular complications. Aim: The aim of this study was to investigate the knowledge about hypertension and associated factors in controlling high blood pressure among hypertensive outpatients in the municipality of Bačka Topola, Republic of Serbia. Methods: The outpatients who visited their doctors and agreed to fill out an anonymous questionnaire were included in the survey conducted in March 2019 at the Primary Health Care Center of the municipality of Bačka Topola. The questions were related to the sociodemographic characteristics and medication-associated factors of significance for assessment of the outpatients' knowledge about antihypertensive drugs. Results: The mean age of patients was 62.9±10.7 years. Most frequently prescribed antihypertensive drugs were ACE inhibitors (80.8%) followed by beta blockers (46.8%), calcium channel blockers (22.6%) and diuretics (21%), fixed dose antihypertensive drugs were used by 4.8% patients. Majority of adequate knowledge participants had well controlled blood pressure (91.4%), while only 37.1% of average knowledge participants had well controlled blood pressure. The other factors related to poor blood pressure control and lower level of knowledge about hypertension were older age, female gender, lower level of education, less frequent visits to the GP, patients with more than one antihypertensive drug, patients with longer duration of hypertension treatment and patients who were not paying copayment for their antihypertensive drugs. Conclusions: The results of our study indicate that the patients' knowledge about hypertension and associated factors regarding the treatment of hypertension play an important role in maintaining blood pressure at the safe level. Therefore, educational campaigns are the key factors for the quality and satisfactory knowledge about use of antihypertensive drugs and management of hypertension.

The effectiveness of the national drug safety monitoring program directly depends on the active participation of healthcare professionals in reporting suspected adverse drug reactions (ADRs). The aim of the study was to explore community pharmacists’ comprehension of pharmacovigilance, their perspectives toward reporting ADRs and investigate the current practice of ADR reporting among pharmacists in Serbia. This descriptive cross-sectional study was performed on a sample of pharmacists in Serbia between November 2019 and March 2020 using a pre-tested questionnaire distributed online. Eligible participants were community pharmacists in Serbia who were willing to participate in the study during the data collection period. Non-parametric statistical tests were performed in the analysis of knowledge, perspectives and ADR reporting. The validity and reliability of the survey were measured by exploratory factor analysis. The median knowledge score was 6 out of 10 (interquartile range 5–7, range 2–10). No significant differences in the knowledge scores of pharmacists were found based on weekly working hours (U = 24,805, p = .374), working experience (χ2 = 4.011, DF = 2, p = .135), being a member of a professional organization (U = 24,312, p = .209), or highest level of pharmacy qualification obtained (χ2 = 3.233, DF = 3, p = .506). Only 28.8% of pharmacists reported ADR at least once a year, while the majority of them have never reported any ADRs. Despite the community pharmacists’ positive attitude toward adverse drug reporting and their role in the process, they show limited knowledge regarding the issue and highly prevalent under-reporting of ADRs. Educational programs are necessary to increase ADRs reporting.

The framework of this study was a comprehensive investigation of Morus nigra L. extracts, with the aim to establish the correlation between chemical composition and antioxidant/hepatoprotective activity of a series of black mulberry extracts obtained from aerial parts of the plant. Black mulberry leaf (MLEE), bark (MBEE), juice (MJ) and fresh fruit (MFEE) extracts were obtained using the conventional Soxhlet extraction, while the supercritical CO2 extraction procedure was employed for preparation of the seed oil (MSO). Analysis of the chemical composition was performed using spectrophotometric, HPLC and GC methods. For the evaluation of antioxidant activity, in vitro FRAP and DPPH assays were applied. In Haan strain NMRI mice with streptozotocin-induced oxidative stress, in vivo antioxidant activity and liver tissue integrity were examined. The content of polyphenolic compounds was the highest in MBEE (68.3 ± 0.7 mgGAE/g) with the most abundant compounds being polyphenolic acids, followed by MLEE (23.4 ± 0.5 mgGAE/g) with the flavonoids isoquercetin and rutin being present in a significant amount. An analysis of MSO revealed a high content of γ-linoleic acid. The highest antioxidant activity in vitro (FRAP and DPPH) was observed for MLEE, MBEE and MSO. Beneficial effects were confirmed in vivo, with lower values of hepatosomatic index, potentiation of the activity of the enzymes superoxide dismutase and catalase, a lower rate of lipid peroxidation and reduced positivity for the P450 enzyme in animals treated with MLEE, MBEE and MSO. Black mulberry leaf and bark extracts as well as seed oil exhibited significant antioxidant activity. Apart from the confirmed biological properties of the fruit and leaf extracts, the observed activities of black mulberry seed oil and bark extract imply its importance as a sustainable source of phytochemicals.

This study aimed to determine and describe the prevalence of combination antibiotics dispensed in outpatients with health insurance in Syria. Data on all dispensed medicines between June 2018 and May 2019 for 81,314 adults were obtained, and medicines belonging to the J01 group of the World Health Organization (WHO) anatomical therapeutic classification (ATC) were included in the analysis. Prescriptions were stratified according to the number of antibiotics, age, and sex. Antibiotic utilization was expressed as the number of prescriptions per 1000 persons per year. Out of 59,404 prescriptions for antibiotics, 14.98% contained antibiotic combinations, distributed to 22.49% of the patients. The prevalence of dispensing antibiotic combinations was higher in female patients (23.00%), and the youngest (18–30 years, 26.19%) and oldest age groups (>70 years, 25.19%). The antibiotics most commonly combined were co-amoxiclav, second- and third-generation cephalosporins, and macrolides. Over 60% of the combinations contained ceftriaxone alone or in combination with sulbactam. The present study shows an alarmingly widespread prescription of antibiotic combinations, posing a risk to global health by promoting resistance development.

This study was conducted in order to evaluate prospective health care professionals’ (HCPs) awareness and attitudes regarding new psychoactive substances (NPSs) in the context of their future role in the prevention and treatment of NPS overdose and addiction. Correlates of NPS perception and use were also examined. This cross-sectional survey was performed on 490 students of the Faculty of Medicine, Novi Sad, Serbia, during 2017. NPS awareness was better in pharmacy students (IRR: 1.926, CI: 1.173–3.163, p = 0.010) than in medicine students—pharmacy students recognized 92.6% more NPS names than their peers studying medicine. Female students knew 36.5% less NPS names than their male colleagues (IRR: 0.635, CI: 0.399–1.013, p = 0.049). Number of NPS names students knew was rising by 15.9% with each age group—the higher the age, the larger the number of NPSs they were aware of (IRR: 1.159, CI: 1.025–1.310, p = 0.018). Students who had used marijuana knew 52.6% more NPS names than those who had never had experience with cannabis (IRR: 1.526, CI: 0.953–2.445, p = 0.049). Although a high number of future HCPs claimed to know what NPSs are, numerous misconceptions were noticed. Further educational efforts are necessary to improve their awareness and attitudes regarding NPSs.

ObjectivesTo determine rate of blood pressure (BP) control and to analyse patient-related, medication-related and healthcare system-related factors associated with poor BP control in outpatients with hypertension (HT).DesignCross-sectional study.SettingTwo study sites with different levels of healthcare (primary healthcare (PHC) and secondary level of healthcare (SHC)) in Vojvodina, Northern Serbia.ParticipantsA total of 581 patients (response rate 96.8%) visiting their primary care physician between July 2019 and June 2020 filled out a pretested semistructured questionnaire and had a BP reading during their regular appointments.Primary and secondary outcome measuresData on demographics, medication, BP control (target systolic BP≤140 mm Hg and∕ or diastolic BP≤90 mm Hg) and knowledge on HT was collected. Based on the median of knowledge score, patients were classified as having poor, average and adequate knowledge.ResultsMajority of the respondents (74.9%) had poorly controlled BP and had HT longer than 10 years. Larger number of patients at PHC site was managed with monotherapy while at the SHC majority received three or more antihypertensive drugs. Respondents from SHC showed a significantly lower knowledge score (9, 2–15) compared with the respondents from PHC (11, 4–15, p=0.001). The share of respondents with adequate knowledge on HT was significantly higher in the group with good BP control (26% and 9.2%, respectively). In a multivariate regression analysis, factors associated with poor BP control were knowledge (B=−1.091; pConclusionsPoor BP control is common in outpatients in Serbia, irrespective of the availability of different levels of healthcare. Patients with poor knowledge on HT, with complications of HT and those with multiple antihypertensive drugs, were at particular risk of poor BP control. Our study could serve as a basis for targeted interventions to improve HT management.

The beneficial medical properties of cannabis in treatment of variety of diseases have been widely recognized across many cultures (Zuardi, 2006, Aggarwal et al., 2009, Birdsall et al., 2016). At the end of the 19th century in Europe, cannabis was considered effective for the treatment of chronic pain, asthma, sleep disorders, depression, and loss of appetite (Guy et al., 2004, Manzanares et al., 2006, Sabo et al., 2013). Medical use of cannabis continued until the first half of the 20th century, when legal restrictions were introduced due to the psychoactive constituent - delta-9-tetrahydrocannabinol (THC), which is one of at least 113 cannabinoids identified in cannabis (Ben Amar, 2006, Horvat et al., 2007). In Serbia, cannabis is classified under narcotic drugs, and the production, sale and possession of cannabis for recreational use or any form of medical marijuana products is illegal (Law on Psychoactive Controlled Substances). Recently, a number of countries in Europe have introduced specific laws and programs to allow patients to use cannabis preparations to effectively relieve the symptoms of chronic pain, muscle cramps and spasticity in patients with multiple sclerosis, to alleviate nausea and vomiting and to improve weight gain and appetite in patients with AIDS (European Monitoring Centre for Drugs and Drug Addiction, 2017). Besides Netherlands, a country with more than 10 years of experience in medical cannabis use, medical cannabis has also been legalized in Italy, Spain, France, Romania and Czech Republic. As for the countries surrounding Serbia, Croatia and Macedonia are the most recent countries which have allowed the use of cannabis in medical purposes (Bifulco and Pisanti, 2015). As more countries in Europe and worldwide continue to change laws for medical marijuana use, public interest in medical cannabis legalization in Serbia is growing. When medical cannabis is legalized in Serbia, doctors will be the ones who will prescribe the products and answer to patients’ questions about its use, benefits and side effects. It is of immense importance to bear in mind specific harmful effects of cannabis, especially in young people. Cannabis is indicated as a possible risk factor for cardiovascular disease in young adults due to increased reporting of cardiovascular complications related to cannabis and their extreme seriousness (Jouanjus et al., 2014). Furthermore, exposure to cannabis during adolescence has been connected to deviations in the normal neurodevelopment, producing a brain particularly at risk of psychiatric disorders such as schizophrenia (Iannitelli et al., 2017, Quartini et al., 2017). Yet, prospective doctors may receive minimal education on this issue throughout the curriculum. A paucity of studies exist evaluating future health care professionals’ knowledge and attitude towards medical cannabis (Sabo et al., 2013, Ben Amar, 2006). In Serbia, one study evaluated beliefs about medical cannabis among fourth-year medical students, while another included only the final year students of pharmacy (Vujcic et al., 2017, Stojanovic et al., 2017). The aim of this study was to determine the frequency of recreational cannabis use among medical students and to explore their knowledge about therapeutic use/abuse, side effects and current legislation status of medical cannabis, as well as attitudes toward its legalization.

dataset with INNs, ATC codes and DIDs.

This study investigated the chemical and nutritional profile and antioxidative properties of cultivated Coprinus comatus. Proximate analysis revealed that C. comatus is rich in carbohydrates, dietary fibres and proteins, and could also be a valuable source of phenolics. Additionally, fat content is low, consisting mainly of polyunsaturated and omega-3 fatty acids. Furthermore, the safety profile of C. comatus is satisfactory, with all elements of toxicological importance within the proposed limits. Oral treatment with C. comatus for 42 days improved the antioxidant capabilities and ameliorated carbon tetrachloride-induced liver damage in rats, marked by decreased serum aminotransferase levels and lipid peroxidation intensity. Glutathione concentrations increased in a dose-dependent manner. Histological morphometric and immunohistochemical analysis confirmed antioxidative and hepatoprotective potential. These findings imply that cultivated C. comatus could be considered a nutraceutical, having beneficial nutrient and therapeutic properties.

© 2020 Edizioni Scientifi che per l'Informazione su Farmaci e Terapia. A surveillance study was performed in an intensive care unit in the largest tertiary health care center in Vojvodina, Serbia from 2014 to 2018. Antibiotic prescription data were collated in the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) format, while antibiotic resistance was expressed as incidence density adjusted for total inpatient-days. Individual trends were determined by linear regression, while possible associations between antibiotic prescription and resistance were evaluated using cross-correlation analysis. An overall decrease in antibiotic utilization was observed. The prescription rates of piperacillin-tazobactam increased significantly, while consumption of 3rd and 4th generation cephalosporins and fluoroquinolones decreased. There were rising incidence densities of doripenem resistant Acinetobacter spp., piperacillin-tazobactam resistant Pseudomonas aeruginosa and carbapenem and colistin resistant Klebsiella pneumoniae. These results can serve as a basis for the development of antimicrobial stewardship strategies in the current setting.

The plant world represents an important source of potential therapeutic agents, but concomitant administration of herbal and conventional medications may result in interactions with subsequent beneficial or adverse effects. This study was designed to examine the analgesic effect of thyme tincture and thyme syrup, two commonly used thyme formulations, and their interactions with codeine, paracetamol, pentobarbital and diazepam in mice. The identification and quantification of thymol and carvacrol were carried out by GC/MS and GC/FID. The analgesic activity was studied using a hot plate method. Effects of thyme syrup on diazepam-induced motor coordination impairment in rotarod test and on pentobarbital-induced sleeping time were also determined. Thymol (175.3 µg/mL and 9.73 µg/mL) and carvacrol (10.54 µg/mL and 0.55 µg/mL) concentrations were measured in tincture and syrup, respectively. Thyme syrup and tincture exhibited effective analgesic activity in the hot plate pain model. Pretreatment with thyme formulations reduced analgesic activity of codeine, and potentiated the analgesic activity of paracetamol. Co-administration of thyme formulations has led to potentiation of diazepam and pentobarbital depressive central nervous system effects. Thyme formulations interacted with tested conventional drugs, probably through interference with their metabolic pathways and succeeding altered concentrations and pharmacological effects.

Background. Attitudes towards conventional and complementary medicine among future healthcare professionals can impact their future pharmacotherapy practice. This study aimed to determine the prevalence and predisposing factors related to self-medication among medical and pharmacy students. Methods. This cross-sectional questionnaire-based study was performed at the Faculty of Medicine, University of Novi Sad, Serbia, on first- and final-year students of medicine and pharmacy. The multivariate Poisson regression model with robust variance was used to identify the main predictors of self-medication. Results. The overall self-medication prevalence in the past year was 81.3%. Independent risk factors for self-medication identified in the regression analysis were the final study year, housing condition, i.e., living in a leased apartment or in a student dormitory in comparison to living with parents, and cigarette consumption. The conventional drugs were the most frequently used, mostly for the symptoms of cold and pain. Final-year students had more confidence in conventional medicines than in herbal drugs and were more aware of the risks of their concomitant use. Conclusion. Self-medication is highly prevalent among students of medical sciences, especially among final-year students. Increased medical knowledge led to the higher awareness of the drug interaction risks.

Objective: Considering that adherence level affects diabetes treatment success and maintenance of glycemic control greatly, the aim of this study was to examine diabetes patients’ adherence to oral hypoglycemic agents (OHAs) and knowledge about their mechanism of action, dosing regimen, and side effects. Material and Methods: This cross-sectional study was conducted on a sample of 100 patients with type 2 diabetes in order to assess their knowledge of OHAs using anonymous questionnaires. Results: Most patients had used OHAs between 2 and 5 years (61.0%), where 78.0% were treated with metformin, and the remaining 22.0% were prescribed sulfonylurea derivatives. Besides drugs used for the treatment of type 2 diabetes, 58.0% of patients took another 1-3 drugs daily for the treatment of other conditions. Although 75.0% achieved a score of 5-6 out of the maximum score of 8, only 2.0% of respondents listed at least 2 side effects of the OHA they used, and none of them could explain its mechanism of action. Most of the information about OHAs was given to patients by endocrinologists (53.0%). Conclusion: More than half of participants considered their knowledge of OHAs insufficient. Results clearly indicate that the respondents were not sufficiently familiar with the mechanism of action and possible side effects of such medications. Information about OHAs given in written form as well as via community pharmacists would contribute to educating type 2 diabetes patients significantly.

Objective: This study aimed to examine the contents of home pharmacies and medication use, as well as storage and disposal habits in urban and rural households in Serbia. Material and Methods: This prospective research was conducted within 70 households in Novi Sad (urban setting) and Laćarak (rural setting) from October 1, 2015 to January 15, 2016. The data were collected using a standardized questionnaire, as well as by direct examination of drugs stored in households. Results: The most common groups of drugs stored were cardiovascular drugs, drugs for the nervous system, antirheumatic products and antimicrobials. A high percentage of drugs for the alimentary tract were found stored in Laćarak, while drugs for the respiratory tract were discovered in Novi Sad. Prescription only medications (POMs) made up 69.7% of all medications in Laćarak and 60.6% in Novi Sad. POMs were purchased independently in high amounts (13.2% in Laćarak and 9.1% in Novi Sad). Presence of expired medications was higher in Laćarak (12.0%) than Novi Sad (5.8%). Over two-thirds of the households stored medications properly; however, only 10.0% of respondents reported the proper disposal of unused medications. Conclusion: The structures of home pharmacies in Novi Sad and Laćarak differ, which implies different healthcare needs. The practice of self-medicating was noted both in Novi Sad and Laćarak. While Laćarak residents rely more on the advice of friends and family, Novi Sad residents buy medicine mostly without any consultation. Medications in both environments are stored properly in the majority of households, but mostly disposed of improperly together with household waste.

This study investigated the chemical and nutritional profile and antioxidative properties of cultivated Coprinus comatus . Proximate analysis revealed that C. comatus is rich in carbohydrates, dietary fibres and proteins, and could also be a valuable source of phenolics. Additionally, fat content is low, consisting mainly of polyunsaturated and omega-3 fatty acids. Furthermore, the safety profile of C. comatus is satisfactory, with all elements of toxicological importance within the proposed limits. Oral treatment with C. comatus for 42 days improved the antioxidant capabilities and ameliorated carbon tetrachloride-induced liver damage in rats, marked by decreased serum aminotransferase levels and lipid peroxidation intensity. Glutathione concentrations increased in a dose-dependent manner. Histological morphometric and immunohistochemical analysis confirmed antioxidative and hepatoprotective potential. These findings imply that cultivated C. comatus could be considered a nutraceutical, having beneficial nutrient and therapeutic properties.

Dietary supplements based on soybean extracts are widely used for a myriad of indications, but there is evidence that isoflavones, components of these supplements affect cytochrome activity. Alteration in pharmacodynamics of cytochrome-substrate drugs after co-administration with dietary supplements based on soybean extracts offers information on clinically significant herb-drug interactions that can cause unanticipated adverse reactions or therapeutic failures. Moreover, herbal drugs can contribute to the development and severity of drug-induced liver injury. Therefore, the aim of this study was to examine the effect of commercially available dietary supplements based on soybean extracts on liver and renal function, oxidative stress and pharmacodynamics of several conventional drugs. After quantification of isoflavones in the supplement using HPLC-DAD, pharmacological tests such as hot-plate, rotarod, pentobarbital-induced sleeping time were performed on Swiss albino mice treated with soybean extracts and several central nervous system acting drugs. Liver, renal function, and oxidative status in liver homogenates were determined in healthy and Wistar rats subjected to oxidative stress with CCl4. Dietary supplements based on soybean extracts weakened the analgesic activity of codeine, significantly potentiated diazepam-induced motor coordination impairment at 10th and 30th minute after diazepam administration, but had the opposite effect on alprazolam effect. Soybean extracts pretreated group also exhibited significantly shorter pentobarbital sleep induction and sleeping time. Soybean extracts administration did not affect the liver and renal function and ameliorated oxidative stress caused by CCl4. Despite exhibiting no negative effects on liver and renal function and demonstrated antioxidant in vivo potential, the safety of soybean extracts in addition to conventional drugs is questionable. The results of our study implicate the potential of dietary supplements based on soybean extracts for serious herb-drug interactions.

Background Worldwide data indicate that self-medication is frequently used inappropriately. Although self-medication is encouraged in most of the countries by introducing over-the-counter drugs, it bears the risk of misuse of drugs issued on prescription due to low observance of legislation of medicines requiring prescription by some pharmacies. Objective The objective of this study was to explore the self-medication practice, with an emphasis on self-medication with prescription-only medications. Setting Households in Novi Sad city, Serbia. Method The study was conducted over 8 month period (December 2011–July 2012) and involved a random sample of households. The questionnaire-based study and personal insight into household drug supplies was performed by a trained interviewer. Main outcome measure Number of drugs obtained without prescription or without consulting a physician in surveyed households. Results The total number of drug items present in the 383 households was 4,384 with a median of 11 drugs per household. More than a half of drugs in households were prescription-only medication (58.5 %). Approximately one third of prescription-only medications were obtained without prescription. The most common drugs obtained without prescription were anti-inflammatory and antirheumatic products and antibacterials for systemic use. Ibuprofen and diclofenac were the most common self-medicated drugs. Number of prescription-only medications bought with ought prescription was significantly higher in households with children under 12 years of age compared to other types of households. Conclusion Our survey indicated that self-medication with prescription drugs appeared to be a rather common practice, which is far away from the concept of “responsible self-medication”, especially regarding antibiotics.

Aims The aims of this study were to assess patients’ non-adherence and associated factors to antidiabetic medication in the primary care setting in the eastern part of Bosnia and Herzegovina (BiH). Methods We conducted a retrospective chart review of 323 patients with type 2 diabetes mellitus (T2DM) attending the primary health care center of the Foca municipality in eastern part of BiH and measured adherence to antidiabetic medication. Adherence was measured using a pill count method. Results The majority of patients were treated with oral therapy (84.21%). Half of the patients (48%) treated pharmacologically were non-adherent and patients on oral and insulin combination therapy showed better adherence than those on oral therapy. Age (B = −0.749; p = 0.004), copayment (B = 0.549; p = 0.028) and oral therapy (B = 0.827; p = 0.045) were the strongest predictors of poor adherence. Conclusion About half of the patients were non-adherent to antidiabetic medication. Interventions oriented towards policy changes regarding availability of antidiabetic medication through copayment reductions, and providing healt education to younger population and patients on oral therapy could lead to better adherence among T2DM patients in eastern part of BiH.

The purpose of this systematic review was to determine the practice of medication disposal around the world and get insight into possible association between environmental awareness and people's behavior regarding this issue. A literature search (2005-2015) was performed to identify reports with quantitative data on disposal practices published in peer-reviewed literature. The most common method for disposal of unused medications in households is disposal in the garbage (Kuwait, United Kingdom, Lithuania, Qatar, Serbia, Ghana, Bangladesh, Malta and Saudi Arabia). The practice of flushing drugs into the sewage system still takes place in New Zealand, USA and Bangladesh. Only in Sweden and Germany, practice of returning drugs to pharmacy was practiced to a larger extent. The environmental impact of improper medication disposal is expected in countries with poorly functioning waste management schemes (Middle Eastern, Asian and African countries). Lack of the adequate information and clear instructions on proper manners of drug disposal was reported in many surveyed countries (USA, New Zealand, Bangladesh, Malta and Ireland). Clear and definite connection between knowledge about environmental detrimental effects of improper drug disposal and the preference towards disposal methods could not be established. Many respondents were generally concerned with issues of inadequate medicines discarding but the behavior regarding disposal of unused drugs often did not equate the awareness (Serbia, USA, Kuwait, Malta and UK). The current data emphasizes the global issue of improper medicine disposal, prevalent in environmentally-aware people.

The purpose of this systematic review was to determine the practice of medication disposal around the world and get insight into possible association between environmental awareness and people’s behavior regarding this issue. A literature search (2005–2015) was performed to identify reports with quantitative data on disposal practices published in peer-reviewed literature. The most common method for disposal of unused medications in households is disposal in the garbage (Kuwait, United Kingdom, Lithuania, Qatar, Serbia, Ghana, Bangladesh, Malta and Saudi Arabia). The practice of flushing drugs into the sewage system still takes place in New Zealand, USA and Bangladesh. Only in Sweden and Germany, practice of returning drugs to pharmacy was practiced to a larger extent. The environmental impact of improper medication disposal is expected in countries with poorly functioning waste management schemes (Middle Eastern, Asian and African countries). Lack of the adequate information and clear instructions on proper manners of drug disposal was reported in many surveyed countries (USA, New Zealand, Bangladesh, Malta and Ireland). Clear and definite connection between knowledge about environmental detrimental effects of improper drug disposal and the preference towards disposal methods could not be established. Many respondents were generally concerned with issues of inadequate medicines discarding but the behavior regarding disposal of unused drugs often did not equate the awareness (Serbia, USA, Kuwait, Malta and UK). The current data emphasizes the global issue of improper medicine disposal, prevalent in environmentally-aware people.

Introduction The objective of this study was to investigate the knowledge, attitudes and behavior regarding antibiotics of the general population. Methods The study sample consisted of adult subjects who consulted general practitioners at health centers in Serbia and agreed to complete the questionnaire. A total of 668 questionnaires were distributed; 500 respondents completed the entire questionnaire (response rate 74.85%). Results The average age was 51.65 ± 16.56 years, 60.80% of the respondents were women. The median antibiotic knowledge score was 9. Predictors of adequate antibiotic knowledge were higher education level and a family member whose ocuppation was related to health-care. Overall, 58.4% of respondents believed that antibiotics could be used to treat common cold. Around a half of the respondents (47.2%) self-medicated with antibiotics at least once during their life-time, and around a quarter (24.2%) during the last treatment of infection. Patients with inadequate knowledge had 3 times higher chances of self-medicating with antibiotics compared to those with adequate knowledge. Although 98.20% of respondents claimed that antibiotic treatment should be started after a visit to a doctor and receiving a prescription, only 65.8% obtained antibiotics with prescription from a doctor during the last infection. Conclusions Although these results demonstrate that respondents had a relatively adequate level of knowledge regarding antibiotics use, some areas of misconceptions and improper behavior were identified. Therefore, further rationalization should be focused on educational campaigns targeting the behavior of patients with regard to antibiotic use.