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Introduction: In the spirit of maintaining health and seeking medicine to cure a disease, the question of halal and haram still needs to be answered. This coincides with the words of the Prophet Muhammad SAW “Verily Allah does not make your healing in what He has forbidden you” (HR. Imam Bukhari). The purpose of this quantitative study was to determine the effect of religiosity, perception, knowledge, and attitudes of Muslim doctors on the use of halal drugs in Indonesia.Materials and methods: This quantitative research method with correlational type examines the relationship between religiosity, perceptions, knowledge, attitudes, intentions, and behaviors that are shared online using google form. Data was measured using a Likert scale. A five-point Likert scale was used for statements: Strongly Disagree: 1, Disagree: 2, Uncertain: 3, Agree: 4, and Strongly Agree: 5. The sample size used was 435 Muslim doctors. The data obtained were then processed using the SmartPLS 3.0 application.Results: The results obtained are that there is a relationship between the religiosity of Muslim doctors on perceptions so as to encourage intention so that there is a change in behavior in the use of halal drugs in Indonesia. In addition, there is a relationship between knowledge and attitudes so as to encourage intentions that cause behavioral changes in the use of halal drugs in Indonesia by Muslim doctors. In fact, every practice depends on the intention, therefore it is important to maintain the intention, which in this study is influenced by perceptions and attitudes so that charity will result in commendable behavior that is blessed by Allah SWT. In addition, there is also a need for education about halal drugs that are appropriate to be taught at the medical faculty of Islamic universities in Indonesia.

Metabolites of Brazilian Cerrado species are considered an immense font of biologically active compounds The diversity of organic compounds generated by the secondary metabolism of various Cerrado plants draws attention especially because many of these compounds have the capacity to be structurally modified and, consequently, produce other very interesting derivatives for pharmacological purposes. Despite this, little is described in the literature about fast, easy, and accessible identification methods for any laboratory, such as infrared spectroscopy. In this sense, this work demonstrates the synthesis and elucidation through spectroscopic techniques of lapachol and its synthetic derivatives. Through quick and simple extractions or reactions, lapachol, β-lapachone, and hydroxy-hydrolapachol were obtained with adequate yields. From this, the main FTIR absorptions of the mentioned naphthoquinones are described, which facilitates the identification of these metabolites with high biological potential. The present work contributes could become a simpler source of data for extraction, synthesis, and spectroscopic characterization by FTIR of the compounds.

Chronic thromboembolic pulmonary hypertension is a notoriously underdiagnosed cause of severe pulmonary hypertension. It is a form of precapillary pulmonary hypertension (PH) that results from intraluminal thrombus organization and fibrous formation which ultimately results in the complete obliteration of pulmonary arteries, resulting in increased pulmonary vascular resistance which leads to the development of pulmonary hypertension and as a result right heart failure. The mechanism involves the narrowing of the pulmonary artery which increases blood pressure within the lungs and impairs blood flow which increases the workload of the right side of the heart ultimately causing right heart failure. Pulmonary hypertension can also cause arrhythmias, blood clots, and bleeding in the lungs. Even though CTEPH is a deadly condition, among all forms of pulmonary hypertension, CTEPH is the only curable form. Echocardiography is the initial assessment tool for suspected PH. A right heart catheterization may be performed to confirm the presence of pulmonary hypertension. Confirmation of CTEPH requires a V/Q scan. Although ventilation/perfusion scintigraphy has a major role in the evaluation of patients with suspected CTEPH, nowadays CTA chest is being used widely as it produces much better-quality images compared to V/Q scan. Without treatment, the prognosis is very poor. Out of three treatment modalities such as; pulmonary endarterectomy (PEA) surgery, balloon pulmonary angioplasty (BPA), and medical therapy, surgery is the gold standard. The physician must be familiar with the disease entity, early diagnosis, and appropriate treatment to improve survival. Here we present a literature review on this topic.

Mowat-Wilson Syndrome (MWS) is an autosomal dominant genetic syndrome caused by mutations in the ZEB2 gene. It is characterized by distinctive facial appearance, intellectual disability (ID), epilepsy, Hirschsprung disease (HSCR), and other congenital anomalies. The psychiatric symptoms, associated with MWS have rarely been reported. The following report highlights a case of schizoaffective disorder in a 24-year-old male with MWS and the challenges he encountered over his treatment course.After considering numerous diagnoses including bipolar disorder and psychosis secondary to a general medical condition, the patient was diagnosed with schizoaffective disorder. Various trials consisting of atypical antipsychotics and mood stabilizers were unsuccessful in managing his symptoms. Eventually, the patient stabilized on a medication regimen consisting of clozapine 300 mg once daily, topiramate 75 mg twice per day, and lithium 1800 mg once daily. This case report documents co-occurrence of MWS and Schizoaffective disorder.

Fructus Amomi is “one of the top four south authentic Traditional Chinese Plant Medicines”, widely distributed in tropical and subtropical districts of China, such as Fujian, Guangdong, Guangxi, Hainan, etc., which has ever been used in clinical for treatment of the digestive diseases. In addition, it has also been used as spices. In recent years, some research about its components together with pharmacological activities have been reported. In this Mini review, we mainly describe the recent progress of the components and pharmacological activities of Fructus Amomi, to provide the reference for the relevant researchers.

Thousands of tons of biodegradable organic waste generates in urban and rural areas every day, creating disposal problems. Urban organic waste can be converted into valuable output products (vermicompost, vermin-liquid, and earthworms) by applying a vermicomposting technique that had different. Implementing green roofs via soilless culture systems as micro-scale farms led to increasing natural resource use efficiencies as well as producing fresh food. The integration of both techniques will create not just reduce pollution and climate change impacts but also for increasing food production and security in urban, enhance the lifestyle and increase public awareness of environmental issues. This process is profitable at any scale of operation.

Objective: To assess the knowledge, attitudes, and skills in pre-hospital care and emergency medicine of doctors, nurses and Emergency Medical Technicians (EMT), who accompanied emergency patients in ambulances? Methods: A descriptive cross-sectional study was conducted among the doctors, nurses, and EMT who accompanied emergency patients in ambulances to the National Hospital. All ambulances arriving from August to October 2008 (n=409) were screened. A self-administered questionnaire with 30 items was used to assess knowledge, attitudes, and skills. The knowledge was categorized into three levels, EMT-basic level, EMT-intermediate level, and EMT-paramedic level and the scores were converted into the percentages. Results: The overall knowledge score on basic, intermediate and paramedic level were 57.5%, 42.9%, and 33.9% respectively. The knowledge on airway management (84.3%), bleeding control (82.9%), patient transport (71%) and first aids (61%) at the EMT-basic level were higher, however oxygen administration (37.1%) and basic life support (38.6%), spinal immobilization (45.7%), traction splinting (47%) and triage (48.6%) were lower. For the EMT-intermediate level, knowledge on endotracheal intubation (41.4%) and initial cardiac drug therapy (44.3%) were low. For the EMT-paramedic level, the knowledge on the advanced respiratory support (53%), ECG interpretation (37%), pharmacology (13%) and paediatric life support (20%) were lower. Most staff showed positive attitudes towards the need of basic knowledge in pre-hospital care (97.1%, n=34), need for proper training (97.1%, n=34) and cost for pre-hospital care (77.1%, n=27), while they showed relatively negative attitudes towards the outcome of pre-hospital care (74.3%, n=26). For the required skills for advanced life support, most of the staff showed skills in IV cannulation (71.4%, n=25) and IV drug administration (71.4%, n=25) however less skills were shown cricothyroidotomy (22.9%, n=8), pleural drainage (25.7%, n=9) and laryngoscopy and intubation (31.4%, n=11). Conclusion: The knowledge at the EMT-basic level was average and intermediate and paramedic levels were lower than average. The attitudes were generally positive. However they lacked some specific skills.

The increasing occurrence of wastewaters associated with industrial development has begotten a permanent search for new and more efficient techniques for the removal of hazardous substances such as heavy metals and dyes. The use of natural and available resources to develop improved and sustainable commodities for this purpose remains crucial and is among promising emerging green technologies for water treatment. It offers the gradual shifting of hazardous industrial chemicals precursors to the abundant non-metallic mineral resources that receive an added value. This work investigated the uptake capacity by the adsorption process of methylene blue (MB) and azocarmine G (AG) onto nano-silica synthesized from kaolinite clay. The effects of contact time (0-30 min), the adsorbent dosage (5-100 mg), the initial pH of the solution (1-11 for MB and 1-7 for AG), and the initial dye concentration (5-50 mg/L) were studied. The selected conditions to carry out kinetic and isotherm adsorption experiments were: 15 mins, 20 mg, 11 for MB, 1.01 for AG, and 50 mg/L. Four adsorption isotherms and three kinetic models were used to model the adsorption data thanks to linear and non-linear regression methods. From the obtained results, the Freundlich isotherm model fitted well the adsorption phenomenon while the pseudo-second-order kinetic model described well the adsorption mechanism. Furthermore, the free energy of adsorption was similar for the two absorbents, 0.71 kJ, pointing physisorption as the dominant adsorption mechanism. The optimum MB and AG uptake were respectively 13.8 and 36.1 mg/g. Conclusively, the nano-silica represents a potentially viable and powerful adsorbent whose use could lead to a plausible improvement in environmental preservation.

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a major limiting side effect of many common chemotherapeutics often leading patients to terminate their chemotherapy treatment regimen early. The development of CIPN differs by chemotherapeutic class, with platinum- and taxane-based treatments demonstrating the highest incidence rates. Despite its relatively high prevalence, there are currently no FDA-approved treatments for CIPN, and clinicians must rely on the off-label use of several analgesics and various non-pharmacological approaches to treat CIPN symptoms in patients. Novel insights on the development of CIPN have identified new drug targets leading to several Phase II clinical trials to be initiated. Here, we describe recent advances in drug development for CIPN.

Background: There is enough evidence to suggest that vancomycin increases the risk of acute kidney injury (AKI) but the exact mechanism is not well understood. This study aims to understand the incidence of vancomycin-associated acute kidney injury (VA-AKI) among hospitalized patients and to identify the risk factors for VA-AKI. Methods: Patients aged 18 and above who received a minimum of 24 hours of intravenous vancomycin and who had serial creatinine measurements over a 13-month period were identified through electronic records. Patients with pre-existing AKI, or eGFR of less than 30ml/min, and patients with end stage kidney disease were excluded. Results were analyzed using t-test and Fisher’s test. A logistic regression model was used to identify the predictors for VA-AKI. Results: From the 598 patients who met the inclusion criteria, 70 developed AKI. Compared to those without AKI, patients with VA-AKI had higher mean serum vancomycin trough levels (22.6 mg/L vs. 14.6 mg/L), and a statistically significant longer duration of vancomycin use (6.7 vs. 5.2 days). Multivariate analysis revealed that serum vancomycin level of > 20 mg/L was associated with a six-fold increase in odds of VA-AKI when compared to those with vancomycin levels < 15 mg/L. The presence of hypotension, iodinated contrast use, and concomitant use of piperacillin-tazobactam were all associated with increased odds of VA-AKI. Conclusion: The incidence of VA-AKI in hospitalized patients with eGFR > 30 ml/min was 11.7%. Serum vancomycin levels of > 20 mg/L, hypotension and administration of iodinated contrast significantly increased the risk of VA-AKI. Piperacillin-tazobactam, when used with vancomycin, was noted to be an independent predictor of AKI, regardless of serum vancomycin trough levels, prompting a reevaluation of the safety of this widespread practice as empiric therapy. Close monitoring of kidney function, avoiding high serum vancomycin levels, maintaining hemodynamic stability, and avoiding unnecessary use of iodinated contrast seem to be essential for the prevention of VA-AKI.