A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the requirements for the degree of Master of Science in Medicine in Pharmaceutical Affairs Johannesburg, South Africa 2017 / In the Republic of South Africa codeine containing medicines are either sold as prescription only medicines or over the counter depending on the strength of codeine contained in the medicine. The analgesic properties of codeine are thought to be derived from the conversion of codeine to morphine. Codeine is often combined with nonsteroidal anti-inflammatory drugs (NSAIDs).Codeine is a relatively weak opioid analgesic that has seemingly addictive properties; the misuse of codeine-containing-medicines can cause morbidity in patients with known codeine addiction. The Regulation of codeine has been reviewed in a number of countries to try and curb the misuse of the product. This involves the reduction in the strength of codeine, reduction in the package size and duration of treatment of over-the-counter (OTC) codeine containing products and in some countries the OTC codeine containing products have been rescheduled into prescription only medicines. The study aims to monitor and describe trends in the sales of OTC codeine-containing medicines from Pick n Pay retail pharmacies in Gauteng, Western Cape and KwaZulu Natal provinces of South Africa from July 2011 to June 2014. Secondary data on the sales of OTC codeine-containing medicines from Pick n Pay Pharmacies database was obtained, which described the(1) pharmacy name, (2) the trade name of the medicine items sold, (3) the quantities of the medicines sold, (4) the purchase date of medicine, (5) the cost of the medicine, (6) the age of the purchaser, (7) the gender of the purchaser and (8) the mode of payment used when purchasing for the study period. A statistical software system, SPSS® version 20 was used to analyse the data. The study findings indicate a steady increase in the sales of the OTC codeine containing medicine over the years. Females were found to be the main purchasers of these products and the age group which purchased most of the products is the 40 to 45 years age group. The top three selling brands of the OTC codeine containing medicines were found to be Genpayne Capsules (30%), Myprodol Capsules (27%) and Mybuline Tablets (14%) of all the sales of these products in the three provinces combined. The mode of payment used for these purchases was mainly cash payment which accounted for sixty-five percent of the payments. There is a need to review the Codeine Car Initiative to monitor and audit the sales of these products so as to make an informed decision on their appropriate regulation. / MT2017

Thesis (Ph. D.)--University of Rhode Island, 2002. / "... presents a comprehensive analysis of the classification of nonprescription medicines and Rx-to-OTC switch criteria policy in the United States, United Kingdom, Canada, Japan and Australia."--abstract. Includes bibliographical references (leaves 245-251). Also available on the internet.

Book Summary: The Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care contains the most authoritative information on nonprescription drug pharmacotherapy, nutritional supplements, medical foods, nondrug and preventive measures, and complementary therapies. The 18th edition shows students and practitioners how to assess and triage a patient's medical complaints. And it provides FDA-approved dosing information for nonprescription medications along with evidence-based research on the efficacy and safety of over-the-counter, herbal, and homeopathic medications.

Dysmenorrhoea, defined as cramping pain in the lower abdomen occurring during menstruation, is known to affect up to 90% of women of childbearing age to varying degrees. The underlying causes of this condition are believed to be due to a number of factors, but are mainly attributed to increased myometrial activity, increased prostaglandin production and hormonal influences. Although there are pharmaceutical treatments available, they mainly concentrate on symptomatic relief, with the main treatment being the use of non-steroidal anti-inflammatory drugs (NSAIDs) to directly relieve the pain. Other treatments include the use of the combined oral contraceptives which are believed to influence myometrial contractility via regulation of hormonal activity. However due to the gastric and contraceptive side effects of these treatments respectively, other alternative treatments are becoming increasingly popular. One such treatment is the use of Bak foong pills (BFP), a traditional Chinese medicine used in China for the treatment of various gynaecological disorders including primary dysmenorrhoea. The aims of the current project were therefore to highlight the major beneficial effects of BFP and attempt to elucidate its major mechanisms of action in treating dysmenorrhoea. / The study demonstrated that BFP's anti-dysmenorrhoeal properties were due to a combination of hormonal, myometrial relaxant and analgesic effects. Treatment of mice with BFP caused an estrogen-like effects as demonstrated with increased cystic fibrosis transmembrane conductance regulator (CFTR) mRNA expression. Furthermore, serum estrogen and progesterone levels were also elevated in BFP treated rats. BFP was also able to significantly reduce myometrial contractions, indicating that BFP's anti-dysmenorrhoeal effect may be aided by reduced contractility of the myometrium following treatment. The uterine relaxation caused by BFP was not dependant on increases in nitric oxide or cAMP, but appeared to affect calcium mobilization. Investigation of the analgesic effect of BFP, assessed using a visceral pain model in mice showed that following sub-chronic (72 hour) treatment with BFP, there was a significant reduction in pain response, demonstrating that BFP had direct analgesic effect. (Abstract shortened by UMI.) / Rowlands Dewi Kenneth. / "July 2005." / Adviser: Hsiao Chang Chan. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3533. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 148-165). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

Brain stroke is considered as one of the three diseases that threaten human health all over the world. Hypertension and cerebral arteriosclerosis are thought to be the most dangerous risk factors of brain stroke, and they frequently occur together, leading to ischemia of brain tissue. Unfortunately, it is not clear whether the pathological changes resulting from hypertension are related to those resulting from cerebral arteriosclerosis. There have been no ideal animal models mimicking the pathological changes in such a combined condition. In this thesis, an animal model of hypertension combined with cerebral arteriosclerosis in rats was established by occlusion of both the left and right common carotid arteries in spontaneous hypertension rats. Pien Tze Huang (PTH), a reputed traditional Chinese medicinal complex, contains Radix notoginseng, snake bile, calculus bovis, and musk and some other components that are known to protect vessels and cells from injuries. Since different tissue injuries share many common cellular mechanisms, the protection by PTH to in nerves and the circulation systems may also be benefical to cerebrovascular conditions as well. In present experiments, PTH was used to treat hypertension rats that also developed chronic brain ischemia as a result of the bilateral carotid occlusion, and its protective role for neurons and blood vessels was investiaged. / From the data above, more severe damage could be caused by hypertension combined with chronic ischemia. The model of SHR with bilaterally occluded common carotid artery can be used to study pathological changes resulted from hypertension combined with chronic ischemia. PTH was able to protect neurons in stroke. / In the initial part of the work, patients from clinics in two cities in South and North China were compared and analysed; they had been suffering from brain ischemic stroke. About two thirds of the stroke patients were found to have hypertension before the onset of stroke. Their prognosis was significantly worse than those stroke patients without hypertension. In the hypertensive rats with occluded arteries, mean of functional magnetic resonance imaging (fMRI) examination showed that brain blood flow was very weak or even transiently became undetectable at the beginning of the acute stage of brain ischemia, but was restored one hour after the occlusion surgery. In addition, pathological changes in brains of hypertensive rats with induced brain ischemia (carotid occlusion) were examined by Nissl staining, TUNEL staining, cell death ELISA and anti-oxidation enzymes. At day 15 after ischemia, a large number of pyramid cells in the hippocampus of SHR were lost and a great deal of apoptotic cells were found in the CA1 of the hippocampus, while activities of some enzyme including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) were increased. At day 30 and 60, some degenerative changes appeared to have subsided and the cells appeared morphologically normal. The activities of the above enzymes were also decreased at day 60. In WKY control rats with normal blood pressure, neurons in the CA1 were found less damaged after the bilateral carotid occlusion. It was found that apoptotic and dead cells were significantly reduced in rats with hypertension combined with chronic brain ischemia if they had been pre-treated with PTH. Moreover, brain stroke damage was less severe in this pretreated rats. / Zhang, Lihong. / "March 2010." / Adviser: WH Kwong. / Source: Dissertation Abstracts International, Volume: 72-01, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 116-134). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Submitted by Rosangela Silva (rosangela.silva3@unioeste.br) on 2018-06-25T17:26:39Z No. of bitstreams: 2 Giulia Rechia Vasconcelos da Rosa.pdf: 1665574 bytes, checksum: d99a127a8e7bd4287f3110e3ca19d9fd (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-06-25T17:26:39Z (GMT). No. of bitstreams: 2 Giulia Rechia Vasconcelos da Rosa.pdf: 1665574 bytes, checksum: d99a127a8e7bd4287f3110e3ca19d9fd (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-04-15 / Objetivo: Esta revisão sistemática e meta-análise foi realizada para avaliar a mudança de cor, risco e intensidade da sensibilidade dentária (SD) e irritação gengival (IG) e satisfação do paciente comparando tiras de clareamento dental em relação ao clareamento caseiro ou de consultório em pacientes adultos de qualquer idade. Fontes: Em 10 de agosto de 2017, efetuou-se uma pesquisa abrangente no MEDLINE via PubMed, Cochrane Library, Biblioteca Brasileira de Odontologia, banco de dados de Literatura em Ciências da Saúde da América Latina e Caribe (LILACS) e bancos de dados de citações, Scopus e Web of Science. Os resumos do International Association for Dental Research (IADR) (1990-2017), registros de ensaios inéditos e em curso, dissertações e teses também foram pesquisados. Seleção do estudo: Foram selecionados artigos relevantes que avaliaram Ensaios Clínicos Randomizados (ECR’s) paralelos e boca-dividida que compararam fitas clareadoras com clareamento caseiro ou de consultório em pacientes adultos de qualquer idade. Todos os artigos foram publicados antes de 10 de agosto de 2017. Foram identificados 4586 estudos e dois revisores realizaram a remoção de duplicatas, seleção de título e rastreamento de resumo, restando 14 estudos a serem incluídos na análise. A meta-análise foi realizada para a mudança de cor (ΔE*, ΔSGU), risco e intensidade de SD, risco de IG e satisfação do paciente, a partir de Escala Analógica Visual (EAV) usando modelo de efeitos aleatórios. Não houve diferença significativa na escala subjetiva com escala de cores (ΔSGU), risco e intensidade de SD, risco de IG e satisfação do paciente (p > 0,05). Porém, na escala objetiva com espectrofotômetro (ΔE), a mudança de cor foi maior no grupo de clareamento caseiro com peróxido de carbamida em comparação ao uso de fitas. Conclusão: Apesar de não ter sido identificada diferença nos tratamentos, deve-se interpretar esse resultado com cautela em vista escassez de ECR’s comparando tratamentos clareadores supervisionados com fitas clareadoras com baixo risco de viés. Relevância Clínica: Apesar da efetividade equivalente entre os tratamentos clareadores avaliados, na avaliação de ΔE*, o clareamento caseiro com peróxido de carbamida demonstrou melhor resultado em mudança de cor quando comparado com as fitas. Porém, este estudo não pode afirmar este resultado devido a alta varibialidade dos protocolos e presença de poucos estudos com baixo risco de viés. / Objective: A systematic review and meta-analysis were performed to evaluate the color change, risk and intensity of tooth sensitivity (TS), risk of gingival irritation (GI) and patient’s satisfaction comparing whitening strips versus dental bleaching in adult patients of any age made at home or in office. Methods: On August 2017 the literature was elletronically searched in MEDLINE via PubMed, Cochrane Library, Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature database (LILACS) and citation databases, Scopus and Web of Science. Abstracts from International Association for Dental Research (IADR) (1990–2017) unpublished and ongoing trials registries, dissertations and thesis were also searched. Study selection: It was selected relevant articles that evaluated parallel and split-mouth Randomized Clinical Trials (RCTs) that compared whitening strips versus dental bleaching made at home or in office in adult patients of any age group. All articles were published only before August 10th, 2017. 4586 studies were identified and two reviewers removed the duplicates, title and abstract screening, remaining 14 studies to be included on analysis. As Meta-analysis was conducted for color change in objective scale (ΔE*) and subjective scale (ΔSGU), risk and intensity of TS and risk of GI with Visual Analog Scale (VAS), and patient’s satisfaction using random effects model. No significant difference in ΔSGU, risk and intensity of TS, risk of GI and paient’s satisfaction was observed (p > 0.05). However in ΔE* evaluation, color change was higher on the tray group with carbamide peroxide when compared to strips group. Conclusion: Although no difference was identified in the comparative treatments, this result should be interpreted with caution in view of the existence of few ECRs comparing supervised bleaching treatments with whitening tapes with low risk of bias. Clinical Relevance: Despite the equivalent effectiveness among the bleaching treatments evaluated, on ΔE* evaluation, there was higher color change for at-home with carbamide peroxide group. However, this study cannot confirm this result due to the high varibiality of the protocols and the presence of few studies with low risk of bias.