Pharmaceutical Sciences

The use of field grown plants as a direct source of explant material for the production of 'clean' in vitro plantlets, presents a major challenge. Surface sterilization trials were conducted using nodal explants of guinea hen weed (Petiveria alliacia), jack-in-the-bush (Eupatorium odoratum), spanish needle (Bidens pilosa), rice bitters (Andrographis paniculata), mint (Mentha viridis), lantana (Lantana camara), vervine (Stachytarpheta jamaicensis), french thyme (Plectranthus amboinicus), dog blood (Rivina humilis), and broom weed (Cassia jamaicensis) selected from mature field grown plants. Use of acidified bleach (pH 7) produced the largest reduction in bacterial and fungal contamination.

Juice squeezed from cereal grasses harvested at the jointing stage, i.e., wheatgrass (Triticum aestivum), exhibits high antioxidant activity. Rice (Oryza sativa) may also exhibit antioxidant activity. We therefore examined the antioxidant activity of juices squeezed from grasses harvested at the jointing stage for seven coloured and seven white Thai rice cultivars. The antioxidant activity was determined using 2,2-diphenyl-1-picrylhydrazyl, ferric reducing antioxidant power, β-carotene bleaching, and thiobarbituric acid reactive substances assays. The total phenolic content (TPC) and total monomeric anthocyanin content (TMAC) were also determined. Coloured (purple) rice grass juices exhibited greater antioxidant potential than the grass juices from white rice and wheat. The coloured rice cultivar Kum Doisaket exhibited the highest antioxidant activity in all assays. Correlation analysis indicated that the TPC and TMAC could be responsible for the antioxidant activity. The DNA protective properties of the coloured rice cultivars Kum Doisaket and Kum Noi and wheat were also examined. Only the Kum Doisaket cultivar exhibited a dose-dependent DNA protective effect. The notable antioxidant efficacy for the Kum Doisaket cultivar may be influenced by the high level of anthocyanins present in its grass juice. This finding suggests the possibility of developing functional foods from coloured rice grass.

after the onset of dialysis. Thereafter, the risk of death increased on PD patients. Results were consistent in different propensity score models and in sensitivity analyses. CONCLUSIONS: In conclusion, there was an initial survival advantage of PD compared with HD among younger or non-DM patients. As the increase in age, with the presence of DM, and vintage, this relative survival advantage vanished, and even reversed.

A435 population-based cohort to inform health care planners on trends in costs and resource needs related to fractures. METHODS: We used the Population Health Research Data Repository for the Province of Manitoba, Canada which is a comprehensive collection of databases including physician visits, hospitalizations and pharmaceutical prescriptions. Age and sex-adjusted fracture rates were calculated for men and women age fifty years and older from 1986 to 2006 according to fracture site (defined by ICD-9-CM codes) and mechanism (presence/absence of ICD-9-CM external injury codes). Generalized linear models with generalized estimating equations were used to derive adjusted annual rates and test the linear change overall, and for men and women separately. RESULTS: Osteoporotic fractures (non-traumatic fractures of the hip, forearm, spine and humerus) showed a significant linear decline (0.8% per-annum [95% CI 0.3-1.2%]), with a greater decline in women (1.0% [0.4-1.7%]) than in men (0.5% [0.0-1.3%], P .05 for sex interaction). Similar trends were seen for all fractures sites: hip 0.9% (0.2-1.7%), forearm 0.8% (0.4-1.3%), humerus (0.7% [0.2-1.2%]) and spine (0.5% [0.0-1.0%]) A greater reduction in traumatic fractures was observed (1.8% per-annum [95% CI 1.0-2.6%]), with a greater decline in men (2.2% [1.3-3.1%]) than in women (1.3% [0.2-2.4%], P .05 for sex interaction). Similar results were seen when testing the difference between the initial 5 years (1986)(1987)(1988)(1989)(1990)(1991) and the final five years (2001)(2002)(2003)(2004)(2005)(2006) of data. CONCLUSIONS: We observed a decrease in both non-traumatic (osteoporotic) and traumatic fracture rates over the study period. This decline was apparent in years prior to widespread osteoporosis testing or availability of modern pharmacotherapy. OBJECTIVES: It has been reported that bone fracture the risk of developing increases for patients who had fractures once before, and and that such patients do not receive enough osteoporosis treatment. In this present study, we investigated incidence of recurrent fractures and the circumstances of pharmacotherapy for osteoporosis among patients who had experience first hip fracture. METHODS: Female patients 65 years and older who had experienced first hip fractures from January 1, 2006 to December 31, 2007 were enrolled at 25 hospitals.We reviewed their medical records and conducted a patient survey to collect information on surgical methods, osteoporosis treatments and prognosis for 1 year after first hip fracture.The questionnaires were filled out by either the patient or family member. This interim analysis was conducted for 477 patients of 7 hospitals out of 2,266 enrolled patients. RESULTS: The average age was 84.0 (66-103) years old. In terms of fracture type, we identified 237 cervical cases and 237 intertrochantric fractures, with 3 cases that were not specified. A total of 94.3 % of the patients received an operation. During hospitalization, 26.2% were on pharmacotherapy and 22.9% received no pharmacotherapy. For the observational period, 1 year after first fractures, 13.4% of the patients received pharmacotherapy, but 57.2% received no treatment. For the observational period, 44 patients (9.2%) experienced recurrent fractures and 18 (3.8%) out of those suffered hip fractures. CONCLUSIONS: In this study, the incidence of recurrent hip fractures among patients who have already experienced a first hip fracture was 3,800/100,000 person-year. This is 7.4 times the rate found in the general population of the same age group. Despite this increase in incidence rate, only 13% of patients had received osteoporosis treatment after the first hip fracture. Japanese patients who have already suffered from a first hip fracture must be considered high risk patients who should be treated with preventive action. OBJECTIVES: Osteoporosis is characterized by low bone mass and increased fracture risk. Increased mortality rates have been documented following fractures, particularly hip and vertebral. Our aim was to compare short-term and long-term mortality rates following an incident fracture in men and women at different sites (hip, wrist, spine, humerus and others). METHODS: We identified a population-based cohort of men and women with non-traumatic incident fractures between 1986 and 2006 within the hospital, physician and pharmacy administrative database repository of the Province of Manitoba, Canada. The cohort-entry date was the date of a first fracture (index fracture) after age 50 years. Two matched controls from the same databases were identified for each case. Crude and adjusted mortality rates for each fracture site were computed separately for men and women. Secular trends in fracture site-specific mortality rates over the study period were tested using generalized linear models. RESULTS: We identified 23,514 index fractures in men and 52,897 in women. The crude mortality rates were consistently higher in men compared to women. Highest first year mortality rates were noted after hip (women 20.1% vs. men 33.6%) followed by spine fractures (13.9% vs. 15.8%), with lower mortality rates after humerus (7.4% vs. 15.3%), wrist (3.4% vs. 5.3%) and other fractures (9.2% vs. 11.0%). Similar rankings by fracture site were seen for year five mortality: hip fractures (women 53.1% vs. men 66.7%) followed by spine (38.4% vs. 43.1%), humerus (26.6% vs. 41.2%), wrist (15.7% vs. 21.2%) and other fractures (26.5% vs. 29.3%). Post-fracture mortality rates were generally stable over the study period. CONCLUSIONS: Fractures at all sites are associated with significant mortality rates, particularly in men. Better understanding of factors associated with increased post-fracture mortality will inform the development of practice guidelines and improved clinical outcomes.

Objective: To compare the cost utility of using erythropoietin (EPO) to maintain different hemoglobin (Hb) target levels in hemodialysis patients from a societal perspective. Methods: A Markov model was used to estimate the incremental cost and quality-adjusted life-year of five Hb levels: 9 or less, more than 9 to 10, more than 10 to 11, more than 11 to 12, and more than 12 g/dl. A systematic review of EPO treatment in hemodialysis patients was conducted to estimate transitional probabilities. Cost data were estimated on the basis of the reference price of Siriraj Hospital, the largest university hospital in Thailand. Utility scores were derived from the six-dimensional health state short form (derived from short-form 36 health survey), which were collected from 152 hemodialysis patients receiving EPO at Siriraj hospital. Probabilistic sensitivity analysis was conducted to investigate the effect of uncertain parameters. All future costs and outcomes were discounted at the rate of 3% per annum. Results: The incremental cost-effectiveness ratios of Hb levels more than 9 to 10, more than 10 to 11, more than 11 to 12, and more than 12 g/dl compared with the least costly option (Hb r 9 g/dl) were US $24,128.03, US $18,789.07, US $22,427.36, and US $28,022.33 per quality-adjusted lifeyear, respectively. From probabilistic sensitivity analysis, the hemoglobin level of more than 10 to 11 g/dl was appropriate when the willingness to pay was US $15,523.88 to US $46,610.17 and the probability of cost-effective was 29.32% to 95.94%. Conclusions: Providing EPO for a hemoglobin level of more than 10 to 11 g/dl had a cost-effectiveness higher than that of doing so for other hemoglobin levels. This finding will be put forward to the policy level to set up the EPO treatment guideline of the hospital for hemodialysis patients.