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Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

This scientific article aims to evaluate the efficacy of the drug Doxorubicin for treating hepatocellular carcinoma (HCC) in Egypt. The study analyzes data from patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University. The study includes 40 intermediate-stage HCC patients who underwent treatment with either Doxorubicin-Lipiodol or Doxorubicin-loaded drug-eluting beads-trans-arterial chemoembolization (DEB-TACE).

Patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University with a possible diagnosis of HCC in the intermediate stage were eligible for the study.

The study finds that the plasma peak concentration of Doxorubicin is significantly higher in patients treated with Lipiodol compared to those treated with DEB-TACE. The median plasma peak concentration of patients treated with Lipiodol was significantly higher 424 (202.5–731) than the peak level of patients treated with beads 84.95 (26.6–156.5) with p-value = 0.036. However, there is no significant difference in other pharmacokinetic parameters between the two treatment groups. The research article also investigates the genetic polymorphisms in HCC patients treated with Doxorubicin-Lipiodol and Doxorubicin-loaded DEB-TACE. It identifies a significant association between the ABCB1 gene (C3435T) and the concentration of Doxorubicin in plasma. Patients with the CCand computed tomography (CT) genotypes of ABCB1 have higher concentrations of Doxorubicin compared to those with the TT genotype. Furthermore, the study examines the progression-free survival rates and tumour response in the two treatment groups. It demonstrates that DEB-TACE patients have a higher progression-free survival rate compared to cTACE patients. DEB-TACE also leads to better tumour regression.

The current study helps to increase the understanding of the genetic factors that may contribute to HCC susceptibility in the Egyptian population. However, it is essential to consider that genetic polymorphism is just one aspect of HCC risk, and other factors such as environment, lifestyle and viral infections also play crucial roles. Further research is needed to elucidate the complex interactions between genetic and environmental factors in HCC development among Egyptians.

This study aims to study the distribution characteristics of antibiotic resistance in direct-eating food and analysis of Citrobacter freundii genome and pathogenicity. Residual antibiotics and antibiotic resistance genes (ARGs) in the environment severely threaten human health and the ecological environment. The diseases caused by foodborne pathogenic bacteria are increasing daily, and the enhancement of antibiotic resistance of pathogenic bacteria poses many difficulties in the treatment of disease.

In this study, six fresh fruits and vegetable samples were selected for isolation and identification of culturable bacteria and analysis of antibiotic resistance. The whole genome of Citrobacter freundii isolated from cucumber was sequenced and analyzed by Oxford Nanopore sequencing.

The results show that 270 strains of bacteria were identified in 6 samples. From 12 samples of direct food, 2 kinds of probiotics and 10 kinds of opportunistic pathogens were screened. The proportion of Citrobacter freundii screened from cucumber was significantly higher than that from other samples, and it showed resistance to a variety of antibiotics. Whole genome sequencing showed that Citrobacter freundii was composed of a circular chromosome containing signal peptides, transmembrane proteins and transporters that could induce antibiotic efflux, indicating that Citrobacter freundii had strong adaptability to the environment. The detection of genes encoding carbohydrate active enzymes is more beneficial to the growth and reproduction of Citrobacter freundii in crops. A total of 29 kinds of ARGs were detected in Citrobacter freundii, mainly conferring resistance to fluoroquinolones, aminoglycosides, carbapenem, cephalosporins and macrolides. The main mechanisms are the change in antibiotic targets and efflux pumps, the change in cell permeability and the inactivation of antibiotics and the detection of virulence factors and ARGs, further indicating the serious risk to human health.

The detection of genomic islands and prophages increases the risk of horizontal transfer of virulence factors and ARGs, which spreads the drug resistance of bacteria and pathogenic bacteria more widely.

The purpose of this study is to understand the complex interplay between illicit opioids trade and consumption practices and state policies that aim to reduce their misuse.

The study adopted an exploratory design. Data were gathered through in-depth interviews with 31 commercially oriented drug dealers in Uyo, Nigeria. The framework approach was used in data analyses, while “friction” provided the interpretive lens.

Accounts revealed public concerns over the misuse of tramadol and other opioids among young people and the associated health and social harms. These concerns provided support for enforcement-based approaches to prescription opioids control, including police raids on pharmacy stores. These measures did not curtail opioids supply and consumption. Instead, they constrained access to essential medicines for pain management, encouraged illegal markets and fuelled law enforcement corruption in the form of police complicity in illegal tramadol trade.

The findings reveal the frictions of drug control in Nigeria, wherein enforcement-based approaches gained traction through public concerns about opioids misuse but also faced resistance due to the persistence of non-medical use and illegal supply channels made possible by law enforcement complicity. These indicate a need to prioritize approaches that seek to reduce illegal supply and misuse of opioids while ensuring availability of these medications for health-care needs.

The study is unique in its focus on the creative tension that exists between state control measures and local opioids supply and consumption practices.

The purpose of this study is to examine the politics, political economy, and fallout of hawkish regulatory policy on prescription drugs in Nigeria. Hawkish regulatory policy on prescription drug in Nigeria, such as opioid analgesics, is a very complex and multifaceted one, which usually involves the interplay of many factors and parties.

Policy manuals, official government gazettes (legislations, regulations, Acts and decrees), academic literature and a direct ethnographic observation of events surrounding the regulation of prescription drugs were reviewed and engaged.

The results revealed that Nigerian and global political economy and politics interface to define the direction of the new restrictive opioid policy, with resultant friction between prohibition and consumption. The reviews showed that the overarching “get-tough” and “repressive” policy are not necessarily founded on empirical evidence of an increase in prescription drug sales or use, but more as a product of the interplay of both internal and external politics and the prevailing socioeconomic order.

Instead of borrowing extensively from or being influenced by repressive Western drug laws and perspectives, Nigerian policymakers on prescription opioids should take control of the process by drawing up a home-grown policy that is less intrusive and punitive in nature for better outcomes. A mental sea change is required to understand the intrigues of Western power in Nigeria’s politics and political economy to avoid the continuous symptomatic failure of drug policy.

The politics and economic influence of the United Nations, USA and Western powers, as well as the axiom of moral panic of prescription drugs scares within the Nigerian environment, are particularly significant in the making of the emerging hawkish policy on prescription drugs in Nigeria.

Given the historical legacy of policing Black bodies, this research focuses on the structures of anti-Blackness within school policing and the strategies students of Color activists use as they work to defund or abolish police departments in the Los Angeles Unified School District (LAUSD).

Specifically, this article looks to Twitter as a counter-storytelling space for students of Color activists to organize and build movements to end anti-Black school policing. Through the frameworks of critical race theory (CRT) and Black critical theory (BlackCrit), this research applies inductive coding to analyze 42 Twitter posts from three students of Color-led organizations based in Los Angeles.

This document analysis presents four themes, which describe four dominant strategies students of Color activists use in their campaigns to defund or abolish school police in the LAUSD: (1) centering Blackness and Black student experiences, (2) making demands for the elimination of funding and support for school police, (3) calling for a shift in funding to support Black students and (4) employing multiple tactics concurrently.

These findings demonstrate the importance of developing and centering a critical understanding of anti-Blackness to achieve racial and educational justice within social movements.

Moreover, the demands of students of Color activists reflect visions of public schools free from anti-Black school policing.

Recently, powerful instruments for biomedical engineering research studies, including disease modeling, drug designing and nano-drug delivering, have been extremely investigated by researchers. Particularly, investigation in various microfluidics techniques and novel biomedical approaches for microfluidic-based substrate have progressed in recent years, and therefore, various cell culture platforms have been manufactured for these types of approaches. These microinstruments, known as tissue chip platforms, mimic in vivo living tissue and exhibit more physiologically similar vitro models of human tissues. Using lab-on-a-chip technologies in vitro cell culturing quickly caused in optimized systems of tissues compared to static culture. These chipsets prepare cell culture media to mimic physiological reactions and behaviors.

The authors used the application of lab chip instruments as a versatile tool for point of health-care (PHC) applications, and the authors applied a current progress in various platforms toward biochip DNA sensors as an alternative to the general bio electrochemical sensors. Basically, optical sensing is related to the intercalation between glass surfaces containing biomolecules with fluorescence and, subsequently, its reflected light that arises from the characteristics of the chemical agents. Recently, various techniques using optical fiber have progressed significantly, and researchers apply highlighted remarks and future perspectives of these kinds of platforms for PHC applications.

The authors assembled several microfluidic chips through cell culture and immune-fluorescent, as well as using microscopy measurement and image analysis for RNA sequencing. By this work, several chip assemblies were fabricated, and the application of the fluidic routing mechanism enables us to provide chip-to-chip communication with a variety of tissue-on-a-chip. By lab-on-a-chip techniques, the authors exhibited that coating the cell membrane via poly-dopamine and collagen was the best cell membrane coating due to the monolayer growth and differentiation of the cell types during the differentiation period. The authors found the artificial membrane, through coating with Collagen-A, has improved the growth of mouse podocytes cells-5 compared with the fibronectin-coated membrane.

The authors could distinguish the differences across the patient cohort when they used a collagen-coated microfluidic chip. For instance, von Willebrand factor, a blood glycoprotein that promotes hemostasis, can be identified and measured through these type-coated microfluidic chips.

In the developing field of nano-materials synthesis, copper oxide nanoparticles (NPs) are deemed to be one of the most significant transition metal oxides because of their intriguing characteristics. Its synthesis employing green chemistry principles has become a key source for next-generation antibiotics attributed to its features such as environmental friendliness, ease of use and affordability. Because they are more environmentally benign, plants have been employed to create metallic NPs. These plant extracts serve as capping, stabilising or hydrolytic agents and enable a regulated synthesis as well.

Organic chemical solvents are harmful and entail intense conditions during nanoparticle synthesis. The copper oxide NPs (CuO-NPs) synthesised by employing the green chemistry principle showed potential antitumor properties. Green synthesised CuO-NPs are regarded to be a strong contender for applications in the pharmacological, biomedical and environmental fields.

The aim of this study is to evaluate the anticancer potential of CuO-NPs plant extracts to isolate and characterise the active anticancer principles as well as to yield more effective, affordable, and safer cancer therapies.

This review article highlights the copper oxide nanoparticle's biomedical applications such as anticancer, antimicrobial, dental and drug delivery properties, future research perspectives and direction are also discussed.

This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.

The study was conducted in Kajang prison, starting in July 2013 in the men’s prison and June 2015 in the women’s prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.

Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232–526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48–5.68]).

Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.

The purpose of this article is to examine the expectations, challenges and tensions officers describe while engaged with public schools to demonstrate that officers engage with students in public schools in a conscious, goal-oriented process to establish and maintain useful relationships.

Data collection involved 104 semi-structured interviews (including follow up interviews) and 31 focus groups, conducted between 2014 and 2018 with police officers working in rural areas of a province in Atlantic Canada.

Utilizing the concept of social capital, we analyze practices of investments alongside the understanding of rurality as socially interconnected and the rural school as a particular site of interconnectedness for police officers. We demonstrate how, while accumulating social capital, officers face role tension and fundamental barriers when trying to integrate into rural school communities.

By demonstrating the specificities of building social capital in schools and community environments in a rural setting, we contribute to understandings regarding the unique opportunities and challenges faced by police in rural schools in integrating effectively into schools and responding to youth-specific problems.