Iran Food and Drug Administration (IFDA) has the mission to regulate all aspects of pharmaceutica... more Iran Food and Drug Administration (IFDA) has the mission to regulate all aspects of pharmaceutical market including registration of the new medicines. Iran Drug Selection Committee has the responsibility to maintain and revise Iran Medicine List (IML). The National law has banned production, importation, distribution, and prescription of medicines not included in IML. Although, IFDA policy makers have created a mechanism to provide medicines not included in the list but might be essential for the treatment of specific patients. A cross-sectional study was carried out on prescription of out of IML medicines during the year 2015. This study was conducted on a total of 1375 application forms received by Secretariat of Iran Drug Selection Committee for prescription of out of IML medicines. It has been shown that among 402 specialist physicians, the most out of IML medicine were prescribed by oncologist/hematologist. Antineoplastic and immunomodulating agents were the most frequently pre...
Chromium (Cr) as an essential trace element in metabolism of carbohydrate, lipid and protein is c... more Chromium (Cr) as an essential trace element in metabolism of carbohydrate, lipid and protein is currently prescribed to control diabetes mellitus (DM). The objective of this meta-analysis was to compare the effect of Cr versus placebo (Pl) on glucose and lipid profiles in patients with type 2 DM. Literature searches in PubMed, Scopus, Scirus, Google Scholar and IranMedex was made by use of related terms during the period of 2000-2012. Eligible studies were randomized clinical trials (RCTs) with intake of Cr higher than 250 µg at least for three months in type 2 DM. Glycated hemoglobin (HbA1c), fasting blood sugar (FBS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglyceride (TG), and body mass index (BMI) were the main outcomes. Seven out of 13 relevant studies met the criteria and were included in the meta-analysis. HbA1c change in diabetic patients in Cr supplement therapy comparing to Pl was -0.33 with 95%CI= -0.72 to 0.06 (P= 0.1). Change of FBG in Cr therapy vs. Pl was -0.95 with 95%CI= -1.42 to -0.49 (P< 0.0001). TC change in Cr therapy vs. Pl was 0.07 with 95%CI= -0.16 to 0.31 (P= 0.54). TG change in diabetic patients in Cr supplement therapy comparing to Pl was -0.15 with 95%CI= -0.36 to 0.07 (P= 0.18). Cr lowers FBS but does not affect HbA1c, lipids and BMI.
Medical science monitor: international medical journal of experimental and clinical research
TNF-alpha has an important role in the pathogenesis of ulcerative colitis (UC). It therefore seem... more TNF-alpha has an important role in the pathogenesis of ulcerative colitis (UC). It therefore seems that infliximab, the antibody against TNF-alpha, is beneficial in the treatment of UC. The aim was to determine whether infliximab induces clinical response and remission in patients with UC using the meta-analysis technique. The Pubmed and Embase databases were searched for studies investigating the efficacy of infliximab on UC. Data from 1966 to 2006 were collected. The keywords used to search were "ulcerative colitis" with "infliximab", "anti tumor necrosis factor", or "anti tumor necrosis factors". The reference lists from the retrieved articles were also reviewed for additional applicable studies. The summary odds ratio (OR) for clinical remission in four studies was 3.24 with a 95%CI of 1.6-6.57 and a significant OR. The summary OR for clinical response in three studies was 3.93 with a 95%CI of 2.84-5.45 and a significant OR. Infliximab is ...
World journal of gastroenterology : WJG, Jan 14, 2015
To investigate the efficacy and adverse effects of antioxidant therapy in acute pancreatitis (AP)... more To investigate the efficacy and adverse effects of antioxidant therapy in acute pancreatitis (AP), chronic pancreatitis (CP) and post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). PubMed, Scopus, Google Scholar, Cochrane library database, and Evidence-based medicine/clinical trials published before August 2014 were searched. Clinical and laboratory outcomes of randomized trials of antioxidant therapy in patients with AP, CP and PEP were included. The methodological quality of the trials was assessed by the Jadad score based on the description of randomization, blinding, and dropouts (withdrawals). The results of the studies were pooled and meta-analyzed to provide estimates of the efficacy of antioxidant therapy. Thirty four trials out of 1069 potentially relevant studies with data for 4898 patients were eligible for inclusion. Antioxidant therapy significantly reduced the length of hospital stay in AP patients {mean difference -2.59 d (95%CI: -4.25-(-0.93)], P ...
Pharmacists are members of the healthcare teams that provide valuable services to society. Their ... more Pharmacists are members of the healthcare teams that provide valuable services to society. Their incentive to deliver such services is influenced by remuneration methods. In this study, we aimed to review the remuneration models for pharmacists' services and the factors affecting the profitability of pharmacies in some selected countries, including France, Ireland, Canada and Turkey, and compared them to Iran. International data were collected by literature review on Google, Google scholar, PubMed and Scopus. In addition, domestic data were collected by contacting relevant organizations. There is no payment for pharmacists' cognitive services in Iran and in the countries investigated, except for some Canadian provinces. The dispensing fee system in Iran does not seem to be adequate, especially considering that most of the insurers do not cover these fees. The pricing method in Iran has resulted in a low price level, in comparison to the other countries, and this issue has dr...
There are still limited data on the effect of hypertension therapy in elderly patients. Therefore... more There are still limited data on the effect of hypertension therapy in elderly patients. Therefore the aim of the present meta-analysis was to investigate the effect of hypertension therapy on blood pressure (BP), and cardiovascular (CV) and mortality outcomes. The safety of BP lowering in elderly patients was also analysed. Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of randomized controlled trials for years 1966 – September 2013 were searched for appropriate studies. Eleven trials with 40325 hypertensive elderly patients randomized to receive either antihypertensives or placebo were included. BP lowering therapy was associated with the significant reduction of systolic BP (ΔSBP: -12.43 mmHg, 95%CI: -21.07 to -3.79; p=0.005) and diastolic BP (ΔDBP -5.06 mmHg, 95%CI: -9.21 to -0.92; p=0.02). Antihypertensive therapy was associated with the reduction of all-cause mortality rate by 13% (relative risk [RR] 0.87, 95%CI: 0.81-0.93; p<0.0001), the risk of...
Malignant melanoma is an important issue in oncology due to its high incidence, high mortality, a... more Malignant melanoma is an important issue in oncology due to its high incidence, high mortality, and resistance to systemic therapy; however, targeted immunotherapy has noticeably improved the survival rates of melanoma patients. Promising targeted immunotherapies for malignant melanoma include the blockade of immune checkpoints with antibodies targeting cytotoxic T lymphocyte-associated antigen 4 and the programmed cell death protein 1 pathway. The US FDA-approved antibody ipilimumab targets cytotoxic T lymphocyte-associated antigen 4; however, it was limited by toxicity and a low response. Nivolumab and pembrolizumab (formerly lambrolizumab), the two FDA-approved anti-programmed death-1 monoclonal antibodies, show highly durable response rates and long-term safety, validating the importance of the programmed cell death protein 1 pathway blockade for treatment of malignant melanoma.
Wet age-related macular degeneration (AMD) is a potentially blinding eye disease that causes visi... more Wet age-related macular degeneration (AMD) is a potentially blinding eye disease that causes vision loss among individuals &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 50 years old. The main goal in the treatment of wet AMD is to inhibit the choroidal neovascularization (CNV). Currently, ranibizumab and aflibercept are two available anti-VEGF drug for the treatment of wet AMD. Here, we reviewed the clinical outcome of treatment with ranibizumab or aflibercept in patients with wet AMD from recent studies with a special focus on eyes with unusual presentations or treatment resistant and compared these agents with other available wet AMD therapies. Areas covered: For this review, a literature search from 2011 to present was performed using the following terms (or combination of terms): anti-vascular endothelial growth factors, anti-VEGF, age-related macular degeneration, AMD, aflibercept, and ranibizumab. The studies were limited to studies used ranibizumab, and especially those switched from ranibizumab to aflibercept. Also the clinical trial website (www.clinicaltrials.gov) was searched for recently completed trials of aflibercept or ranibizumab for wet AMD treatment. Expert opinion: Ranibizumab and aflibercept are effective for the treatment of wet AMD including those with retinal angiomatous proliferation (RAP) and CNV unresponsive to other anti-VEGF agents. Although high-dose ranibizumab has the potential to treat unresponsive CNV, switching to another anti-VEGF agent may be a preferable option in these eyes.
Iran Food and Drug Administration (IFDA) has the mission to regulate all aspects of pharmaceutica... more Iran Food and Drug Administration (IFDA) has the mission to regulate all aspects of pharmaceutical market including registration of the new medicines. Iran Drug Selection Committee has the responsibility to maintain and revise Iran Medicine List (IML). The National law has banned production, importation, distribution, and prescription of medicines not included in IML. Although, IFDA policy makers have created a mechanism to provide medicines not included in the list but might be essential for the treatment of specific patients. A cross-sectional study was carried out on prescription of out of IML medicines during the year 2015. This study was conducted on a total of 1375 application forms received by Secretariat of Iran Drug Selection Committee for prescription of out of IML medicines. It has been shown that among 402 specialist physicians, the most out of IML medicine were prescribed by oncologist/hematologist. Antineoplastic and immunomodulating agents were the most frequently pre...
Chromium (Cr) as an essential trace element in metabolism of carbohydrate, lipid and protein is c... more Chromium (Cr) as an essential trace element in metabolism of carbohydrate, lipid and protein is currently prescribed to control diabetes mellitus (DM). The objective of this meta-analysis was to compare the effect of Cr versus placebo (Pl) on glucose and lipid profiles in patients with type 2 DM. Literature searches in PubMed, Scopus, Scirus, Google Scholar and IranMedex was made by use of related terms during the period of 2000-2012. Eligible studies were randomized clinical trials (RCTs) with intake of Cr higher than 250 µg at least for three months in type 2 DM. Glycated hemoglobin (HbA1c), fasting blood sugar (FBS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglyceride (TG), and body mass index (BMI) were the main outcomes. Seven out of 13 relevant studies met the criteria and were included in the meta-analysis. HbA1c change in diabetic patients in Cr supplement therapy comparing to Pl was -0.33 with 95%CI= -0.72 to 0.06 (P= 0.1). Change of FBG in Cr therapy vs. Pl was -0.95 with 95%CI= -1.42 to -0.49 (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). TC change in Cr therapy vs. Pl was 0.07 with 95%CI= -0.16 to 0.31 (P= 0.54). TG change in diabetic patients in Cr supplement therapy comparing to Pl was -0.15 with 95%CI= -0.36 to 0.07 (P= 0.18). Cr lowers FBS but does not affect HbA1c, lipids and BMI.
Medical science monitor: international medical journal of experimental and clinical research
TNF-alpha has an important role in the pathogenesis of ulcerative colitis (UC). It therefore seem... more TNF-alpha has an important role in the pathogenesis of ulcerative colitis (UC). It therefore seems that infliximab, the antibody against TNF-alpha, is beneficial in the treatment of UC. The aim was to determine whether infliximab induces clinical response and remission in patients with UC using the meta-analysis technique. The Pubmed and Embase databases were searched for studies investigating the efficacy of infliximab on UC. Data from 1966 to 2006 were collected. The keywords used to search were "ulcerative colitis" with "infliximab", "anti tumor necrosis factor", or "anti tumor necrosis factors". The reference lists from the retrieved articles were also reviewed for additional applicable studies. The summary odds ratio (OR) for clinical remission in four studies was 3.24 with a 95%CI of 1.6-6.57 and a significant OR. The summary OR for clinical response in three studies was 3.93 with a 95%CI of 2.84-5.45 and a significant OR. Infliximab is ...
World journal of gastroenterology : WJG, Jan 14, 2015
To investigate the efficacy and adverse effects of antioxidant therapy in acute pancreatitis (AP)... more To investigate the efficacy and adverse effects of antioxidant therapy in acute pancreatitis (AP), chronic pancreatitis (CP) and post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). PubMed, Scopus, Google Scholar, Cochrane library database, and Evidence-based medicine/clinical trials published before August 2014 were searched. Clinical and laboratory outcomes of randomized trials of antioxidant therapy in patients with AP, CP and PEP were included. The methodological quality of the trials was assessed by the Jadad score based on the description of randomization, blinding, and dropouts (withdrawals). The results of the studies were pooled and meta-analyzed to provide estimates of the efficacy of antioxidant therapy. Thirty four trials out of 1069 potentially relevant studies with data for 4898 patients were eligible for inclusion. Antioxidant therapy significantly reduced the length of hospital stay in AP patients {mean difference -2.59 d (95%CI: -4.25-(-0.93)], P ...
Pharmacists are members of the healthcare teams that provide valuable services to society. Their ... more Pharmacists are members of the healthcare teams that provide valuable services to society. Their incentive to deliver such services is influenced by remuneration methods. In this study, we aimed to review the remuneration models for pharmacists' services and the factors affecting the profitability of pharmacies in some selected countries, including France, Ireland, Canada and Turkey, and compared them to Iran. International data were collected by literature review on Google, Google scholar, PubMed and Scopus. In addition, domestic data were collected by contacting relevant organizations. There is no payment for pharmacists' cognitive services in Iran and in the countries investigated, except for some Canadian provinces. The dispensing fee system in Iran does not seem to be adequate, especially considering that most of the insurers do not cover these fees. The pricing method in Iran has resulted in a low price level, in comparison to the other countries, and this issue has dr...
There are still limited data on the effect of hypertension therapy in elderly patients. Therefore... more There are still limited data on the effect of hypertension therapy in elderly patients. Therefore the aim of the present meta-analysis was to investigate the effect of hypertension therapy on blood pressure (BP), and cardiovascular (CV) and mortality outcomes. The safety of BP lowering in elderly patients was also analysed. Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of randomized controlled trials for years 1966 – September 2013 were searched for appropriate studies. Eleven trials with 40325 hypertensive elderly patients randomized to receive either antihypertensives or placebo were included. BP lowering therapy was associated with the significant reduction of systolic BP (ΔSBP: -12.43 mmHg, 95%CI: -21.07 to -3.79; p=0.005) and diastolic BP (ΔDBP -5.06 mmHg, 95%CI: -9.21 to -0.92; p=0.02). Antihypertensive therapy was associated with the reduction of all-cause mortality rate by 13% (relative risk [RR] 0.87, 95%CI: 0.81-0.93; p<0.0001), the risk of...
Malignant melanoma is an important issue in oncology due to its high incidence, high mortality, a... more Malignant melanoma is an important issue in oncology due to its high incidence, high mortality, and resistance to systemic therapy; however, targeted immunotherapy has noticeably improved the survival rates of melanoma patients. Promising targeted immunotherapies for malignant melanoma include the blockade of immune checkpoints with antibodies targeting cytotoxic T lymphocyte-associated antigen 4 and the programmed cell death protein 1 pathway. The US FDA-approved antibody ipilimumab targets cytotoxic T lymphocyte-associated antigen 4; however, it was limited by toxicity and a low response. Nivolumab and pembrolizumab (formerly lambrolizumab), the two FDA-approved anti-programmed death-1 monoclonal antibodies, show highly durable response rates and long-term safety, validating the importance of the programmed cell death protein 1 pathway blockade for treatment of malignant melanoma.
Wet age-related macular degeneration (AMD) is a potentially blinding eye disease that causes visi... more Wet age-related macular degeneration (AMD) is a potentially blinding eye disease that causes vision loss among individuals &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 50 years old. The main goal in the treatment of wet AMD is to inhibit the choroidal neovascularization (CNV). Currently, ranibizumab and aflibercept are two available anti-VEGF drug for the treatment of wet AMD. Here, we reviewed the clinical outcome of treatment with ranibizumab or aflibercept in patients with wet AMD from recent studies with a special focus on eyes with unusual presentations or treatment resistant and compared these agents with other available wet AMD therapies. Areas covered: For this review, a literature search from 2011 to present was performed using the following terms (or combination of terms): anti-vascular endothelial growth factors, anti-VEGF, age-related macular degeneration, AMD, aflibercept, and ranibizumab. The studies were limited to studies used ranibizumab, and especially those switched from ranibizumab to aflibercept. Also the clinical trial website (www.clinicaltrials.gov) was searched for recently completed trials of aflibercept or ranibizumab for wet AMD treatment. Expert opinion: Ranibizumab and aflibercept are effective for the treatment of wet AMD including those with retinal angiomatous proliferation (RAP) and CNV unresponsive to other anti-VEGF agents. Although high-dose ranibizumab has the potential to treat unresponsive CNV, switching to another anti-VEGF agent may be a preferable option in these eyes.
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