1 DECISION MAKING IN HEALTH SYSTEMS WORLDWIDE: AN OVERVIEW REFLECTING INNOVATIONS, OPPORTUNITIES AND CHALLENGES, Vjollca Qerimi
Innovations and new health technology can significantly improve the clinical practice, health outcomes, and life expectancy. However, governments must make a decision about which intervention is of the best value,offers the best improvement in terms of health gain, fewer adverse events, and all of that in the frame of therestricted resources. Exploring the literature we can see that by using decision-making science and Healthtechnology assessment (HTA) a lot of countries had achieved the balance in the innovative health care world. Their approaches, framework, and development give us an insight of limitations and strengths that decision-makers and HTA agencies face to assess and optimize outcomes and the benefit-harm balance of new medicines and diagnostic tools. Bringing HTA in countries in development is also a concern that has economic and political restrictions and it raises a lot of questions and challenges for development of decision making sciences itself. Our findings suggest that within all the limitations and future challenges that are to come and even we do not have the perfect information, decision must be made. In most health care situations clinical and economic evidence must be extrapolated through time or space, transferred from one study to another, or combined and linked in a way that they can demonstrate a balance between the costs and consequences and capture the benefits of new technologies, overcome uncertainties, and recognize the value of innovation, all within the limits ofoverall health resources and constrained health budgets of the respective country.
2 ANTIOXIDANTS IN FOOD AND PHARMACEUTICAL RESEARCH, Carlo Schillaci, Ridvan Nepravishta, Alessia Bellomaria
In this work we provide a general overview about the natural and synthetic antioxidants and studies carried out to improve their potential. These compounds are able to scavenge free radicals that cause deterioration of food and pharmaceutical products during processing and storage. Today there are several known natural compounds with antioxidant properties that are extracted from plants, which are mainly phenols and polyphenols. The limit for the use of these compounds in the food and pharmaceutical industry as antioxidants concerns their poor solubility in hydrophobic environment. This limitation was overcame in the past years by the introduction of synthetic antioxidants, such as BHA (butylated hidroxy anisole), BHT (butylated hydroxyl toluene), TBHQ (tert butyl hydroquinone) and PG (propyl gallate). Unfortunately several authors showed that BHA, BHT, TBHQ and PG may present adverse effects on the health of living organisms. In recent years novel antioxidants have been synthesized from natural polyphenols in order to modify the hydrophilicity/lipophilicity balance and increase their biological functionalities arising from insertion of new functional groups or molecule moieties in pre-existing natural polyphenols. The aim of these modifications was to avoid the major adverse effects associated with the use of BHT, BHA, TBHQ and PG.
3 APPLICATION AND COMPARISON OF THREE DIFFERENT EXTRACTION METHODS OF CAPSAICIN FROM CAPSICUM FRUITS, Enkelejda Goci, Entela Haloçi, Kliton Vide, Ledjan Malaj
Beside their use as a food additive, Capsicum (due to its capsaicin content) is currently used for various therapeutic purposes such as asthma, coughs, sore throats, to relieve toothaches, counter-irritant balm for external application, to alleviate pain in shingles, rheumatoid arthritis, diabetic neuropathy, etc. The pungent components responsible for the medical uses are the alkaloids called capsaicinoids. Isolation of capsaicin from Capsicum fruits was described by many authors with different methods of extraction. The most used methods are maceration, Soxhlet extraction, supercritical fluidextraction (CO2) and ultrasound. The aim of this study was to apply and compare three extraction methods of capsaicin from Capsicum fruits, in order to find the most suitable method and appropriate organic solvents. The qualitative and quantitative estimation of this substance was realized by Thin Layer Chromatography (TLC) and High Performance Thin Layer Chromatography (HPTLC). The amount of caspsaicin in each extract varied from 0.009% to 0.052 %.The most easy and appropriate methods were maceration and Collins. The best solvents were ethanol and methanol.
4 FORMULATION AND IN-VITRO/IN-VIVO ASSESSMENT OF ENHANCED BIOAVAILABILITY OF LACIDIPINE USING NANO PURE TECHNIQUE, Subas Chandra Dinda, Sunil Kumar Panda
The objective of this study was to formulate and evaluate a novel drug solubilization platform (so called Nano-suspension prepared by comminution method using High pressure homogenizer; GEA Niro soavi) and further use the nano-suspension as granulating fluid admixed with excipients for further tablet production. The solid state characterization of Lacidipine along with the excipients reveal compatibility , as confirmed X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Differential scanning calorimetry (DSC). The performance of Nano suspension is highly dependent on the selection of polymer stabilizer; hence different polymers such as hydroxy propyl cellulose, propylene glycol and poly vinyl pyrollidone were used in the study and evaluated. The results revealed hydroxy propyl cellulose as a suitable stabilizer compared to others polymer. The dissolution studies of Lacidipine shows complete release of drug within 45 minutes using hydroxy propyl cellulose as stabilizer in comparison to available marketed product. Hydroxy propyl cellulose was better adsorbed with the drug compared to other polymers resulting in better mechanical interaction during comminution which causes the drug particle size to reach in nano-meter scale. The particle size of the nano suspension as confirmed by Zeta sizer revealed a particle size of 293.7 nm. The appearance of the nano suspension shows a bluish opalescence and the morphology revealed by Transmission electron microscope shows a particle size of 200.0 nm. The In-Vivo pharmacokinetic study was performed on rabbits to assess the bioavailability, since the bioavailability is directly proportional to the particle size. The In-Vivo pharmacokinetic results revealed that the AUC and Cmax were increased to two and six folds respectively in comparison to conventional market tablet. This may be recognized to increase solubility and permeability of the drug due to this novel formulation approach.
5 COUPLING OF DETONATION NANODIAMONDS (DNDS) WITH STILBENES: THE RESVERATROL CASE, Maringlen Angjellari, Anisa Peçuli
The interest of science in compounds that have antioxidant, antitumoral and cardio protective properties and can be founded in food has risen in nowadays. The case of resveratrol, a stilbene founded in wine, originated from grape as response of the wine against the damages, is the biggest case of studies. Resveratrol took all this attention after the term of French Paradox that describe the low incidence of French population, in cardiovascular disease as they are known as a regular wine consumer. The evaluation of bioavailability and toxicity of resveratrol in organism has been conducted with both methods, in vitro and in vivo. A number of studies have given evidences about the pathways how resveratrol is metabolized, the mechanism of action and its pharmacokinetic properties. But even now that is clear how resveratrol metabolism works there are a lot of questions, but the question to take in consideration is: which is the best way to intake these compounds to produce a pharmacological effect? The key for a pharmacological effect is the bioavailability of non-metabolized resveratrol. Higher the quantity of non-metabolized resveratrol, higher is the pharmacological affect. Oral intakes from wine or supplements are the only ways of resveratrol delivery. Coupling the resveratrol with detonation nanodiamonds (DNDs) raises the bioavailability of resveratrol and its pharmacological effect.