Background: Antihypertensives bisoprolol fumarate (BIS) and perindopril arginine (PER) were simultaneously determined in their pure, bulk, and combined tablet dosage form. Objective: This study develops a novel, reproducible, and accurate Reversed phase high-performance liquid chromatography (RP-HPLC) and Reversed phase ultra-performance liquid chromatography (RP-UPLC) with photodiode array detection techniques, which were then applied to in vitro dissolution studies. Methods: The first RP-HPLC method relied on isocratic elution using a mobile phase of methanol–0.05 M phosphate buffer pH 2.6 (1 + 1, by volume), and separation was performed using a Thermo Hypersil C8 column (150 mm × 4.6 mm, 5 μm). Ion-pair UPLC was the second method. An acceptable resolution was achieved using an RP-C18 chromatographic column, Agilent Eclipse (100 × 2.1 mm, 1.7 μm), with a mobile phase containing 0.005 M sodium 1-heptane sulfonate–triethylamine (64 + 1 + 35, by volume), adjusted with phosphoric acid to a pH of 2.0. RP-HPLC used a 1.0 mL/min flow rate, while UPLC used 0.5 mL/min, and the two methods used detection at 210 nm. Results: Calibration curves of BIS and PER were linear for RP-HPLC and RP-UPLC methods at 0.5-15 and 0.5-40 μg/mL, respectively. BIS and PER had RP-UPLC LODs of 0.22 and 0.10 μg/mL, respectively, and LOQs of 0.68 and 0.31 μg/mL, respectively. As a result, the approach has been effectively applied to in vitro dissolution testing for drugs in generic and reference products, showing that the two products are comparable. The Six Sigma approach was implemented to compare the recommended and United States Pharmacopeia (USP) procedures, which both exhibited process capability index (Cpk) >1.33. A content uniformity test demonstrated that the drugs in their dosage form met the acceptance limit (85–115%). The degradation products were reliably distinguished from pure drugs for a range of retention times. Conclusion: In their commercial drug product, the proposed method could be used in QC laboratories for concurrent testing, content uniformity, and in vitro dissolution investigations of BIS and PER. The methods were successfully validated per International Council for Harmonisation (ICH) guidelines. Highlights: This study is innovative since it is the first to establish and validate specific and reproducible UPLC and HPLC methods for the concurrent quantitation of the studied drugs in their binary mixture and application to lean Six Sigma, content uniformity, and comparative dissolution approaches.

Background: Antimicrobial resistance (AMR) has been identified as one of the top ten public health threats facing humanity. Aim: The purpose of this study was to assess the effect of an antimicrobial stewardship educational intervention on family caregivers’ knowledge and practices in primary healthcare settings in Egypt. Methods: A quasi-experimental, one-group pretest-posttest design involving a sample of 300 family caregivers attending family health centers. The data were collected using questionnaires that assessed caregiver knowledge and self-reported practices regarding AMR before and after the intervention (primary outcomes). The intervention combined tailored knowledge and practice components that carefully evaluated participants’ knowledge regarding AMR, health risk, antibiotic usage, and prevention of infection. Furthermore, their practice of using antibiotics, including previous antibiotic exposure, their antibiotic use during the past year, reasons for taking antibiotics, ways of obtaining antibiotics, and reasons for discontinuing of antibiotic therapy were also recorded. Results: The pre-intervention assessment revealed poor knowledge and practice regarding antibiotic use. Post-intervention, mean knowledge scores increased significantly from 18.36 to 23.28 (t = 19.5, p < 0.0001), while mean practice scores improved from 9.83 to 12.37 (t = 6.4, p < 0.0001). Conclusions: The intervention successfully improved caregivers’ knowledge and practices regarding AMR. However, there are some limitations that could affect the generalization, and the impact of the results such as the relatively small sample size recruited from a single center, lack of a control group, reliance on self-reported data, and lack of long-term follow-up. Future studies should aim to address these constraints in order to assess the intervention’s effectiveness.

The identification and control of toxic impurities are vital components of patient safety. Impurities may adversely affect a drug's potency as well as cause adverse reactions. A drug's therapeutic effectiveness depends on maintaining acceptable levels of impurities. A study was conducted to develop four sustainability tools with a green-and-white metric approach. These tools are designed to investigate the potential environmental impacts of innovative and straightforward RP-UPLC strategies used for simultaneous analysis and separation of the drug and its impurities in their pure form. The calibration curves for candesartan cilexetil and impurity B, impurity C, impurity D, impurity E, and impurity F from 0.00020–0.0101, 0.00101–0.0505, 0.00103–0.0514, 0.000975–0.0487, 0.00102–0.0511, and 0.00102–0.0512 mg mL⁻¹ exhibited a correlation value exceeding 0.9998. The recovery ±15% of the actual amount, which is considered acceptable. ICH guidelines thoroughly validate the recommended approach for analyzing newly developed formulations, ensuring their high reliability. A technique that can estimate antihypertension drugs and their impurities simultaneously using RP-UPLC has been successfully developed. Green and white metrics were used to assess this approach's environmental sustainability.

Background and Objectives: The investigation of the psychosomatic symptoms in women residing in developing countries is still emerging. To be precise, the prevalence and correlates of severe fibromyalgia, depression, anxiety, and insomnia are understudied in Arab women, as these symptoms could relate to improper self-medication. This study mainly investigated the association between self-medication with analgesics and fibromyalgia, depression, anxiety, and insomnia symptoms among a community-based cohort of females in Jordan. Materials and Methods: We used a web-based cross-sectional study design. Fibromyalgia, depression, anxiety, and insomnia were assessed using validated scales. The used over-the-counter (OTC) painkillers were recorded. Results: Data were analyzed from 741 women, and fibromyalgia was screened in 16.4%, depression in 37.4%, anxiety in 27.8%, and insomnia in 38.3%. Fibromyalgia was associated with “married” (OR = 1.5, 95% CI = 1.017–2.305), “using OTC acetaminophen” (OR = 1.75, 95% CI = 1.15–2.69), “using herbal remedies” (OR = 2.02, 95% CI = 1.33–3.07), and “using antiseizure medications” (OR = 2.43, 95% CI = 1.38–4.28). Severe depression was significantly associated with “age” (OR = 0.97, 95% CI = 0.96–0.99), “high school education” (OR = 1.90, 95% CI = 1.21–2.98), “smoking” (OR = 1.72, 95% CI = 1.15–2.56), “OTC acetaminophen” (OR = 1.40, 95% CI = 1.02–1.92), “OTC non-steroidal anti-inflammatory drugs” (OR = 1.75, 95% CI = 1.15–2.65), and “antiseizures” (OR = 2.19, 95% CI = 1.30–3.70). Severe anxiety was significantly associated with “smoking” (OR = 2.08, 95% CI = 1.40–3.12), “OTC acetaminophen” (OR = 1.48, 95% CI = 1.06–2.06), and “antiseizure medications” (OR = 2.04, 95% CI = 1.22–3.41). Severe insomnia was significantly associated with “age” (OR = 0.98, 95% CI = 0.96–0.99), “high school education” (OR = 1.58, 95% CI = 1.01–2.47), “smoking” (OR = 1.51, 95% CI = 1.01–2.25), “OTC non-steroidal anti-inflammatory drugs” (OR = 1.74, 95% CI = 1.13–2.64), “antiseizure medications” (OR = 1.84, 95% CI = 1.09–3.11), and “No analgesics” (OR = 0.48, 95% CI = 0.32–0.71). Conclusions: Self-medication with analgesics is associated with a high burden of psychosomatic symptoms in Arab women, and awareness campaigns are required to guide self-medication behavior.