Examinando por Autor "Castillo Soto, Pedro Félix"

Mostrando 1 - 20 de 20

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Análisis de la utilización de ceftriaxona inyectable en Lima Metropolitana de enero 2019 hasta diciembre 2020
(Universidad Privada Norbert Wiener, 2023-09-22) Freyre Torres, Susana Yadel; Castillo Soto, Pedro Félix
The present research had as its general objective to determine the consumption of ceftriaxone in public hospitals and pharmacy groups of Metropolitan Lima during the period from January 2019 to December 2020. The method was analytical with a quantitative approach, descriptive type, non-experimental, observational, cross-sectional, and retrospective design. The population corresponds to the consumption in units of ceftriaxone in the public and private sectors of Metropolitan Lima. The technique used was observation, for which a data collection sheet was applied as the instrument. It was concluded that the average consumption of ceftriaxone units was higher in the public sector, with a total of 1,198,386 units. Within the public sector, MINSA showed the highest consumption during the period from January to December 2020, while in the private sector, Boticas Perú prevailed in the period from August to September.
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Análisis de prescripciones médicas durante la pandemia de COVID-19, Lima - 2021
(Universidad Privada Norbert Wiener, 2022-09-29) Ramírez García, Lizi; Castillo Soto, Pedro Félix
Objective: To determine the characteristics of compliance with Good Prescribing Practices (GPP) and analyze the results of the drug utilization study in medical prescriptions dispensed between July and December 2020. Method: The method used was deductive, a basic type, with a quantitative approach, and a non-experimental, descriptive, observational, retrospective design. This was a Quantitative Investigation. 106 medical prescriptions captured in different pharmaceutical establishments in Metropolitan Lima were analyzed. Results: The analysis showed an 82.0% compliance rate with GPP. Broken down by non-compliance criteria, the most prominent omissions were the consignment of the disease diagnosis (62.4% of prescriptions) and illegibility (19.8%). Patient characteristics detailed an average age of 51.95 years. Regarding patient sex, 53.0% of prescriptions belonged to males. The medical specialty that prescribed the most was general medicine (24.5%). The medications with the highest prescription rates were Azithromycin and Paracetamol (9.1%) and Ivermectin (8.5%). The largest percentage of prescriptions came from the public sector (42.5%) and the private sector (33%). The quantity of medications per prescription showed 5 or more medications in 6.3% of cases and 4 medications in 6.1% of cases. The most prescribed dosage form was tablets (49.0%). Conclusion: This study determined that there is an 82.0% compliance rate with Good Prescribing Practices in medical prescriptions prescribed during the COVID-19 pandemic.
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Determinación de calidad del agua para el consumo humano aplicando la metodología de revisión sistemática y metaanálisis en tesis universitarias
(Universidad Privada Norbert Wiener, 2021-10-21) Estrada Lapas, Guillermina; Vidal Olortegui, Claudia Lisset; Castillo Soto, Pedro Félix
The objective of this study was to establish the quality of water for human consumption by analyzing the results of studies on physicochemical and microbiological parameters, using a systematic review complemented by a meta-analysis. The use of these techniques established that the scientific production at the university academic level is of low quality. A synthesis of results based on the standardized mean difference between the values found for each analyzed parameter and its corresponding standard allowed the study to establish that not all of the required tests for mandatory control parameters were performed. A standardized mean of 0.04 (95% CI: -0.15 to 0.22) was found for pH, and 0.11 (95% CI: -0.9 to 0.32) was found for free chlorine content. Both values showed a tendency toward the standard but were not statistically significant. This indicates that the analyzed studies do not provide robust information to draw conclusions about the quality of the water consumed in Lima.
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Determinación, caracteristicas y análisis de sospechas de reacciones adversas a medicamentos no notificadas durante COVID-19
(Universidad Privada Norbert Wiener, 2022-01-24) Marengo Yarame, Tatiana; Castillo Soto, Pedro Félix
The objective of this study was to establish an underreporting rate of adverse drug reactions (ADRs) during the COVID-19 pandemic. Methodology: An observational, descriptive, and analytical study was designed for this purpose. A validated questionnaire was used to capture first-hand information from medication consumers who were approached in duly authorized pharmaceutical establishments. The study had the approval of an independent ethics committee. Results: The main findings showed an adverse reaction rate of 28.2%, with an accumulation of 34 suspected mild to moderate ADRs. This provided a cumulative incidence of 0.43 (95% CI: 0.330 – 0.538) that was not properly reported to the national pharmacovigilance system. These reactions corresponded to the pharmaceutical product Ivermectin oral solution drops. Conclusion: It is concluded that adequate and participatory surveillance among healthcare professionals must be established so that the information can lead to appropriate decisions regarding medication supply.
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Efectos adversos de los esteroides anabólicos androgénicos en usuarios de gimnasios en Lima – 2023
(Universidad Privada Norbert Wiener, 2024-02-27) Contreras Mendoza, Claudia Maria; Castillo Soto, Pedro Félix
This observational, prospective, analytical, and cross-sectional study aimed to identify suspected adverse reactions in athletic consumers of products containing androgenic steroids. Through participant engagement and follow-up, sociodemographic data, medication history, and background information were collected. First-hand results were obtained regarding the incidence of adverse reactions caused by pharmaceutical products with androgenic and steroidal characteristics, in compliance with national and international standards and ethical considerations applicable to this type of clinical study within Phase IV of drug research and development. Results: An incidence rate of 13.21% (95% CI: 8.40–17.98) was obtained, indicating a notable frequency of adverse drug reactions (ADRs) according to CIOMS standards. The study participants had an average age of 28.2 years; 54.72% were female. The average weight was 60.7 kg, and the average height was 171.8 cm, resulting in a BMI of 22.8, which falls within the normal range for athletes. The most commonly reported adverse reaction was pain at the site of application, which is considered expected. Conclusion:Further clinical studies in the Peruvian population are needed to better understand the risks associated with the consumption of these types of products. This study serves as a starting point.
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Eficacia y seguridad del aceite medicinal de cannabis en pacientes epilépticos refractarios: revisión sistemática y metaanálisis
(Universidad Privada Norbert Wiener, 2023-09-08) Monago Casimir, Fernando; Rojas Delzo, Vicente José; Castillo Soto, Pedro Félix
This study aimed to evaluate the efficacy and safety of medicinal cannabis oil in refractory epileptic patients using a systematic review technique complemented with meta-analysis. Randomized, placebo-controlled clinical trials were identified. The primary outcomes for efficacy were the mean percentage reductions in seizure frequency of ≥50%, and for safety, the adverse events presented. Risk ratios with 95% confidence intervals were estimated using the CASPe method. A total of two clinical trials with 291 participants were included in the meta-analysis. In the cannabidiol group, 64 patients (43.5%) out of 147 (100%) achieved efficacy, compared to 36 patients (25%) out of 144 (100%) in the placebo group [risk ratio 1.74, 95% CI: 1.24-2.44; p=0.001]. For safety, 130 patients (88.4%) in the cannabidiol group experienced at least one adverse event, compared to 104 patients (72.2%) in the placebo group [risk ratio 1.22, 95% CI: 1.09-1.38; p=0.00068]. Adverse events significantly associated with cannabidiol included drowsiness (23.1%), diarrhea (20.4%), decreased appetite (17%), vomiting (10.2%), and pyrexia (6.8%). Adjunctive cannabidiol significantly reduced the mean percentage frequency of seizures and showed a higher rate of adverse events compared to placebo in refractory epileptic patients.
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Eficacia y seguridad del producto dprost premium capsulas: revisión sistemática
(Universidad Privada Norbert Wiener, 2024-11-04) Medina Prado, Alex Martin; Castillo Soto, Pedro Félix
The objective of this research work was: Determine the efficacy and safety of the DPROST Premium Capsules product based on the individual evidence that each of the components of the product has on prostatitis. Method. Study of a basic, deductive nature, with a non-experimental qualitative approach, whose study population is made up of all clinical studies carried out independently with any of the components of the formulation of DPROST Premium Capsules or in associated form, as interventions or comparisons against prostatitis or prostate cancer, which a systematic review was carried out. Results. Twelve studies were carried out in articles on Blueberry: Vaccinium corymbosum for prostate cancer, followed by Sauco: Sambucus with thirteen articles for prostate cancer and in Chuquiraga spinosa two studies were found in articles for prostate cancer, The food supplement of the product Dprost Premium, of this product in its health record, does not declare the nutritional value of its formula in general or of each of its components; Even more so, without the caloric value it provides and in the face of DIGEMID, it could not demonstrate its potential as a pharmaceutical product, the lack of basic information that could be considered to have an adequate product under the conditions offered on the DPROST PREMIUM product. Conclusion. There is not enough evidence for the DPROST PREMIUM Capsules product to promote its consumption based on therapeutic benefits on pathologies that do have protocols and interventions duly approved in a technical and scientific manner for their treatment.
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Estudio de utilización de medicamentos y verificación del cumplimiento de buenas prácticas de prescripción en 2 servicios médicos especializados del Hospital Nacional Hipólito Unanue entre enero–diciembre del 2018
(Universidad Privada Norbert Wiener, 2021-06-30) Aquino Vega, Sergio Dennys; Vidal Solorzano, Geraldine Olenka; Castillo Soto, Pedro Félix
In recent years, the use of prescribed and dispensed medications has been deemed inappropriate in 50% of cases, according to the WHO. The study was analytical, cross-sectional, observational, comparative, retrospective, and descriptive. Statistical analysis involved Excel for descriptive statistics and SPSS for plotting. The data collection instrument used was the Good Prescribing Practices (GPP) checklist on a sample of 216 medical prescriptions. Results: The frequency of prescriptions related to medication use was high in relation to the dose, which is a determining factor in irrational prescribing. The most prescribed drugs were ranitidine (11.3%) and tramadol (8%). Non-compliance with GPP was found in: prescriber's name (3.1%), signature (8.1%), expiration date (100%), diagnosis (6.5%), pharmaceutical form (34.5%), duration of treatment (99.1%), and legible handwriting (64.8%). Conclusion: The characteristics of medication use (EUM) were determined in its irrational prescribing, and there is non-compliance with GPP in the specialized surgery and medicine 2 services at the Hipólito Unanue National Hospital from January to December 2018.
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Estudio de utilización de medicamentos y verificación del cumplimiento de buenas prácticas de prescripción en recetas médicas dispensadas en boticas Hollywood de julio–diciembre 2019
(Universidad Privada Norbert Wiener, 2023-03-07) Martinez Herrera, Jenny Maria; Castillo Soto, Pedro Félix
The present study utilized a quantitative, descriptive, observational, and retrospective approach. A total of 350 medical prescriptions collected from Boticas Hollywood in Metropolitan Lima were analyzed. The most notable criteria of non-compliance were the inclusion of the disease diagnosis, observed in 26.9% of the prescriptions, and illegibility in 88.3% of the cases. This study determined that there was a 74.7% compliance rate with Good Prescription Practices in the analyzed medical prescriptions.
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Farmacovigilancia activa del producto farmacéutico Betriderm crema en usuarios de la botica Avi Pharma S.A.C., Lima 2023
(Universidad Privada Norbert Wiener, 2023-11-20) Carrasco Arias, Dana Patricia; Castillo Soto, Pedro Félix
Active pharmacovigilance is one of the methods used to assess information on the safety profile of medicines in relation to the characteristics of their consumers. The objective of this study was to establish the frequency of suspected adverse reactions in users of the pharmaceutical product Betriderm Cream, through an observational, prospective, analytical, and cross-sectional study, conducted in accordance with ethical and clinical guidelines. Sociodemographic characteristics revealed a mean age of 41.9 years (SD 15.2), mean weight of 64.4 kg (SD 12.4), and mean height of 159.0 cm (SD 9.4), with 63.1% being female. Medication use was mainly based on pharmaceutical recommendation (97.9%) and only 2.1% on self-medication, with 95.7% reporting three applications per day, predominantly for 1–3 days (71.9%). Participants reported healthy habits, such as fruit and vegetable consumption at least five days per week (55.6%), but also negative habits, including alcohol and cigarette use in 88.8%. Concomitant medications included naproxen (14.4%), ibuprofen (12.9%), omeprazole (8.6%), valsartan (7.2%), celecoxib (7.2%), paracetamol (7.2%), among others. The prevalence of suspected adverse reactions was 6.47%, corresponding to pruritus. It is concluded that the objectives were achieved, and the frequency observed corresponds to the category defined as very frequent manifestation.
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Farmacovigilancia activa del producto farmacéutico Dolo Farmadic-Forte tabletas recubierta en establecimientos farmacéuticos de Lima Metropolitana
(Universidad Privada Norbert Wiener, 2022-09-09) Jiménez Cárdenas, Elizabeth; Castillo Soto, Pedro Félix
This study, which was observational, prospective, descriptive, and analytical, obtained first-hand results on the incidence of adverse drug reactions (ADRs) in patients consuming the product Dolo Famedic Forte, adhering to national and international standards and ethical aspects involved in a clinical study of Phase IV research and development. An incidence of 12.26% of adverse drug reactions was obtained in a sample with an average age of 41.74 years, a weight of 67.35 kg, and a height of 159.59 cm. The suspected ADRs correspond to those listed in the pharmaceutical product insert, ensuring better safety.
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Farmacovigilancia activa del producto farmacéutico Neo BB® solución gotas pediátricas en establecimientos farmacéuticos de Lima Metropolitana, 2019
(Universidad Privada Norbert Wiener, 2019-11-28) Fayad Pinedo, Sara Silvana; Castillo Soto, Pedro Félix
Objectives: The main objective of this research was to determine the safety profile of the product NEO-BB® Pediatric Drops Solution to ensure its proper use, as well as to determine the frequency of adverse reactions and identify predisposing factors associated with the reported adverse reactions. Methods: First-hand information was obtained through questionnaires applied to a parent or legal guardian of children aged 1 to 3, who were enrolled in various pharmaceutical establishments in metropolitan Lima from February to July 2019. Results: During the follow-up of the 186 enrolled patients, seven individual case reports were filed, which included a total of seven suspected non-serious ADRs (3.76%). No suspected serious ADRs were reported. The reported suspected ADRs corresponded to reactions listed in the NEO-BB® Pediatric Drops Solution product insert. The suspected ADRs were managed by suspension (n=4, 2.15%), reduction of the daily dose (n=1, 0.54%), or continuation of the treatment with no changes (n=2, 1.08%), and no specific treatment was indicated for the ADR. Conclusion: The information obtained allows us to establish that the product's safety profile remains consistent with the authorized information in the insert and provides no reason for an insert update. The benefit-risk profile of NEO-BB® Pediatric Drops Solution remains unchanged and favorable.
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Farmacovigilancia y la notificación oportuna de reacciones adversas a medicamentos en el policlínico Surco Salud, Lima -2023
(Universidad Privada Norbert Wiener, 2024-09-03) Zegarra Azaña, Alex Omar; Castillo Soto, Pedro Félix
The overall objective of this research was to determine the relationship between pharmacovigilance and the timely reporting of adverse drug reactions at the Surco Salud Polyclinic in Lima, Peru, in 2023. The methodology was hypothetical-deductive, with a quantitative approach, basic research, non-experimental design, cross-sectional, and correlational in scope. The study population consisted of 80 pharmacy workers at the Surco Salud Polyclinic, including pharmacologists, nurses, doctors, and other healthcare professionals, who were the sample for this study. The research results determined a moderate direct correlation between pharmacovigilance and timely reporting of adverse drug reactions, with a rho of 0.655. A moderate direct correlation was also identified between data collection and dissemination, with a rho of 0.624. of data and the timely notification of adverse reactions. The administrative activities showed a moderate correlation with a value (Rho = 0.592) with the notifications of adverse drug reactions. Finally, a strong direct correlation was found with a value (Rho = 0.749) between the evaluation of notifications and the preparation of reports with the notifications of adverse drug reactions. Therefore, it is concluded that there is a relationship between pharmacovigilance and the timely notification of adverse drug reactions at the Surco Salud Polyclinic, Lima – 2023. This was determined by the result, with a Spearman's Rho correlation coefficient of 0.655 and a significance level of 0.000.
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Impacto físico y emocional asociado al manejo del dolor osteoarticular en personas adultas atendidas en la botica “NA FARMA” de Puente Piedra, Lima 2022
(Universidad Privada Norbert Wiener, 2023-03-16) Preciado Morales, Danitza Emperatriz; Del Carpio Montero, Leonardo Perfecto; Castillo Soto, Pedro Félix
This research aims to evaluate the relationship between osteoarticular pain management and its physical and emotional impact on adults attended at the NA FARMA pharmacy in Puente Piedra, Lima, 2022. Regarding the methodology, it is a basic type of research, using a hypothetical-deductive method, non-experimental design, quantitative approach, correlational level, prospective and cross-sectional study, with non-probabilistic sampling. The technique employed was a survey, and the instrument was a questionnaire consisting of 25 questions. The study involved 196 participants (patients with osteoarticular problems) to understand how the patients' quality of life and physical condition affect their emotional and family life. The Spearman’s Rho correlation test was used. The results showed a relationship between the physical and emotional impact on adults attended at the NA FARMA pharmacy in Puente Piedra, Lima, 2022, with a correlation coefficient of 0.715, indicating a strong positive relationship.
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Interacciones medicamentosas potenciales en la Unidad Hospitalaria de Medicina Interna del Hospital Militar Central Jesús María – Lima Metropolitana, periodo enero–agosto del 2021
(Universidad Privada Norbert Wiener, 2023-03-17) Guzman Villanueva, Johann Ronny; Castillo Soto, Pedro Félix
Drug interactions occur when the object drug is modified by another drug called the precipitant, leading to two types of interactions: pharmacokinetic and pharmacodynamic. This demonstrates that evaluating and/or determining the onset of a drug interaction becomes more complex for the immediate intervention of healthcare professionals. The present study aimed to identify potential drug interactions in the Internal Medicine hospital unit of the Central Military Hospital Jesús María-Lima Metropolitana, during the period January - August 2021. The method was analytical, descriptive, and non-experimental, and the document analysis technique was used. For the evaluation of interactions, the Micromedex database was employed. Results: Regarding age and gender, 76.6% of the cases involved males, and the age group with the highest prevalence of interactions was 30-59 years, accounting for 87.7%. The most frequent interaction was dexamethasone-diclofenac at 8.5%. The type of interaction was pharmacodynamic in 73.9% of cases. The therapeutic group with the highest prevalence was group A, with 20.2%, and the severity level with the greatest predominance was "important," at 73.9%.
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Ivermectina, determinación de su eficacia y seguridad en COVID-19
(Universidad Privada Norbert Wiener, 2023-03-11) Fernandez Ramos, Joselin Victoria; Rodriguez Navarro, Norma; Castillo Soto, Pedro Félix
According to the World Health Organization, which was one of the first organizations to provide information about the situation in China, the virus began claiming its first victims. Once the initial symptoms of COVID-19 were published, the virus started spreading exponentially, leading many countries to implement drastic measures, such as locking down people regardless of whether they showed symptoms of the virus. In response to this issue, industries began a race to find a cure to alleviate the symptoms of COVID-19. One of the medications used at the time was Ivermectin, which began to be administered without solid scientific evidence. Objective: To determine the safety and efficacy of Ivermectin as a potential treatment for patients testing positive for COVID-19. Methodology: Our research focuses on various informational sources, employing a qualitative or descriptive approach. Results: For this research project, results were defined based on the quality of the findings, which included information on Ivermectin and its evaluation as a treatment for the virus. The outcome revealed that evidence supporting its use was limited.
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Notificación e incidencias de sospechas de reacciones adversas del enantato de noretisterona y valerato de estradiol en adultos atendidos en una botica de San Juan de Lurigancho, 2022
(Universidad Privada Norbert Wiener, 2023-02-02) Salazar Núñez, Verónica Mercedes; Surichaqui Ticse, Carlos Eduardo; Castillo Soto, Pedro Félix
The objective of this study was: "to determine the incidence of adverse reactions from the use of the product norethisterone enanthate and estradiol valerate in adults attended at a pharmacy in San Juan de Lurigancho, 2022." Method: The study was basic, non-experimental, descriptive, and cross-sectional. The instrument used was a validated interview. The selected sample consisted of 85 patients. Patient data were collected using the Electronic Data Capture Form in the JAZZ CLINICAL information system, and suspected adverse reactions were recorded in the Adverse Drug Reaction Reporting Format for Healthcare Professionals and migrated to the JAZZ SAFETY database. General data were processed using SPSS statistical software version 23. Results: The demographic characteristics were as follows: the average age was 24.95 years, 100% (n=85) of participants were female, although male sex was considered (off-label use). The average weight was 67.5 kg, the average height was 159.2 cm, and the average body mass index (BMI) was 26.6 kg/m². The most common preexisting condition was hypertension, at 31.6% (n=6). Eight patients reported suspected adverse reactions (pain at the application site and erythema at the injection site). Conclusion: The cumulative incidence was determined to be 9.42% (95% CI: 0.0481 – 0.1808), which highlights the frequency of adverse reactions according to the Council for International Organizations of Medical Sciences (CIOMS).
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Percepción de COVID-19 en usuarios de boticas de los distritos de San Juan de Lurigancho y Villa El Salvador, Lima – 2021
(Universidad Privada Norbert Wiener, 2023-04-18) García Ramos, Dante Vidal; Herco Congora, Giovanna Katherin; Castillo Soto, Pedro Félix
The objective of this study was to "Evaluate the perception of users regarding the COVID-19 pandemic in pharmacies in the districts of San Juan de Lurigancho and Villa El Salvador in April 2021." Methodology: The research is descriptive, with an observational and cross-sectional design. The population consisted of pharmacy users from the districts of San Juan de Lurigancho and Villa El Salvador in Lima, with a sample of 330 pharmacy users who were given a questionnaire. Results: 91.5% (n=302) of pharmacy users consider SARS-COV-2 or Coronavirus to be more dangerous than the influenza virus; 24.5% (n=249) know they belong to a risk group; 29.7% feel very affected; 32.1% were emotionally affected, and 53.6% feel lonely for not being able to be with others; 73.6% plan to get vaccinated against COVID-19. Conclusions: The perception of the study population about the COVID-19 pandemic is that it is dangerous. However, most do not consider themselves part of the risk group for complications from this disease, except for older adults who are aware of their condition. Additionally, most feel emotionally affected and express their intention to get vaccinated, preferably with Pfizer vaccines, which they consider to be the most effective and safest.
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Riesgos por contaminación con metales pesados en alimentos en Perú: metaanálisis
(Universidad Privada Norbert Wiener, 2022-01-26) Proleon Valladares, Jonathan Nino; Siccha Mendez, Cristian Alfredo; Castillo Soto, Pedro Félix
Toxic metals, even in low concentrations, have harmful effects on human health, and food has been identified as a primary source of heavy metal intake. Objective: To establish the risk of consuming certain foods based on the toxic concentrations of heavy metals through a meta-analysis. Methodology: An evaluation and synthesis were performed through a meta-analysis of undergraduate theses on toxic metals (arsenic [As], cadmium [Cd], mercury [Hg], lead [Pb]) in food in Peru. Results: Only 6 studies contained relevant and "quality" information, and heterogeneity tests indicated high variability among the studies. Conclusions: The quality evaluations of the selected studies showed that they do not meet the content criteria to extrapolate their results for decision-making. The Peruvian population is exposed to consuming food contaminated with heavy metals, which poses a high risk of toxicity, and therefore, objective studies are needed to complement this research.
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Síntesis de los resultados de la actividad antibacteriana y antiinflamatoria de la Curcuma longa L. "cúrcuma" a nivel preclinico utilizando la revisión sistemática y metaanalítica en investigaciones peruanas
(Universidad Privada Norbert Wiener, 2021-11-04) Fernández García, Yesly Alelí; Hilasaca Hilasaca, Livia Isabel; Castillo Soto, Pedro Félix
The objective of this study was to determine the synthesis of results for the antibacterial and anti-inflammatory activity of Curcuma longa L. ('turmeric') at the preclinical level, utilizing a systematic and meta-analytical review of Peruvian research. Methodology: Information was searched in electronic databases, including Google Scholar, PubMed, and SUNEDU. The CONCYTEC and ARRIVE Guidelines tools were used for quality assessment, and the meta-analytical evaluation was performed using Review Manager 5.3 software. Results: With the CONCYTEC tool, the results were 88.57% (non-compliant), 8.57% (possibly compliant), and 2.86% (compliant). For the anti-inflammatory activity quality assessment using the ARRIVE Guidelines, 45.45% (compliant) and 54.55% (non-compliant) were obtained. For the antibacterial activity, 49.17% (compliant) and 50.83% (non-compliant) were obtained. The forest plot indicated that turmeric has no significant antibacterial activity against chlorhexidine, suggesting high heterogeneity. Conclusion: The synthesis of the systematic and meta-analytical review on the pharmacological activities of Curcuma longa L. ('turmeric') at the preclinical level indicates that turmeric does not present antibacterial activity, as the results are inclined toward the positive control group.