15^th Asia-Pacific Pharma Congress July 18-20, 2018 Melbourne, Australia

Tay Sook Muay is Associate Dean at the Yong Loo Lin School of Medicine at Singapore General Hospital. She is a senior consultant anaesthesiologist with a special interest in liver transplantation anaesthesiology, burns intensive care medicine and the psychology of learning and development. She is a highly experienced medical educator and has been the Lead Clinical Educator at Singapore General Hospital since 2012 . Her many education activities include being an ATLS Course Educator (Train the Trainers programme) and a facilitator for the 7 Habits programme at Singapore General Hospital. She also served as an Adjunct Associate Professor at the Office of Education, Duke NUS Graduate Medical School. Adj A/P Tay has published many papers on anaesthesiology and educational practice as well as co-authored in the book Anaesthesia for Emergency Medicine (World Scientific Publishing, 2004). She is currently involved in a variety of research projects examining clinician work practices and burns treatment. She is a member of many professional associations such as the Singapore Intensive Care Society, College of Anaesthesiologist, St John’s Order, Adult Education Network (AEN) and sat on committees such as the Pedagogy Committee at the Postgraduate Medical Institute and the Committee for Core Skills- Simulation Training Work. She has presented papers at a number of international conferences including the World Congress of Intensive Care Medicine, the ASME Conference and the Congress of the Western Pacific Association of Critical Care Medicine. Adj A/P Tay cares deeply about achieving the best possible outcomes for patients, as well as the resulting satisfaction and affirmation experienced by clinicians when this occurs. She firmly believes that this affirmative journey starts with the education of medical students on patient safety and best outcome.

Singapore General Hospital (SGH) is the first and largest hospital in Singapore. It provides affordable specialist care for patients, training for doctors and other healthcare professionals, and conducts research to bring better care to its patients. Every year, the SGH Campus caters to over 1 million patients. With a 10,000-strong workforce, SGH accounts for about a quarter of the total acute hospital beds in the public sector and about one-fifth of acute beds nationwide The Antimicrobial Stewardship Unit (ASU) in SGH is a multidisciplinary team, composed of Infectious Diseases Physicians, pharmacists and an executive who are responsible for directing complementary multi-pronged efforts to promote safe, optimal and cost-effective use of antimicrobials via several antimicrobial stewardship strategies. One of the strategies involves the prospective audit feedback of selected targeted broad-spectrum antimicrobials. Patients who are prescribed with targeted antimicrobials (e.g. carbapenems, piperacillin-tazobactam, IV ciprofloxacin and IV levofloxacin) are reviewed holistically by the ASU pharmacists. In the event where the antibiotic is inappropriately or sub-optimally prescribed, cases will be discussed with the ASU physician and suggestions given which typically include antimicrobial discontinuation when a bacterial infection is deemed less likely or when the infection has been adequately treated, de-escalation of antimicrobials to narrower- spectrum agents and IV-to-PO switch. The goal of antimicrobial stewardship is to reduce inappropriate antimicrobial use, improve patient care outcomes and minimize unintended consequences of antimicrobial use such as antimicrobial resistance, acquiring Clostridium difficile infections, unnecessary antimicrobial drug costs and antimicrobial-related complications.

Cuilian Sun has obtained her PhD from the National University of Singapore. She is currently the Deputy Laboratory Director of the Pharmaceutical Laboratory, at the Health Sciences Authority in Singapore. She leads the ASEAN Reference Substances Project and is actively involved in the development of western medicine monographs for the International Pharmacoepoeia fo the World Health Organisation (WHO).

Chinese medicinal materials (CMM) (also known as Chinese medicinal raw herbs) and Chinese proprietary medicines (CPM), being natural in nature, have been perceived by the public as relatively low risk. However, they are not completely free from the possibility of toxicity or other adverse effects. Potential harm can occur due to inherent toxic properties of the herbs, as well as contaminants or adulterants in CMM and CPM. Previously, various heavy metal surveys performed by the health authorities of China (in 2016) and Taiwan (in 2006) have indicated presence of high levels of arsenic in Cordyceps and high levels of cadmium in Bulbus Lilii. As China and Taiwan are major suppliers of CMM and CPM in Singapore, such findings in China and Taiwan raised safety concerns regarding raw and finished products of Cordyceps and Bulbus Lilii sold in Singapore. Hence, as a follow-up to a smaller pilot-study conducted in Singapore (2015/2016), a more extensive survey was carried out by the Pharmaceutical Laboratory of the Health Sciences Authority in 2017 to study the levels of arsenic, lead, mercury and cadmium present in 20 CMM samples of Cordyceps and Bulbus Lilii, as well as in 17 CPM samples containing these herbs retailed locally, using inductively-coupled plasma mass spectrometry (ICP-MS) technique. The results of this study are presented in this poster; these findings would be useful for facilitating the review of regulatory controls on toxic heavy metals in Chinese medicinal raw herbs and Chinese proprietary medicines, retailed in Singapore.

Wenfeng Guo has completed his PhD from Heilongjiang University of Chinese Medicine and postdoctoral studies from Guangzhou University of Chinese Medicine. He is doing research on pharmacology and toxicology of Chinese medicine for about 15 years.

Venenum bufonis is a very promising Chinese herbal medicine, its pharmacological effects clear, but because of its complex composition, mechanism of pharmacologic is diverse, the main active ingredient of toad base with toxicity, so the clinical use of relatively safe range become smaller. In this study, the primary cultured cardiomyocytes were extracted to establish an in vitro experimental model to observe whether Cinobufagin is toxic to primary cardiomyocytes, and to investigate the toxic effects of Cinobufagin on the heart and its related mechanisms from the perspective of autophagy and apoptosis. The survival rate of isolated primary cardiomyocytes was about 70%-85%, After 72h, the pulsatility of clustered cells was accordance, with 50-110/min pulsation. DAPI staining could observe the nuclear fragmentation of the cells treated with toad toxin above the concentration of 15μM and the formation of apoptotic bodies. The detection of mitochondrial membrane potential showed that the red orange fluorescence of the cardiac myocytes, in the Cinobufagin treated group was significantly higher than that in the blank control group. The result of AO and MDC staining indicated that Cinobufagin could induce the increase of autophagic vacuoles and autolysosome production in primary cardiac myocytes. the toxicity of Cinobufagin on primary myocardial cells is concentration dependent, and large concentration can reduce cell viability and inhibit cell proliferation. Cinobufagin could induce apoptosis of primary cardiomyocytes through mitochondrial pathway, and induce autophagy in cardiomyocytes, which is one of the causes of myocardial damage. The Cinobufagin in vitro shows potential cardiac toxicity.

Chihiro Sakai has completed her PhD from Graduate School of Human Development and Environment, Kobe University. Currently, while working as a pharmacist at Gifu Pharmaceutical University pharmacy, she is engaged in research on medicine education for young people and work improvement of community pharmacists.

Education for Medicines was integrated into the Japanese junior high school health and physical education (HPE) guidelines in 2012, in tandem with revisions to the Course of Study. However, according to the survey we conducted targeting high school students in Gifu prefecture, it became clear that there were many students who think that they have never attended "Education for Medicines". In this research, we survey knowledge, behavior and attitudes about medicines among high school first graders in Japan. Furthermore, we clarify the relationship between awareness of taking the class of "Education for Medicines" and behavior, attitudes and knowledge about medicines. A questionnaire survey was administered at 81 high schools throughout Japan from May to August 2017. We received valid responses from 17,437 students (8,205 males, 9,232 females). Responding to a question on whether they were aware of the class of "Education for Medicines," 29.5% of the students answered “Yes,” 45.2% “I don’t know,” and 24.9% “No.” Students with awareness of the class tended to have more knowledge and take favorable attitudes and behaviors than non-aware students. Furthermore, students with positive attitude were likely to take medicines appropriately. The results of this survey suggest that ongoing implementation of the class of "Education for Medicines" promotes students to acquire knowledge and favorable behavior and attitudes about medicines. In future, further development of both the classes and the instructions are required, to accomplish the purpose given in the Course of Study.

Leong-Perng Chan is associated doctor at Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University. He focus on otorhinolaryngology-head and neck surgery, Squamous cell carcinoma of the head and neck, and Oncology filed.

8-Hydroxyquinoline derivatives have highly sensitive fluorescent chemosensors for metal ions, which are associated with a wide range of physiological activities, including anti-tumor, anti-microbial, anti-HIV-1, anti-oxidant activities. A novel 8-hydroxyquinoline derivative, Feq3, was synthesized. Oral cancer is generally detected in the late stages when the cancer has advanced, and therefore has a poor prognosis and survival rate. Therefore, effective chemotherapy agents are required to address this public health issue. This work is the first to identify the inhibition of cell growth by Feq3 and to examine its effects on cell cycle distribution and apoptosis in oral cancer cells. Squamous cell carcinoma (SCC) of oral cavity is of malignant tumors. Treatment of SCC25 cells with Feq3 increased expression of TNF-related apoptosis inducing ligand receptors (TRAIL-Rs), and enhanced the susceptibility of cells to TRAILs, and involved signal cascades caspase-3 effectors of apoptosis. This study of molecular mechanisms of the anti- oral cancer effects of Feq3 in SCC25 cells suggests that Feq3 can be applied as a chemopreventive agent for human oral cancer.

Kawthar Alghasham, PharmB, student in UWA. Master of Infectious diseases. Her practice expertise includes drug information, drug utilization review, medication therapy management and geriatrics in Almoosa Hospital. Her focus in cost effective medication management programs in a medical group setting, including target drug programs for providers and individual patient consults to minimize out-of-pocket medication expenses. She participated in several conferences and won third place at the Dubai conference 2017.

In-Vitro Introduction: In spite of significant risks, as well as non-clinical importance due to loss of potency, stiff penalties against administration of expired antibiotics are still not appropriately enforced by health policy makers in many developing countries, possibly because of little evidence to support that expired medications are hazardous Objective: To investigate the effect of expiration dates on in vitro bacteriostatic potentials of different oral antibiotics. The potency of five antibiotics , both expired and unexpired, Azithromycin, Clarithromycin, Levofloxacin and Cloxicillin, and tetracycline were investigated, based on the antimicrobial potentials. The investigation was done by challenging local isolates of different concentrations of S. aureus bacteria; using Disc diffusion technique. Results and Discussion: Although the expired antibiotics potency was less than that of the control ones, it was found that the microorganisms challenged with these antibiotics were evaluated as susceptible (According to NCCLS) , as the diameter of inhibition zone lies within the susceptible range. Recommendations: 1. If the antibiotic is needed, and the patient is not able to replace the expired antibiotic, there is no evidence that it is unsafe to take the medication in most cases 2. Guidelines for storage of essential medicine should be followed with antibiotics. 3. Public health policies based on national guidelines should include monitoring of the quality control of the expired antibiotic.

Bina Lee has completed her master degree at the age of 26 years from KyungHee University. She is studying doctoral degree at Kyunghee University of Korean Medicine. She published more than 4 papers related to inflammation and immuity in the SCIE journals and more than 3 papers related to bone in the global journals including SCIE journals. She is participating in several national research project to skin , bone and inflammation.

Steroid is a strong immune regulator which is used in inflammation diseases widely. However, altough its effectiveness, steroid usage is strictly controlled becuase of its severe side effects such as osteoporosis, diabetes, immune system broken and cushing’s syndrom. The cuase of secondary osteoporosis is known that occurs in certain diseases or treatments condition. The steroid has been pointed out as crucial cuase of secondary osteoporosis. There is many efforts to replace steroid, but usage of steroid is still increasing. Lycii Radicis Cortex (LRC) is has been used to treat high blood pressure, decrease body temperature and pain killing traditionally. In our previous study, LRC had reduced bone-loss in ovariectomized rat. According to reports, LRC had effect of anti-high glucose and anti-inflammation also. However, the effect of LRC in steroid-induced osteoporosis has not been invetigated. Therefore, we establish the research methodology for evaluation of medicine in bone loss by steroid side effect in atopic dermatitis condition. In this result, LRC has effect especially trabecular number and bone volume on steroid-induced secondary osteoporosis model. Futhermore, LRC inhibited Dickkopf-1 (DKK-1) and sclerostin (SOST) in animals serum. For that reason, LRC might has inhibitory effect on secondary osteoporosis through its wnt-pathway blocking.

Eun-Young Kim has completed her PhD at the age of 40 years from Kyung Hee University and she is investigating the osteoporosis and atopy dermatitis at department of oriental medicine in Kyung Hee University. She has published more than 20 papers in journals.

Abeliophyllum distichum(AD), called misun, is one of the Korean monotypic endemic species. AD has been used to treat the inflammatory disease, stomachache, diarrhea, deodorant and gynecologic disease with folk remedy in Korea. Some researcher have laready reported that AD has anti-cancer, anti-inflammatory and anti-oxidant effect. But protective effect for osteoporosis of AD has not reported yet. In this study, we investigated that anti-osteoporotic effects of ethyl-acetate fraction from AD leaf on RANKL-induced osteoclastogenesis and OVX-induced osteoporosis. RAW 264.7 cells were used as a model for RANKL-induced osteoclastogenesis. To investigate the effect of AD, TRAP activity, pit formation, and expression of osteoclast-related genes such as MMP-9, CA II, c-fos, NFATc-1, RANK, TRAP, OSCAR, ATP6v0d2 and CTK were measured. To investigate the mechanism of AD, expression of NFATc-1, c-fos and MAPK were analyzed using a western blot assay. OVX-induced osteoporosis model was used as menopausal osteoporosis. After both ovaries were removed through surgical procedure called ovariectomy, and AD or 17b-estradiol was orally administered for 8 weeks. Femurs of rat were extracted and measured bone parameter such as BV/TV, trabecular thickness, number and surface using a micro CT. AD significantly inhibited tarp activity, pit formation, expressions of osteoclast related genes by dose-dependent manner through inhibition of the MAPK pathway and c-fos/NFATc1 pathway. Also AD prevented bone loss without change of estradiol concentration. These results suggest that AD can be the basis of reasonable alternative for treating postmenopausal osteoporosis without adverse effect by change of hormone.

Sooyeon Hong is studying master degree at Kyung Hee University and she is investigating the osteoporosis and atopy dermatitis at department of oriental medicine in Kyung Hee University.

Fritillaria Thunbergii Miquel (FT) is bulbous plant of Liliaceae, has traditionally been used as an as an antitussive, expectorant, antihypertensive and anti-inflammatory agent. In this study, we aimed to determine the anti-inflammatory and anti-allergy effects of solvent extracts from FT. FT was extracted with 4 kinds of solvents. The extracted sample were as follows; methanol extreact (M-FT), chloroform fraction (Cl_FT), ethyl acetate fraction (EA_FT) and water fraction (w_FT). To determine the anti-inflammatory effect, we measured the expression of thymus and activation regulated chemokine (TARC/CCL17) and macrophage-derived chemokine (MDC/CCL22), which well known as typical inflammatory chemokines using a HaCaT keratinocyte. Also we investigated b-hexosaminidase to determine anti-allergy effect from RBL2H3. In this resulut, w_FT did not show anti-inflammatory effect. M_FT and EA_FT significantly inhibited TARC/CCL17 and MDC/CCL22 at a 400ug/ml dose, Cl-FT significantly inhibited TARC/CCL17 and MDC/CCL22 at a 50ug/ml. Additionally, Cl-FT inhibited the IL-4 expression. Anti-allergy effect was not showed in M_FT, EA_FT and w_FT. But Cl_FT sinificantly inhibited the release of b-hexosaminidase at 25ug/ml and 50ug/ml. These results suggest that Cl_FT could be suitable in development of inflammatory agent.

Jaehyun Kim has completed his master degree at the age of 26 years from KyungHee University and He is studying doctoral degree at Kyunghee University of Korean Medicine. He has been working as a researcher for various basic research projects and has published more than 3 papers related to bone in the journal. In addition, He has been a "Brain Korea 21" scholarship student since 2014 and constantly researched the effects of herbal medicines and ingredients on various diseases (skin disease, allergy, etc).

Fracture is one of the common orthopedic diseases. Recently, Korean medicine has shown a good effect in the treatment of fracture, and the number of patients who choose Korean medicine for fracture treatment is increasing. Fracture healing is closely related to the number and activity of bone marrow mesenchymal stem cells near the fracture site. Therefore, studies on medicine that activate osteoblasts are important in the treatment of fractures. The medicine used to treat fractures are selective estrogen receptor modulators (SERMs), parathyroid hormone (PTH1-34), bisphosphonates, and calcitonin. However, long-term administration has various side effects. Therefore, it is necessary to study natural products which have low toxicity and positive effect for long-term administration. Prunus davidiana Franchet (PF) is the dried semen of Prunus persica (L.) Batsch. PF has been used as an anti-oxidant, anti-thrombotic lipids, anti-influenza virus and Increase blood circulation. Blood circulation affects the fracture treatment, so it is expected that PF will be effective in treating fractures. In this study, we aimed to determine the effects of ethanol extracts of PF on fracture healing of rats and investigate its mechanism of actions related to the RUNX2 and MAPK signaling pathway.

Soo-Cheon Chae has completed his B.S. and M.S. degree from Chonbuk National University of South Korea and earned a PhD degree in molecular biology from Tohoku University of Japan in 1998. He trained as a Postdoctoral fellow at UC San Diego during 1998-2001. He is a professor of School of Medicine at Wonkwang University of the South Korea. He has published more than 90 papers in reputed journals and has been serving as an editorial board member of repute.

MiRNAs are non-coding RNAs that play important roles in the pathogenesis of human diseases by regulating target gene expression in specific cells or tissues. Previously we identified colorectal cancer (CRC) associated MIR196B, which was specifically up-regulated in CRC cells and tissue. We also identified 18 putative MIR196B target genes by comparing the mRNAs down-regulated in MIR196B-overexpressed cells with MIR196B target genes predicted by public bioinformatics tools. In this study, we verified the association between MIR196B and three genes, HOXA5, HOXB6 and GLTP. HOXA5, HOXB6 and GLTP transcripts were directly down-regulated by MIR196B. The mRNA and proteins levels of HOXA5, HOXB6 and GLTP were also down-regulated in CRC cells by the up-regulated MIR196B. GLTP protein expression was decreased in CRC tissues compared to adjacent non-tumor tissues. These results suggest that HOXA5, HOXB6, and GLTP were direct target genes of MIR196B in CRC cells, and that the up-regulated MIR196B in CRC tissue regulates the expression levels of HOXA5, HOXB6, and GLTP during colorectal carcinogenesis. Our results suggest that MIR196B may have a therapeutic value in relation to various human cancers.