Evaluation of Rational Medicine Use Based on WHO Core Drug Use Indicators in Public Hospitals in Wes by jamesfranklin229

urnal of Civi l Jo

es in Pharm nc

Engineering

ISSN: 2167-1052

Advances in Journal of Pharmacoepidemiology & Drug Safety

OPEN

ACCESS Freely available online

tal

y & Drug log

oepidem n i vironmen ac &E o

fety Sa

ISSN: 2165-784X

Civil & Environmental Engineering

Research Research Article Article

Adv a

Comparative Study ofMedicine the Mechanical Performance of Core Bitumen Drug Use Evaluation of Rational Use Based on WHO Binders and Mixtures Utilizing Rubber, Super, and Indicators in Public Hospitals in Crumb West Shoa Zone,Tafpack Oromia, Ethiopia polypropylene Esayas Tadesse Gebramariam and Mustefa Ahmed *

UnitXiaoming of Pharmaceutics andEldouma Social Pharmacy, H1* and IB1,2 Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ethiopia 1Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China; 2Department of Civil Engineering, Nyala Technological College, South Darfur, Nyala, Sudan

ABSTRACT ABSTRACT Background: The irrational use of medicines is a worldwide problem increasing morbidity, mortality and costs through increasing medicine patients arerendering not achieving theirsuper, desired This research aimsadverse to assess and thenreactions compareand the hence high-temperature of tafpack tire outcomes. rubber, andIn Ethiopia, althoughDynamic there areshear studies that show the presence of irrational use of medicines in the country, Polypropylene. rheometer experiment out righted to mensuration linear viscoelasticity areasthere of is limited objective evidence on evaluating medicine from prescriber, patientrutting and health facility perspectives. the modified bitumen at 58-88°C. Additionally, theuse modified asphalt mixture's deepness is measured in Therefore, theusing objective of this study test. was Finally, to evaluate rational medicine usethebased on WHO-core use millimeters the wheel tracking the rheological features of improved asphalt weremedicine contrasted indicators public WestasShoa Oromia region, Ethiopia. togetherinwith eachhospitals other asinwell with zone, the perspicuous asphalt. Conclusions manifested that the tire rubber modifierRetrospective has more excellent characteristics in high temperatures and less ruttingto depth thandata pothfrom polypropylene as Methods: and prospective cross sectional study were employed collect prescriptions well tafpack super. dispensed through main pharmacies and Information for patients respectively. A structured questionnaire was employed to collect information fromrubber prescription papers and respondents after obtaining a verbal consent. Data Keywords: Tafpack super; Crumb modifier; Polypropylene; Phase angle; Rutting parameter; Temperature wassweep entered, test cleaned, edited and analyzed using SPSS Version 23.0 statistical software package. Results: The average number of medicines prescribed per encounter was 1.74. The% of encounters in which an antibiotic and injection was prescribed was 48.9% and 12.6% respectively. The mean consultation timeand spent excellent characteristics in high temperatures less rutting INTRODUCTION between the prescriber and patient was 5.12 minutes and the mean pharmacy dispensing time was 1.28 minutes. depth than Poth polypropylene as well tafpack super. Binders The availability of selected tracer medicines in the health wastafpack 79.6%. characteristics improvement is possible either by facilities The pavement utilizing super (TPS) [1,8], crumb rubber modifier (CRM), bitumenConclusion: properties amendment or through asphalt and polypropylene (PP) and modified The study identified thatmodified the pattern of prescribing was appreciable nearlybitumen similar were with discussed. WHO Creep mixturesstandard improvement. ThisHowever, matter needs numerous for these binders were measured by using the dynamic shear reference. the patient careexperiments factors needs todata be improved. to assert this demand. The bitumen mechanical behaviors are rheometer (DSR) test over a wide range of temperatures at (58°C Keywords:upon Rational drugtemperature use; Indicators; Patient; Health facility highly depending ambient due toPrescriber; viscoelasticity to 88°C) to describe the behaviors of shear creep of modified propertyAbbreviations [1]. When temperature increased the Essential viscosity decreased, and Acronyms: EDL: Drug List; OPD: Out Patient Department; RMU:mixture Rationalevaluation Medicineto protect bitumen binders. Asphalt concrete and theUse; asphalt is becoming Thus, Sciences; the pavement SPSS: Statisticalresilient Package[2,3]. for Social STG: Standard Line; WHO: World Health it versusTreatment the ruttingGuide phenomenon of wheel track has turned to becomesOrganization permanently disfigured, therefore accelerating the rutting the substantial research area in recent years [6,8]. Thus, the wheel in the vehicles' wheel path [4,5]. Besides, the stress induced by tracking experiment was conducted to examine the permanent loading represents another significant parameter that permanently deformation of bitumen mixtures utilizing the above modifiers deforms the asphalt pavement [6,7]. CRM, TPS, and PP have for measuring the rutting depth. To characterize the attitude of INTRODUCTION broad applications to get better the pavement rutting performance. accessibility of medicines, prescribers’ knowledge and experience shear creep of the TPS, CRM, and PP modified asphalt, the shear Shear resistance characteristics of pure and amended asphalt. This of health professionals, health budget, and promotional activities rate andmanufacturing shear creep modulus was[3]. used. Wheel tracking Medicines substances a mixture of substances used in the ofstrain the medicine companies researchareaims to assessorand then compare the high-temperature test consequences were utilized to compare the influence of the prevention, cure,super, mitigation or treatment of disease renderingdiagnosis, of tafpack tire rubber, and Polypropylene. Rational medicine use (RMU) is well recognized as an important modified asphalt mixtures on the permanent deformation. The [1]. They are indispensable products in the course oftohealth care Dynamic shear rheometer experiment outrighted mensuration part of health policy. It requires that taking appropriate medication shear strain rate and the shear creep modulus of the TPS, CRM, service delivery and when available and managed well have been linear viscoelasticity areas of the modified bitumen at 58-88°C. by patients to the right clinical needs, in right doses for an adequate and PP modified asphalt binders are acquired, and compared, shown to improvethecustomer and patient Additionally modifiedsatisfaction asphalt mixtures' ruttingattendance deepness is period of time, at an affordable price. RMU is achieved when the together with each other and with base asphalt. The overall [2]. However, medicine use is a complex activity involving the measured in millimeters using the wheel tracking test. Finally, prescribers used essential medicines (EML)the to pavement prescribe objectives of thisan paper are to evaluate andlist compare interaction of different bodies like health professionals, the patient the rheological features of the improved asphalt were contrasted medicines. According to the World Health Organization (WHO), distresses regarding permanent deformation, moisture damage,a (client) and health institutions. It is as influenced by factors such as together with each other as well with the perspicuous asphalt. and the temperature cracks, in terms of extending the pavement Conclusions manifested that the tire rubber modifier has more Correspondence to: Esayas Tadesse Gebramariam, Unit of Pharmaceutics and Social Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, Ambo O. Box: 19, Ambo, Tel-251911925214; E-mail-Jiangsu, esayastadesse23@ Correspondence to: Xiaoming H,University, DepartmentEthiopia, of Civil P. Engineering, School of Ethiopia, Transportation Southeast University, China, Tel: yahoo.com; +861390517408; E-mail: huangxm seu.edu.cn February 28,; 2019; Accepted: 06, 2019; Published: March 2019 Received:Received: February 15, 2019 Accepted: AprilMarch 05, 2019 ; Published: April 15,15, 2019 Xiaoming H,Ahmed EldoumaMIB(2019) (2018) Evaluation Comparativeof Study of the Medicine Mechanical Use Performance of Bitumen Binders andUse Mixtures Utilizing Citation:Citation: Gebramariam ET, Rational Based on WHO Core Drug Indicators inCrumb Public Tafpack polypropylene. J Civil Environ Eng 9:330. doi: 10.24105/2165-784X.9.330 HospitaRubber, ls in West ShoaSuper, Zone,and Oromia, Ethiopia. Adv Pharmacoepidemiol Drug Saf 8:1. Copyright: 2019 XiaomingET, H, et open-access article distributed under the terms of theofCreative Commons Attribution License,License, which Copyright: © 2019 © Gebramariam etal.al.This Thisis isanan open-access article distributed under the terms the Creative Commons Attribution permitsunrestricted unrestricteduse, use,distribution, distribution,and and reproduction reproduction in source areare credited. which permits in any any medium, medium,provided providedthe theoriginal originalauthor authorand and source credited. J Civil Environ Eng, Drug Vol. 9Saf, Iss. Vol. 1 No:8 330 Adv Pharmacoepidemiol Iss. 1 No: 225

Gebramariam ET, et al. nvironm urnal of Civi Jo l

OPEN

ACCESS Freely available online

Engineering tal

rational prescription must meet Journal ofcertain criteria such as appropriate In view of the importance of the hospitals to the overall health of indication, appropriate patient, appropriate medicine, appropriate nearby peoples, this study will present pooled data on the pattern ISSN: 2165-784X Civil &monitoring. Environmental Engineering information and appropriate Prescribed medicines are of prescription medicine use from general outpatient dispensaries Research Article categorized as essential medicines if it satisfies the real demands of of these hospitals and it address key aspects of what the patients majority of the population care services using criteria such as riskexperience at hospitals, and how well they have been prepared to benefit ratio, cost effectiveness and quality [4]. deal with the medicine that have been prescribed and dispensed to limit undesired toxicity and adverse events and maximizes on Irrational medicine use is a global problem. Worldwide greater the benefits that can be derived from optimal use of medications. than 50% of all medicines are prescribed and dispensed incorrectly, Furthermore, the study is beneficial for zonal and regional health while 50% of patients do not take or wrongly take them. Moreover, departments and policy makers to take necessary intervention in about 33% of the world’s populations do not get essential medicines 1 1,2 promoting RMU. Xiaoming H * and Eldouma IB [5]. Misuses of medicines are especially common in low income 1 countries. Common typesEngineering, of irrationalSchool medicines use includes:Southeast poly METHODS Department of Civil of Transportation University, Jiangsu, China; 2Department of Civil Engineering, Nyala pharmacy; inappropriate use of antimicrobials, often in inadequate Technological College, South Darfur, Nyala, Sudan Hospital based cross sectional study design was employed to assess dosage, for non-bacterial infections; over-use of injections when oral rational medicine use based on WHO core medicine use indicators. formulations would be more appropriate; failure to prescribe in Retrospective cross sectional study design was used to evaluate accordance withABSTRACT standard treatment guidelines and inappropriate prescribing indicators while prospective cross-sectional design self-medication for prescription only medicines [6]. This research aims to assess and then compare the high-temperature tafpack super, tire rubber, and was used forrendering patient of care and facility indicators. All outpatient Irrational use ofPolypropylene. medicines can cause inappropriate patient need, out Dynamic shear rheometer experiment righted to dispensed mensuration linear viscoelasticity areas31, of2017 period prescriptions from January 1 to December and result stocktheout of medicines andat loss of patient confidence modified bitumen 58-88°C. Additionally, the modified asphaltindicators); mixture's rutting is measured (prescribing patientdeepness attendants and their in prescriptions in the health care system that reduced access patient millimeters usinglead the to wheel tracking test.and Finally, the rheological features (OPD) of the improved asphalt were contrasted in the hospitals from March 1 to March 31, 2018 (patient care attendance rates. Shortage of essential medicines andwith inappropriate together with each other as well as the perspicuous asphalt. Conclusions that thebased tire rubber indicators) and selected manifested essential medicine on the morbidity doses result inmodifier serious has morbidity and mortality, particularly more excellent characteristics in highfor temperatures and lessas rutting than poth polypropylene was included studydepth population. The sample size asof the study paediatrics infections and chronic well tafpack super. diseases, such as hypertension, were calculated based on WHO criteria, at least 100 sample sizes diabetes, epilepsy and mental disorders. Incorrect use and over-use of prescription and parameter; outpatient Temperature attendants (encounters) Keywords: super; and Crumb rubber modifier; Phaseencounters angle; Rutting of medicines result wastageTafpack of resources in significant patientPolypropylene; are recommended in individual health facility [11]. Therefore, to test patient outcomes and adverse medicine harm in termssweep of poor get a more reliable result (greater point estimate of the population) reactions. Furthermore, increased antimicrobial resistance and 300 prescription encounters and 200 samples of patients were non-sterile injections to the transmission of hepatitis, HIV/AIDS assessed in each hospital. Accordingly 2100 prescriptions 1400 excellent characteristics in high temperatures and lessand rutting INTRODUCTION and other blood-borne diseases can appeared due to inappropriate patients were Poth included in the study. Of these, prescriptions depth than polypropylene as well tafpackthe super. Binders use of antimicrobials [7]. selected by using sampling technique and The pavement characteristics improvement is possible either by were utilizing tafpack supersystematic (TPS) [1,8],random crumb rubber modifier (CRM), the patients were selected through convenient sampling technique bitumen properties amendment or through modified asphalt and polypropylene (PP) modified bitumen were discussed. Creep Improving medicine use would have important financial and public health facility were mixtures improvement. This the matter needs numerous experiments method. data forFor these binders wereindicators measured 14 by essential using the medicines dynamic shear health benefits. Furthermore, magnitude of inappropriate investigated as per WHO recommendation. Data was collected to assert this demand. The bitumen mechanical behaviors are rheometer (DSR) test over a wide range of temperatures at (58°C medicine use at community level is often overlooked and few using retrospective and the prospective structured check highly depending ambient due dispenser to viscoelasticity studies address rationalupon medicine usetemperature from prescriber, and to 88°C) to describe behaviors of shear observational creep of modified list for prescribing and patient care indicators respectively. property [1]. When temperature increased the viscosity decreased, consumer’s perspective. More research is needed on socio-cultural bitumen binders. Asphalt concrete mixture evaluation to protectA reference patient papers used to check patient and the asphalt is becoming resilient [2,3]. Thus, the pavement factors influencing the rational use of medicines, particularly from it versusofthe ruttingprescription phenomenon of wheel track has the turned to knowledge of how to take correct dosage. Stop watch was used becomes permanently disfigured, therefore accelerating the rutting prescriber, dispenser and consumer’s perspective [8]. the substantial research area in recent years [6,8]. Thus, the wheelto the contact was timeconducted of health to care providers patient in the vehicles' wheel path [4,5]. Besides, the stress induced by determine tracking experiment examine the with permanent The loading context represents in Ethiopiaanother is not different the restthat of developing and dispensing time). Prospective observational significantfrom parameter permanently (consultation deformation of bitumen mixtures utilizing the above modifiers countries. There irrational use of medicines practice deforms the isasphalt pavement [6,7]. CRM, TPS, throughout and PP have checklist was also applied for facility indicators. for measuring the rutting depth. To characterize the attitude of the health care system toofget thebetter country. For instance, to broad applications the pavement ruttingaccording performance. shearthe creepdata of the TPS, CRM, and PP modified asphalt, the shear After was manually checked for completeness and national done in 2003, the and availability essential Shearassessment resistance characteristics of pure amendedofasphalt. This strain rate and shear creep modulus was used. Wheel tracking consistencies, it was entered and analyzed by using SPSS version medicines lesstothan 65% of medicines were found researchwas aims assess andand then8%compare the high-temperature 23. statistics including frequency, percentage testDescriptive consequences were utilized to compare themean, influence of the to berendering expired in the same year [9]. Another, retrospective study of tafpack super, tire rubber, and Polypropylene. and table was used to present the data. During data modified asphalt mixtures on the permanent deformation. entry The conducted in shear Gondar university hospital showed thattothe average Dynamic rheometer experiment outrighted mensuration Medical supplies counted as modulus drugs andofanthelmintic and shear strain ratewere and not the shear creep the TPS, CRM, number of medicines prescribed per encounter was 1.76, whereas, linear viscoelasticity areas of the modified bitumen at 58-88°C. antiprotozoal were not counted as antibiotics. Vaccines including and PP modified asphalt binders are acquired, and compared, the Additionally percentage of with antibiotics prescribed was is the encounter modified asphalt mixtures' rutting deepness Tetanus injections. Some togetherantitoxin with eachwere othernot andconsidered with base as asphalt. The overall 52.33%, the percentage of encounters with injections prescribed measured in millimeters using the wheel tracking test. Finally, commonly used brand names of known drug combinations such objectives of this paper are to evaluate and compare the pavement 47.67%, percentagefeatures of medicines prescribed by generic name the rheological of the improved asphalt were contrasted ® ® , Terracortril and Augmentin were considered as Coartem distresses regarding permanent deformation, moisture damage,as 74.68% and with thoseeach prescribed whichasphalt. was together other asfrom well EML as withwas the82.44% perspicuous generic names. Abbreviations as TTC for and the temperature cracks, of in drugs terms such of extending thetetracycline pavement not in line with WHO recommendation Conclusions manifested that the tire[10]. rubber modifier has more and CAF for chloramphenicol were considered as generic names. Over all, although there are studies that indicate the presence of Class names such as antacid and cough syrup were considered as irrational use of medicines in the country, there is Correspondence to: Xiaoming H, Department of few Civilstudies Engineering, School of Transportation University, Jiangsu, the China, Tel: others (neither generic nor Southeast brand names). In counting number conducted on RMU in the county studied the subject from +861390517408; E-mail: huangxmand seu.edu.cn of drugs per prescription, known combination therapies like triple one perspective only; without including WHO recommendation therapy for H. pylori was not counted as 3 and diuretic, ACEI and Received: February 28, 2019; Accepted: March 06, 2019; Published: March 15, 2019 of 3 indicators that is the practice of prescribers, dispensers and spironolactone for cardiac failure was not counted as 3 in recording Xiaoming H, Eldoumathe IB (2018) Performance of Bitumen Binders and Mixtures Utilizing Crumb patientsCitation: about RMU. Therefore, aim ofComparative this studyStudy was oftothe Mechanical the number of drugs per prescription. Rubber, Tafpack Super, and polypropylene. J Civil Environ Eng 9:330. doi: 10.24105/2165-784X.9.330 evaluate rational medicine use based on WHO-core medicine use Ethical approval wasof obtained the research andLicense, community indicators in public hospitals in West zone, regional Copyright: © 2019 Xiaoming H, etShoa al. This is an Oromia open-access article distributed under the terms the Creativefrom Commons Attribution which service team leader of college of medicine and health sciences of permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. state, Ethiopia.

Comparative Study of the Mechanical Performance of Bitumen Binders and Mixtures Utilizing Crumb Rubber, Tafpack Super, and polypropylene

J Civil Environ Eng, Drug Vol. 9Saf, Iss. Vol. 1 No:8 330 Adv Pharmacoepidemiol Iss. 1 No: 225

Gebramariam ET, et al. nvironm urnal of Civi Jo l

OPEN

ACCESS Freely available online

Engineering tal

Concerning the prescribing patterns in each hospital, the average Ambo University Journal and from of the respective hospitals. Besides, a number of medicines per prescription was 1.62, 1.67, 1.76, 1.73, verbal consent was obtained from all participants before starting ISSN: 2165-784X Civil &Confidentiality Environmental Engineering 1.8, 1.79 and 1.81 in AURH, AGH, GIH, GEH, GUH, JH and EH the actual data collection. and anonymity of Research Article respectively. information was maintained throughout the data collection and analysis period by not linking personal identifiers in the data The percentage of medicines encountered with antibiotics were presentations. 122 (40.7%), 115 (38.3%), 148 (49.4%), 139(46.4%), 166 (55.2%), 161 (53.7%) and 176 (58.6%) in AURH, AGH, GIH, GEH, GUH, RESULTS JH and EH respectively. The percentage of medicines prescribed A total of seven hospitals were surveyed. A total of two thousand from Ethiopian EML was 100% in all studied hospitals (Table 2). one hundred (2100), prescriptions were used for the evaluation of Patient care indicators Xiaomingindicators H1* andand Eldouma the prescribing a total of IB one1,2thousand four hundred (1400) 1 patients participated in the study regarding consultation patient China; care, 2Department the study of found that the average Department of Civil Engineering, School of Transportation Southeast Regarding University, Jiangsu, Civil Engineering, Nyala and dispensing times, labelling basics and patient’s knowledge on consultation time was 5.12 minutes. As it can be seen from Table 3, Technological College, South Darfur, Nyala, Sudan correct dosage. Jeldu hospital had the lower mean consultation time 4.20 and the

Comparative Study of the Mechanical Performance of Bitumen Binders and Mixtures Utilizing Crumb Rubber, Tafpack Super, and polypropylene

Prescribing indicators

ABSTRACT The prescribing pattern observed in the seven hospitals indicated

higher was in Ambo general hospital i.e.6.35 minutes. The overall mean pharmacy dispensing time was 1.28 minutes.

Among 332 rendering medicinesof dispensed in all seven hospitals This3654 research aims to were assess and then compare the high-temperature tafpack super, tire rubber, and243 (73.2%) that a total of medicines prescribed from 2100 medicines were actually dispensed to the patients. no Polypropylene. shear rheometer experiment of prescription encounters. The Dynamic average number of medicines per out righted to mensuration linear viscoelasticity areasAlarmingly, single medicine was adequately labelled (0%), patient name was not the modified bitumenfrom at 58-88°C. Additionally, the modified asphalt mixture's rutting deepness is measured in prescription paper was 1.74 ranging 1 to 5 per prescription. indicated in anyofofthe theimproved labels, and whereas of the labels contain using the wheel test.inFinally, the rheological features asphalt wereallcontrasted From the total millimeters of 2100 prescription paperstracking evaluated the study dosage form. However, 56% medicines were fairly labelled, i.e. they together with other per as well as with the perspicuous asphalt. Conclusions manifested that the tire rubber 334 (15.8%) contained one each medicines a single patient, 648 contained at least four of the information, drug name, modifier more excellent characteristics high214 temperatures and less rutting depth than poth polypropylene as strength, (30.9%) contained two,has 904 (43.1%) contained three inand dose and frequency of dosage. The average adequacy of patient well tafpack (10.2%) contained four orsuper. more medicines. The mean number knowledge (n=1400) on correct dosage of medicines dispensed was of medicines prescribed per a single patient was not significantly Keywords: Tafpack super; Crumb rubber modifier; Polypropylene; Phase angle;hospitals Rutting (Table parameter; Temperature 69.6% in all selected 3). different from that of the WHO standard value i.e. 1.6-1.8 mean sweep test per facility. Health facility indicators The numbers of prescriptions containing one or more injectable INTRODUCTION medicines were 12.6% in average, with no significant variations among the seven hospitals. The average percentage of patients The pavement characteristics is possible eithertoby receiving one or more antibioticsimprovement in the hospitals was found bitumen properties amendment or through modified asphalt be 48.9%, the higher (58.6%) in Enchine and the lower (38.3%) mixtures improvement. This matter needs numerous experiments in Ambo general hospital. Among all the medicines prescribed in to assert 88.3% this demand. The bitumen mechanical the hospitals were generic medicines and all ofbehaviors them wereare highly depending upon ambient temperature due to viscoelasticity present in EML (Table 1). property [1]. When temperature increased the viscosity decreased, the asphalt ofis medicine becoming resilient [2,3]. Thus,in the pavement Tableand 1: Distribution prescription indicators seven public becomes disfigured, therefore hospitals, Westpermanently Shoa Zone, Ethiopia, March 2018. accelerating the rutting in the vehicles' wheel path [4,5]. Besides, the stress induced by Total no of loading represents another significantprescription parameter thatPercentage permanently Prescribing indicators deforms the asphalt pavement [6,7]. (N=2100) CRM, TPS, and(%)PP have broad applications to get better the pavement rutting performance. Number of medicine per prescription Shear resistance characteristics of pure and amended asphalt. This One 334 15.8 research aims to assess and then compare the high-temperature Two 648 30.9 rendering of tafpack super, tire rubber, and Polypropylene. Three 904 43.1 Dynamic shear rheometer experiment outrighted to mensuration linear viscoelasticity areas of the modified 58-88°C. Four 182 bitumen at8.7 Additionally Five the modified asphalt mixtures' is 32 rutting deepness 1.5 measured in millimeters using the wheel tracking test. Finally, Number of medicine encounter with antibiotics the rheological features of the improved asphalt were contrasted None 1073 51.1 together with each other as well as with the perspicuous asphalt. One 846 40.3 Conclusions manifested that the tire rubber modifier has more Two

181

8.6

Evaluation of health facility indicators showed that 3 (42.9%) of excellent characteristics in high temperatures and less rutting hospitals had a copy of Ethiopian EML, 7 (100%) had a copy of depth than Poth polypropylene as well tafpack super. Binders standard treatment guideline (STG) for hospitals and 5 (71.4%) of utilizing tafpack super (TPS) [1,8], crumb rubber modifier (CRM), the them had a copy of medicine formulary; however others have and polypropylene (PP) modified bitumen were discussed. Creep not any essential reading materials listed above during the study data for these binders were measured by using the dynamic shear period. the availability of tracer medicines in the studied hospitals rheometer (DSR) test over a wide range of temperatures at (58°C was 79.6% (Table 4). to 88°C) to describe the behaviors of shear creep of modified Moreover, medicines ferrous salts with folic acids, bitumen tracer binders. Asphalt like concrete mixture evaluation to protect Vitamin A and tetracycline eye ointments were not in to it versus the rutting phenomenon of wheel track available has turned majority of the hospitals during the study period (Table 5). the substantial research area in recent years [6,8]. Thus, the wheel tracking experiment was conducted to examine the permanent DISCUSSION deformation of bitumen mixtures utilizing the above modifiers The prescription a reproducible for WHO measuring the ruttingindicators depth. Toprovide characterize the attitudeand of objective measure characterizing prescriptions. The guidelines shear creep of thefor TPS, CRM, and PP modified asphalt, the shear onstrain rational drugscreep had reference of (1.6-1.8) rateuse andofshear modulus values was used. Wheel medicine tracking per the average of 1.74tomedicines study isofmuch testencounter; consequences were utilized compare in thethis influence the comparable and within in the acceptable limits [12]. The findings modified asphalt mixtures on the permanent deformation. The ofshear this study lower than similar studies in different strainwere ratemuch and the shear creep modulus ofdone the TPS, CRM, countries like Nigeria, Bangladesh and others, where as the result and PP modified asphalt binders are acquired, and compared, is together comparable Hawasa referral with with each that otherobtained and within base asphalt. The hospital overall which is 1.9 as reported by Anteneh [12,13]. The lower objectives of this paper are to evaluate and compare the number pavementof medicines encounter might bedeformation, seen in its positive prospect that distressesper regarding permanent moisture damage, asand the the degree of poly pharmacy decreases, low incidences of side temperature cracks, in terms of extending the pavement effects and drug-drug interactions and enhanced compliance by the patients could be obtained [14].

Number of medicine encounter with injection Correspondence to: Xiaoming H, Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China, Tel: The percentage of encounters in which antibiotics were prescribed None E-mail: huangxm seu.edu.cn 1836 87.4 +861390517408; is 48.9% which is greater than the WHO standard value 20.0-26.8. One 184 8.8 Received: February 28, 2019; Accepted: March 06, 2019; Published: March 15, 2019 As this figure indicates that antibiotic prescription is incorrect and Two 80 3.8 it needs regulation. ofIncorrect use of and antibiotics can potentially Citation: Xiaoming H, Eldouma IB (2018) Comparative Study of the Mechanical Performance Bitumen Binders Mixtures Utilizing Crumb Number of medicine prescribed by lead to medicine resistance and increase the necessity to use more 2032 96.7 Rubber, Tafpack Super, and polypropylene. J Civil Environ Eng 9:330. doi: 10.24105/2165-784X.9.330 generic name expensive antibiotics to treat life-threatening infections [13,15]. Copyright: © 2019 Xiaoming H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which Number of medicine prescribed from 2100 100 permits unrestricted provided the original and source arefound credited. the present studyauthor injection use was to be 12.6%, which is essential medicine use, list distribution, and reproduction in any medium, In J Civil Environ Eng, Drug Vol. 9Saf, Iss. Vol. 1 No:8 330 Adv Pharmacoepidemiol Iss. 1 No: 225

Gebramariam ET, et al. nvironm urnal of Civi Jo l

OPEN

Engineering tal

ACCESS Freely available online

Table 2: Average value of medicine Journal ofprescription indicators as compared to WHO standard value in seven public hospitals, West Shoa Zone, Ethiopia, March 2018. ISSN: 2165-784X

Indicators

Civil & Environmental Engineering WHO standard Study findings value (average)

Research Article

Mean core medicine indicator in each hospital

AURH

AGH

GIH

GEH

GUH

Comparative Study of the Mechanical Performance of Bitumen Average number of medicines 1.6-1.8 1.74 1.62 1.67 1.76 1.73 1.8 1.79 Binders and Mixtures Utilizing Crumb Rubber, Tafpack Super, and prescribed % of encounters polypropylene 20.0-26.8 48.9 40.7 38.3 49.4 46.4 55.2 53.7 with antibiotics Xiaoming % of encounters H with 1 injections

* and Eldouma IB

EH 1.81 58.6

1,2

13.4-24.1

12.6

11.2

13.8

10.7

15.4

14.3

12.3

10.5

100

96.7

93.7

90.7

100

97.6

100

Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China; 2Department of Civil Engineering, Nyala % of medicines Technological College, South Darfur, Nyala, Sudan prescribed by generic name

% medicines ABSTRACT prescribed from 100 100 100 100 100 100 100 100 This research aims to assess and then compare the high-temperature rendering of tafpack super, tire rubber, and EDL

100

Polypropylene. Dynamic shear rheometer experiment out righted to mensuration linear viscoelasticity areas of

AURH-Ambo University Referral Hospital; AGH-Ambo General Hospital, GIH-Gindberet Hospital; GEH-Gedo Hospital; JH-Jaldu Hospital; EHthe modified bitumen at 58-88°C. Additionally, the modified Enchine Hospital asphalt mixture's rutting deepness is measured in

millimeters using the wheel tracking test. Finally, the rheological features of the improved asphalt were contrasted together with each other as well as with the perspicuous asphalt. Conclusions manifested that the tire rubber Table 3: Distribution of patient care indicators in seven Public Hospitals, West Shoa Zone, Ethiopia, March 2018. modifier has more excellent characteristics in high temperatures and less rutting depth than poth polypropylene as Indicator well tafpackMean AURH AGH GIH GEH GUH JH super.value

Average consultation 5.12 super; Crumb6.13 6.35 Polypropylene; 4.6 Phase angle; 5.25 Rutting 4.9 4.2 Keywords: Tafpack rubber modifier; parameter; Temperature time (min)

EH 4.41

sweep test

Average dispensing time(min)

1.28

1.43

% medicines actually INTRODUCTION 73.2 dispensed

85.5

1.54

1.1

1.25

1.3

1.24

1.1

excellent characteristics in high rutting 61 67.5 74 temperatures 67.5 and less 66 depth than Poth polypropylene as well tafpack super. Binders pavement characteristics improvement is possible either by %The of medicines utilizing tafpack super (TPS) [1,8], 0 0 0 0 0 0 crumb rubber 0 modifier (CRM), 0 adequately bitumenlabeled properties amendment or through modified asphalt and polypropylene (PP) modified bitumen were discussed. Creep improvement. This matter needs numerous experiments %mixtures of adequacy of data65for these binders by using 69.6 80.5 89 62.5 were measured 67.5 60 the dynamic 62.5shear knowledge of patient to assert this demand. The bitumen mechanical behaviors are rheometer (DSR) test over a wide range of temperatures at (58°C highly depending upon ambient temperature due to viscoelasticity to 88°C)intoWest describe the behaviors of shear Table 4: Health facility indicator results in seven hospitals Shoa Zone, Ethiopia, March 2018.creep of modified property [1]. When temperature increased the viscosity decreased, bitumen binders. Asphalt concrete mixture evaluation to protect HF indicators Frequency (N=7) Percentage (%) and the asphalt is becoming resilient [2,3]. Thus, the pavement it versus the rutting phenomenon of wheel track has turned to becomes permanently disfigured, therefore acceleratingAvailability the rutting of copythe of EML substantial research area in recent years [6,8]. Thus, the wheel in the vehicles' wheel path [4,5]. Besides, Yes the stress induced by 42.9permanent tracking experiment was 3conducted to examine the loading represents another significant parameter that permanently No 57.1 modifiers deformation of bitumen 4mixtures utilizing the above deforms the asphalt pavement [6,7]. CRM, TPS, and PP have the rutting depth. To characterize the attitude of Availability of copyfor of measuring STG broad applications to get better the pavement rutting performance. shear creep of the TPS, CRM, and PP modified asphalt, Yes 7 100 the shear Shear resistance characteristics of pure and amended asphalt. This strain rate and shear creep modulus was used. Wheel tracking No the high-temperature 0 0 research aims to assess and then compare test consequences were utilized to compare the influence of the Availability of copy of medicine formulary rendering of tafpack super, tire rubber, and Polypropylene. modified asphalt mixtures on the permanent deformation. The Dynamic shear rheometer experiment outrighted to mensuration Yes 5 71.4 shear strain rate and the shear creep modulus of the TPS, CRM, linear viscoelasticity areas of the modified No bitumen at 58-88°C. 2 28.6 and PP modified asphalt binders are acquired, and compared, Additionally the modified asphaltof mixtures' ruttingindeepness is % of availability tracer medicines stock 78 and with base asphalt. 79.6The overall together with each other measured in millimeters using the wheel tracking test. Finally, objectives of this paper are to evaluate and compare the pavement the rheological features the improved asphalt were contrasted Table of 5: Distribution of availability of tracer medicines in seven hospitals in West Shoa, Ethiopia, March 2018. distresses regarding permanent deformation, moisture damage, together with each other as well as with the perspicuous asphalt. Tracer medicines in the stock AURH AGH GIH in terms GEH of extending GUH JH pavement EH and the temperature cracks, the Conclusions manifested that the tire rubber modifier has more Amoxicillin (all dosage forms)

Arthemether-lumefantrine 1 1 1 1 1 1 1 Correspondence to: Xiaoming H, Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China, Tel: Paracetamol tablet 1 1 1 1 1 1 1 +861390517408; E-mail: huangxm seu.edu.cn Benzoic28, acid + salicylic acidMarch Ointment 0 1 0 0 0 0 Received: February 2019; Accepted: 06, 2019; Published: March 15,02019 Ceftriaxone injection 1 Performance 1 1 1 and Mixtures 1 1 1 Citation: Xiaoming H, Eldouma IB (2018) Comparative Study of the Mechanical of Bitumen Binders Utilizing Crumb Rubber, Tafpack Ferrous Super, and J Civil Environ Eng 9:330. doi: 10.24105/2165-784X.9.330 saltpolypropylene. + Folic acid tablet 1 1 0

Mebendazole tablet 1 1 of the Creative 1 0 0 1 1 Copyright: © 2019 Xiaoming H, et al. This is an open-access article distributed under the terms Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided Medroxyprogesterone Acetate (Depo-Provera) Injection 1 the original 1 author 1and source 1are credited.1 1 1 J Civil Environ Eng, Drug Vol. 9Saf, Iss. Vol. 1 No:8 330 Adv Pharmacoepidemiol Iss. 1 No: 225

Gebramariam ET, et al. nvironm urnal of Civi Jo l

OPEN

Engineering tal

ISSN: 2165-784X

Journal Oralof rehydration salts

ACCESS Freely available online

Civil &RHZE-table Environmental Engineering 1

Tetracycline ointment

Lamivudine + Tenofovir + Efavirenz tablet

Research Article 1

ComparativeOxytocin Study of the Mechanical Performance injection 1 1 1of Bitumen 1 1 0 A (retinol) Utilizing Crumb Rubber, 0 0 Tafpack 0 0Super, 1 and0 Binders and Vitamin Mixtures Iodine/gentian violet 1 1 0 0 0 0 polypropylene % of availability 85.7 92.9 78.6 78.6 78.6 71.4

1 1 0 0 71.4

H * and Eldouma IB 1=Xiaoming Yes, 0=No. AURH-Ambo University Referral Hospital; AGH-Ambo General Hospital, GIH-Gindberet Hospital; GEH-Gedo Hospital; JH-Jaldu Hospital; EH-Enchine Hospital. 1 2 1

1,2

Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China; Department of Civil Engineering, Nyala Technological College, South Darfur, Nyala, Sudan This finding closer to the WHO standard value i.e. 13.4%-24.1%. 73.2% were actually dispensed, this percentage is lower than similar is much lower than that obtained from Hawasa referral hospital studies conducted in north west Ethiopia and in different other which was 38.1%, but it is comparable with the report from North countries like Nigeria and Cambodia. This shows the weakness of ABSTRACT West Ethiopia (11.07%) [10,13]. Low percentage of encounters with the pharmaceutical supply system to provide prescribed medicines This research aims to assess and then theofhigh-temperature of tafpackofsuper, tire rubber, and or noninjections may have an advantageous in reducing thecompare possibility to patients.rendering Non-availability essential medicines Dynamic like shear rheometer experiment righted to linear viscoelasticity areas of reason. transmissions ofPolypropylene. blood born infections HIV and hepatitis [16]. out adherence to mensuration standard treatment protocols could be one the modified bitumen at 58-88°C. Additionally, the modified asphalt mixture's rutting deepness is measured in WHO guideline expects 100% of medicines prescription to be Moreover, the time of data collection was the end of review period millimeters using the wheel tracking test. Finally, the rheological features of the improved asphalt were contrasted generic, similarly in this study 96.7% of medicines were prescribed in both of the facilities which might lead them in significant stock together with each other as well as with the perspicuous asphalt. Conclusions manifested that the tire rubber by generic names. Prescribing the quality and the cost of prescribed outs. Whatever the case could be this may also be an indication of modifier has more excellent characteristics in high temperatures and less rutting depth than poth polypropylene as medications can be determined by the level of compliance to generic poor drug supply management system in the facilities. Because good well tafpack super. prescription. Increasing generic prescription could substantially medicine supply management ensures uninterrupted accessibility Tafpack super; and Crumb rubber modifier; Phase Rutting parameter; Temperature reduce the cost Keywords: of medicines for patients health facilities [17]. Polypropylene; of medicines andangle; prevents frequent stock outs and wastages [17,20sweep test 22]. 100% of the medicines prescribed in this study were found to be listed in the national EML, even though only three hospitals had a In this study, about 70% of the patients know about the dosage copy of the national EML. A study of the patterns of prescription at ofexcellent their medicines at exit in interviews. The remaining 30%rutting of the characteristics high temperatures and less INTRODUCTION Jimma Hospital, south west Ethiopia, showed similar results, where patients has no information aboutas the of medicines, which depth than Poth polypropylene welluse tafpack super. Binders almost medicinescharacteristics prescribed for the health problems onby inutilizing other words implies that 30% of the medicines dispensed go Theallpavement improvement is possiblewere either tafpack super (TPS) [1,8], crumb rubber modifier (CRM), the EML of the country, amendment but few medicines prescribed out ofasphalt the waste because of poor communication. Different factors could lead bitumen properties or through modified and polypropylene (PP) modified bitumen were discussed. Creep list were foundimprovement. in the national list ofnumerous Ethiopia [9,18]. It is fordata thisfor barrier as educational background, cultural, mixtures Thismedicine matter needs experiments these such binders were measured by using the dynamicphysical shear expected that 100% of medicines will be prescribed from the EMLare factors and etc. Moreover, the short dispensing time by itself could to assert this demand. The bitumen mechanical behaviors rheometer (DSR) test over a wide range of temperatures at (58°C or formulary. Prescribing medicines the EML issued by WHO betoa factor, because the clients have no enough time to get enough highly depending upon ambient from temperature due to viscoelasticity 88°C) to describe the behaviors of shear creep of modified provides a framework rational prescribing; on the information about the medicines they have been dispensed [23,24]. property [1]. Whenfor temperature increased themedicines viscosity decreased, bitumen binders. Asphalt concrete mixture evaluation to protect list are medicines,resilient already [2,3]. testedThus, in practice, with andwell-established the asphalt is becoming the pavement it versusofthetherutting phenomenon track were has turned to Majority hospitals included ofin wheel the study used the established use anddisfigured, lower costtherefore than newer medicines becomesclinical permanently accelerating the[19]. rutting national the substantial research area recentbut years [6,8]. EML, formulary andinSTGs none ofThus, them the hadwheel their in the vehicles' wheel path [4,5]. Besides, the stress induced In this study the average consultation and dispensing time inby own EMLs,experiment formularies STGs. Facility based EML and STG tracking wasorconducted to examine the permanent loading represents another significant parameter that permanently facilities was 5.12 minute and 1.28 minutes respectively. Smaller aredeformation very crucialoffor the hospitals since the prevalence diseases bitumen mixtures utilizing the above of modifiers deforms the asphalt pavement and PPflow have is affected by geographic location of the facilities and socio number of health professionals and[6,7]. large CRM, numberTPS, of patient for measuring the rutting depth. To characterize the attitude of applications get better the pavement rutting performance. couldbroad be the probable to reason for such smaller time. The findings demographic characteristics of the shear creep of the TPS, CRM, andresidents. PP modified asphalt, the shear Shear resistance characteristics of pure and amended This from this study were smaller than the study conductedasphalt. in South strain rate and shear creep modulus trackingis About 79.6% of tracer medicines werewas in used. stock. Wheel This finding aims to6.14 assess and then the high-temperature Westresearch of Ethiopia minutes and compare 1.38 minutes respectively. test consequences were utilized to compare the influence the lower than a result from Nigeria (83.3%) [19]. The absence ofoftracer rendering of tafpack super,than tiresimilar rubber, and conducted Polypropylene. Moreover, the value was smaller studies in modified asphalt mixtures on the permanent deformation. The Dynamic rheometer experiment outrighted to mensuration medicines in stock was a strong indicator of weak pharmacy service countries like shear Nigeria and Cambodia [20,21]. shear strain rateand andimpairs the shear modulus of provided the TPS, CRM, in the hospitals thecreep overall services by the linear viscoelasticity areas of the modified bitumen at 58-88°C. and PP modified asphalt binders are acquired, and compared, According to the recommendation of WHO adequate label of health sectors [25]. Additionally the modified asphalt mixtures' rutting deepness is together with each other and with base asphalt. The overall medicines include at least patient name, drug name,test. strength, measured in millimeters using the wheel tracking Finally, LIMITATIONS OF are THE STUDY objectives of this paper to evaluate and compare the pavement dosage (dose and frequency) and duration/quantity of the the rheological features of the improved asphalt were contrasted distresses regarding permanent deformation, moisture damage, medicine. In this study none of labels for the medicines contained to irrational together with each other as well as with the perspicuous asphalt. The present study was not described the reasons leading and the temperature cracks, in terms of extending the pavement at least six informations to be said adequately labelled. However, Conclusions manifested that the tire rubber modifier has more prescribing of medicines. Moreover, the study was not devised any 56% of drug labels were fairly labelled, fulfilling at least four of follow up mechanism to know whether the patient appropriately the information: drug name, strength, dose and frequency. Even use the medicines after they have taken the medicines to their Correspondence to: Xiaoming H, Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China, Tel: though, high load of patient flow could be one of the factors but, home. +861390517408; E-mail: huangxm seu.edu.cn inadequacy of knowledge and skill in labelling of prescribed drugs February Accepted: MarchThe 06, 2019; Published: 15, 2019 CONCLUSION could beReceived: the major factor28, for2019; these low results. findings from March the study was very much smaller than similar studies conducted Citation: Xiaoming H, Eldouma IB (2018) Comparative Study of the Mechanical Performance of Bitumen Binders and Mixtures Utilizing Crumb The pattern of prescribing was appreciable and nearly similar with locally and other countries, the smallerJ Civil figureEnviron for adequate Rubber, Tafpack Super, where and polypropylene. Eng 9:330. doi: 10.24105/2165-784X.9.330 WHO standard reference with regard to numbers of medicines labelling was 67% [18-20]. prescribed per encounter, percentage of injections prescribed and Copyright: © 2019 Xiaoming H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which

from permits unrestricted use, distribution, anddispensed reproduction in any medium, medicines provided theprescribed original author andessential source aremedicine credited. list. However, the Regarding percentage of medicines actually in this study J Civil Environ Eng, Drug Vol. 9Saf, Iss. Vol. 1 No:8 330 Adv Pharmacoepidemiol Iss. 1 No: 225

Gebramariam ET, et al. nvironm urnal of Civi Jo l

OPEN

ACCESS Freely available online

Engineering tal

pattern of prescription was far Journal of from the WHO standard values 10. WHO. How to investigate drug use in health facilities: selected regarding to antibiotic prescription. The average consultation and drug use indicators. World Health Organization, Geneva, ISSN: 2165-784X Civil & Environmental dispensing time was low, which might affect the quality Engineering of service Switzerland. 1993. Research Article given to the patient and there by patient satisfaction. Moreover, 11. Odusanya OO, Oyediran MA. Rational drug use in primary above 70% of prescribed medicines were actually dispensed to health care centers in Lagos, Nigeria. NigQt J Hosp Med. the patients and 80% of tracer medicines were in stock in the 2000;10:4-7. hospitals, which are an indicative of low stock outs and good 12. Anteneh AD. Assessment of drug use pattern using WHO supply management in the hospitals. Almost all guide lines, such prescribing indicators at Hawassa University teaching and as treatment guideline and medicine formularies were available referral hospital, south Ethiopia: a cross-sectional study. BMC in the hospitals, though none of them had their own EMLs. It is 1 1,2 health service research. 2013;13:170. recommended prescription Xiaomingthat H antibiotic * and Eldouma IB should be in line with the 1standard treatment guidelines and all medicine dispensed IE. Evaluation drug use of and patient care practices Department of Civil Engineering, School of Transportation Southeast 13. Chima University, Jiangsu, China; 2of Department Civil Engineering, Nyala should be adequately labelled. in a referral health facility in Yenagoa, Bayelsa State, Nigeria. Technological College, South Darfur, Nyala, Sudan Continental J Pharm Sci. 2012;6:10-16. ACKNOWLEDGEMENT

Comparative Study of the Mechanical Performance of Bitumen Binders and Mixtures Utilizing Crumb Rubber, Tafpack Super, and polypropylene

14. Akinyede AA, Mabadeje AFB, Aliu AA. A comparative study of We would like to thank Ambo university research and community ABSTRACT the patterns of prescription of antibiotics in two health centers service office for sponsoring this research project. We are very much in Lagos.rendering J Nig Infect ContAssoc. This researchfor aims to assess and thenand compare the high-temperature of tafpack super,2000;3:20-23. tire rubber, and thankful to data collectors their commitment scrupulous Polypropylene. Dynamic shear rheometer experiment righted to mensuration linear viscoelasticity of activities they were doing during data collection. We would also out 15. Karande S, Sankhe P, Kulkarni M. Patterns areas of prescription and bitumen 58-88°C. the modified asphalt mixture's rutting deepness is measured in like to thank allthe themodified participants of theatstudy as thisAdditionally, research project drug dispensing. Indian J Pediatr. 2005;72(2):117-121. using the wheel Finally, the rheological features of the improved asphalt were contrasted would not havemillimeters been possible without theirtracking sincere test. cooperation. 16. WHO (2010) The manifested world medicines together with each other as well as with the perspicuous asphalt. Conclusions that the situations: tire rubber chapter 8, COMPETING INTERESTS rational use of medicines. World Health Organization, modifier has more excellent characteristics in high temperatures and less rutting depth than poth polypropylene as Geneva, Switzerland. well manuscript tafpack super. The authors of this declare that they have no competing interests. 17. Mulugeta TA,angle; NasirRutting TW, Raju NJ. Assessment of patterns of Keywords: Tafpack super; Crumb rubber modifier; Polypropylene; Phase parameter; Temperature drug use by using World Health Organization’s prescribing, sweep test REFERENCES patient care and health facility indicators in selected health facilities in southwest Ethiopia. JAPS. 2011;01(07):62-66. 1. Kishore J. National health programs of India: national policies th excellent characteristics in high temperatures and less rutting & legislations related to health. 6 (edn), Century Publications, INTRODUCTION 18. El Mahalli AA. WHO/INRUD drug prescribing indicators at depth than Poth polypropylene as well tafpack super. Binders New Delhi, India. 2006. primary health care centres in Eastern province, Saudi Arabia. The pavement characteristics improvement is possible either by utilizing tafpack super (TPS) [1,8], crumb rubber modifier (CRM), EMHJ. 2012;18(11):1091-1096. 2. Fidler A, Msisha W. Governance pharmaceutical bitumen properties amendment inorthe through modifiedsector. asphalt and polypropylene (PP) modified bitumen were discussed. Creep Euro health. 2008;14(1):25. mixtures improvement. This matter needs numerous experiments 19. Odusanya Drugwere use measured indicatorsbyatusing a secondary healthshear care data for theseOO. binders the dynamic to assert this demand. The bitumen mechanical behaviors are facility in Lagos, Nigeria. Nig J Comm Med Pri Health Care. 3. WHO. The rational use of drugs: report of a conference of rheometer (DSR) test over a wide range of temperatures at (58°C highly depending upon ambient experts. Nairobi, Kenya. 1985. temperature due to viscoelasticity to2004;16(1):21-24. 88°C) to describe the behaviors of shear creep of modified property [1]. When temperature increased the viscosity decreased, bitumen binders. Asphalt mixture to protect 20. Chareonku C, Khun LV,concrete Boonshuyar C. evaluation Rational drug use in 4. Enwere CO, resilient Salako [2,3]. BL. Drug prescribing and the OO, asphaltFalade is becoming Thus, the pavement it versus the rutting phenomenon of wheel track has turned Cambodia. Study of three pilot health centers in south easttoin pattern at the medical outpatient clinic of a tertiary hospital becomes permanently disfigured, therefore accelerating the rutting the substantial research area in recent years [6,8]. Thus,Med the wheel kampong thom province. Southeast Asian J Trop Public inin the southwestern Nigeria. Pharmacoepidemiol Saf.by vehicles' wheel path [4,5]. Besides, the stressDrug induced tracking experiment was conducted to examine the permanent Health. 2002;33(2):418-424. 2007;16(11):1244-1249. loading represents another significant parameter that permanently deformation of bitumen mixtures utilizing the above modifiers deforms asphalt pavement [6,7]. CRM, TPS,study and Nepal. PP have 21. Management Sciences for Health. Managing Drug Supply. 1st 5. Blum NL.the Drug information development. A case for measuring the rutting depth. To characterize the attitude of broad applications to get better the pavement rutting performance. (edn), Kumarian Press, West Connecticut, USA. Rational pharmaceutical management project. United States shear creep of the TPS, CRM, and Hartford, PP modified asphalt, the shear Shear resistance characteristics of pure and amended asphalt. This 1997. Pharmacopoeia. 2000. strain rate and shear creep modulus was used. Wheel tracking research aims to assess and then compare the high-temperature test consequences to compare the OB, influence of the 22. Lamichhane DC,were Giriutilized BR, Pathak OK, Panta Shankar PR. 6. Alam K, Mishra P, Prabhu M, Shankar PR, Palaian S, Bhandari rendering of tafpack super, tire rubber, and Polypropylene. modified asphalt on the permanent deformation. Thein Morbidity profilemixtures and prescribing patterns among outpatients RB, et al. A study on rational drug prescribing and dispensing Dynamic shear rheometer experiment outrighted to mensuration a teaching hospital in western Nepal. Mcgill JofMed. 2006;9:126shear strain rate and the shear creep modulus the TPS, CRM, inlinear outpatients in a tertiary viscoelasticity areas ofcare theteaching modifiedhospital bitumenofatWestern 58-88°C. 133. and PP modified asphalt binders are acquired, and compared, Nepal. Kathmandu Univ Med J. 2006;4:436-443. Additionally the modified asphalt mixtures' rutting deepness is together with each other and with base asphalt. overall measured millimeters using the Finally, 23. Hogerzeil HV, Bimo, Ross-Degnan D, Lang RO, The Ofori-Adjei 7. Otoom S, inBatieha A, Hadidi H, wheel Hasan tracking M, Al- test. Saudi K. objectives of this paper are to evaluate and compare the pavement the rheological features improved contrasted D, Santoso B, et al. Field tests for rational drug use in twelve Evaluation of drug useofinthe Jordan usingasphalt WHOwere prescribing distresses regarding permanent deformation, moisture damage, together with other Health as well J.as2002;8(4-5):537-543. with the perspicuous asphalt. developing countries. Lancet. 1993;342(8884):1408-1410. indicators. Easteach Mediterr and the temperature cracks, in terms of extending the pavement Conclusions manifested that the tire rubber modifier has more 24. Acurcio FA, Perini E, Magalhaes SM, Terceiro LG, Vieira-Filho 8. FMOH, WHO. Assessment of the pharmaceutical sector in JM, Coutinho KE, et al. Analysis of medical prescriptions Ethiopia. Ministry of Health, Addis Ababa, Ethiopia. 2003. Correspondence to: Xiaoming H, Department of Civil Engineering, School of Transportation Southeast University, Jiangsu, China, Tel: dispensed at health centers in Belo Horizonte, Minas Gerais, 9. Admassie E, Begashaw B, Hailuseu.edu.cn W. Assessment of drug +861390517408; E-mail: huangxm Brazil. Cad Saude Publica. 2004;20:72-79. use practices and completeness of prescriptions in Gondar Received: February 28, 2019; Accepted: March 06, 2019; Published: March 15, 2019 25. Baghdadi‐Sabeti G, Cohen‐Kohler JC, Wondemagegnehu E. university teaching referral hospital. IJPSR. 2013;4(1):265-275. Measuring transparency in Binders the public pharmaceutical sector: Citation: Xiaoming H, Eldouma IB (2018) Comparative Study of the Mechanical Performance of Bitumen and Mixtures Utilizing Crumb Rubber, Tafpack Super, and polypropylene. J Civil Environ Eng 9:330. doi: 10.24105/2165-784X.9.330 Assessment instrument. World Health Organization. 2009. Copyright: © 2019 Xiaoming H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. J Civil Environ Eng, Drug Vol. 9Saf, Iss. Vol. 1 No:8 330 Adv Pharmacoepidemiol Iss. 1 No: 225