bluuebunny/crossref_metadata_2025 huggingface dataset:
PATTERNS OF ACUTE POISONING AMONG PATIENTS TREATED IN THE EMERGENCY WARDS OF A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY
Authors: Revathi Devi , Reddy Sathvika , Prasanna V Lakshmi , Ramesh Aruna C
Published: November 2018

Objective: Poisoning is a growing health-care burden in developing countries like India. Predicting the nature of the intention behind poisoning and type of poisoning agent involved will help in facilitating appropriate treatment measures, hence, improving the patient’s quality of life.Methods: The prospective, observational study was conducted in a tertiary care multispecialty hospital for 6 months from November 2016 to April 2017 and involved a total of 133 patients. Treatment and outcomes of the patients were collected, documented in a data collection form. Chi-square test and logistic regression analysis were applied.Results: The mean age of the study participants was 27.76±15.5 with predominance seen in age groups of <30 years (59.3%), females (52.6%), and married (49.6%). Intentional poisoning (69.1%) through oral ingestion (81.2%) of medications (51.6%) in solid forms (60.2%) was predominant. Patients presenting with systemic manifestations (70.4%) arrived in a time duration >1 h (66.2%), received first aid (62.4%), and supportive care (52.7%). Higher ingestion of physical forms was significantly observed in both single (OR: 4.5) and married (OR: 3). The outcomes were correlated with poison severity score and patients with mild symptoms recovered (60.9%).Conclusion: The use of medicines for intentional poisoning continues to be rampant in younger age groups and married individuals. Educational programs with more accentuation on the data regarding toxic substances along with preventive measures are to be implemented to make mindfulness among the overall population.
EVALUATION OF ANTIFUNGAL POTENTIAL OF ALLIUM AMPELOPRASUM AGAINST FUNGAL PHYTOPATHOGENS
Authors: Khan Shahid , Kaur Amandeep , Sharma Neeta Raj
Published: November 2018

Objective: Present study evaluates the antifungal potential of Allium ampeloprasum extracts against two phytopathogens of economic importance, namely Alternaria triticina and Magnaporthe oryzae which are found to be one of the greatest threats to wheat and rice crop worldwide.Methods: Four different organic solvents, i.e., water, methanol, acetone, and hexane were used for extract preparation based on the increasing order of polarity. Further, different concentrations of these extracts were used to perform a quantitative assay for measuring the antifungal activity of extracts. Two-way analysis of variance was used to statistically analyze the results through GraphPad Prism v. 7.00.Results: The best results were shown by water extracts with a maximum inhibition of 99.39±0.2% against A. triticina and 99.39±2.2% against M. oryzae. Water extracts gave minimal inhibitory concentration 90 values at 9.94 μg/mL against M. oryzae and at 16.73 μg/mL against A. triticina.Conclusion: Water extracts of A. ampeloprasum have relatively higher potential for being used as an antifungal agent as compared to other organic extracts used in this study. Further study on the chemical composition of A. ampeloprasum water extracts can reveal potent anti-phytopathogenic fungal compounds which can be used to develop biofungicides.
ANTIPLAQUE EFFICACY OF GANODERMA LUCIDUM TOOTHPASTE - AN IN VITRO STUDY
Authors: S Prabhjeet , A K Meena , M Jesil
Published: November 2018

Objective: The objective of the study was to evaluate the efficacy of Ganoderma lucidum toothpaste as an antiplaque agent and to compare its efficacy with herbal toothpaste and mouthwash.Methods: Pooled saliva was collected in a sterile container from the volunteers after taking the consent. Tissue culture plate with 12 (3 × 4) wells was chosen. Pooled saliva of 20 mL was added to each well using the micropipette and was kept in the incubator at 37°C for 72 h. After 72 h, saliva was removed without touching the walls or the base of the wells. Each row was treated either with slurry prepared with Ganoderma/herbal/Colgate total toothpaste or herbal/chlorhexidine mouthwash/distilled water. One row of wells was kept as a control using erythrosine dye. After 30 s, all the wells were rinsed with distilled water. Erythrosine dye was added to all the wells, kept for 30 s, and rinsed with distilled water. The tissue culture plate was kept in the ELx800MS machine (ELISA reader) which was set at 540 nm, and the readings were obtained.Results: The results showed that G. lucidum toothpaste slurry reduced plaque than herbal and chlorhexidine mouthwash. However, there was no significant difference in plaque reduction between herbal and G. lucidum toothpaste slurries.Conclusion: The present study concluded that G. lucidum had better antiplaque efficacy than herbal toothpaste, herbal mouthwash, and chlorhexidine mouthwash.
EVALUATION OF USE OF ANALGESICS IN PAIN MANAGEMENT AMONG SURGEONS IN A TERTIARY CARE HOSPITAL
Authors: Dawane Jayshree , Khade Kalyani , Ingale Yamini , Pandit Vijaya
Published: November 2018

Objective: The objective of this study is to evaluate pain and to assess if analgesic prescriptions are according to the World Health Organization guidelines. Methods: The study was conducted in the Department of Surgery in a tertiary care hospital. Patients with age >18 years, of either sex, admitted to surgery ward were included in the study. Pain assessment was done using a visual analog scale and McGill questionnaire. Information obtained from case paper sheets was recorded, such as name of analgesics, the generic name of prescribed analgesics, dosage, route of administration, frequency, number of analgesics per prescription, and non-pharmacological techniques. Data generated from the questionnaire were entered into an Excel sheet, and percentages were calculated. Results: A total of eight different analgesics were prescribed in the study group. Paracetamol was the maximally prescribed drug (40%). In 48% of cases, antacids were given along with analgesics. A majority of analgesics were prescribed in generic names (52%). No drug was prescribed to almost 18% cases even though the pain intensity was of mild-to-moderate intensity. Conclusion: Commonly prescribed drugs were paracetamol + tramadol. Prescription pattern of analgesics is partially deviating from standard guidelines. Generic names were written in the majority of prescriptions, which is in accordance with standard prescription writing.
STUDY OF PREECLAMPSIA IN PLACENTA, KIDNEY, AND HEPATIC DISEASES
Authors: Situmorang Putri Cahaya , Ilyas Syafruddin
Published: November 2018

Preeclampsia (PE) have a high risk of pregnancy disorder and can cause liver and kidney disease. PE is a dangerous disease in Indonesia with a high risk of cardiovascular death. PE has biomarkers such as proteinuria, blood pressure, dipstick test, renin-angiotensin system, adipsin, calcium/ creatinine (Cr) ratio, albumin/Cr ratio, and uric acid. Apoptosis occurs in the placenta’s PE, where trophoblasts invade and overhaul the uterine spiral artery in the epidermal growth factor signaling system, and the expression of miRNA in PE is targeting genes in a variety of pathophysiological processes can cause kidney and hepatic disease. In this review, we will discuss role of HSP, miRNA, Immunology cell and the risk of kidney and hepatic disease of patient of Preeclampsia.
DESIGN AND CHARACTERIZATION OF MICROEMULSION GEL FOR TRANSDERMAL DRUG DELIVERY SYSTEM OF DULOXETINE HYDROCHLORIDE
Authors: Tole Karishma , Deshmukh Ganesh
Published: November 2018

Objective: The objective was to improve the bioavailability, stability of formulation, and skin permeability of Duloxetine HCl.Method: Microemulsion was prepared with oleic acid as oil, water, and Smix ratio of tween 20 to propylene glycol (1:3). Pseudo-ternary phase diagrams were constructed to determine the region of existence of microemulsions prepared using oil titration method. Optimization of formulations was done based on the in vitro diffusion studies. The microemulsion was gelled using carbopol 934p and HPMCK 100 as the gelling agent.Result: After the analysis of different evaluation parameter and drug release, the F3 batch was selected as a promising formulation for delivery of duloxetine HCl as a microemulsion gel for transdermal drug delivery with 79.607% drug release in 10 h.Conclusion: It was observed that transdermal microemulsion gel can be formulated successfully for duloxetine HCl with improved bioavailability. Among the other batches, the F3 batch was selected as an optimized batch because all the evaluation parameters results are satisfactory. From stability data, the formulation was found to be stable as no phase separation or turbidity was observed in the formulation after 3 months.
AN OBSERVATIONAL STUDY OF MEDICATION ERRORS AMONG PSYCHIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL
Authors: Jose Reenu , K Krishnaveni , Maria Jesna , Sundaram R Shanmuga , R Sambathkumar
Published: November 2018

Objective: The objective of this study is to evaluate the common medication error (ME), and its causes, category, and severity by using suitable questionnaire.Methods: A prospective observational study was carried out for 6 months in a psychiatric department. Demographic data, clinical history, and complete prescription were noted.Results: A total of 120 psychiatric cases were collected, among that 116 MEs were identified in which male patients were 64 (55%) and females 52 (44.8%). The number of MEs occurred due to physician was 67 (57.7%), due to nurses was 15 (12.9%), and combined was 38 (32.7%). Incomplete prescription was the main type of error that we found. About 43.1% of the error we identified was informed to the staff and and no specific action was needed for 37.1% of errors. In our study, we found that majority of 54 (46.5%) errors were categorized under category B, but there was no harm to the patient.Conclusion: The present study concluded that most of the patients admitted in the psychiatry department would experience MEs. Clinical pharmacist can play a major role in the early detection and prevention of MEs and thus can improve the quality of care to the patients.
EFFECT OF CULTURAL CONDITION ON EVALUATION OF HEPATOPROTECTIVE ACTIVITY OF METHANOLIC BARK EXTRACT OF ANOGEISSUS LATIFOLIA ON ETHANOL-INDUCED HEPATOTOXICITY
Authors: Bisht Prateek , S Chandrashekhara , Das Kuntal , Tribedi Sourav
Published: November 2018

Objective: Geographical location has a great importance on phytoconstituents content in plants. The present study was aimed to understand the impact of soil nature of geographical zone on evaluation of hepatoprotective activity Anogeissus latifolia (AL), (family: Combretaceae) methanolic bark extract on ethanol-induced hepatotoxicity in Wistar rats.Methods: Soil sample was collected and analyzed for various physicochemical properties. Atomic absorption spectrophotometer was used for determination of heavy metals present in soil sample. Thereafter, liver damage was produced by ethanol (3.76 g/kg p.o). The plant extract was administered orally for 25 days. At the end of the study, the biochemical parameters were investigated. Silymarin was used as a standard. Furthermore, histopathology was carried out and characterized by severe vacuolar, cytoplasmic degeneration, and hepatic necrosis. Finally, the impact of soil parameters is correlated with the evaluated study.Results: Analyzed soil sample showed pH is acidic (pH=5.48) and presence of higher amount of iron (Fe), copper (Cu), and zinc (Zn) (77.37 mg/kg, 10.87 mg/kg, and 19.26 mg/kg, respectively) whereas other metals such as nickel, chromium, cadmium, and lead are present in less content. Thereafter, treatment of animals with methanolic extract of AL bark significantly (p<0.05) decrease the levels of serum glutamic oxaloacetic transaminase in serum which is an indicative of hepatoprotective activity. Also brought down the level of serum glutamic pyruvic transaminase significantly (p<0.05 in 200 mg/kg b.w. and 400 mg/kg b.w. doses, respectively). Various parameters physical parameters, cholesterol level, and total protein were estimated. Histopathology studies and triglycerides also were indicative of hepatoprotective property.Conclusion: Finally, the results concluded that the presence of higher amount of Fe and Zn helps to get the significant results of the present investigation which has great impact on liver protection and the selected plant extract showed dose-dependent significant hepatoprotective effect against ethanol-induced hepatotoxicity in Wistar rats.
NASAL COLONIZATION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AMONG CLINICAL POSTGRADUATES IN A COASTAL KARNATAKA MEDICAL COLLEGE - PREVALENCE AND ANTIBIOGRAM PATTERN
Authors: Juneja Isha , Hegde Ashwini , Rao Pooja , M Radhakrishna
Published: November 2018

Objective: The incidence of community-acquired and hospital-acquired Staphylococcus aureus infections has been rising with increasing emergence of drug-resistant strains called methicillin-resistant S. aureus (MRSA). The prime objective of the study was to ascertain the prevalence of carriage rate of MRSA among the clinical postgraduate students of a medical college of Coastal Karnataka, India.Methods: A total of 133 clinical postgraduates have participated in the present study. Swabs from both anterior nares were collected and processed for S. aureus from the consenting participants after giving a set of questionnaires. The isolated strains of S. aureus were screened for methicillin resistance by the modified Kirby-Bauer method using cefoxitin (30 μg) disc. Antibiotic susceptibility testing for all isolates of S. aureus was also done against other antibiotics. E test was used to know vancomycin resistance for MRSA.Results: The numbers of S. aureus isolated of 133 participants were 22 (16.5%). Of 22 isolates of S. aureus, 12 were MRSA (54.5%). The MRSA carriage rate of clinical postgraduates of a medical college from Coastal Karnataka, India, was 9%. All the MRSA isolates were susceptible to vancomycin and teicoplanin. Contact with chronic patients and consumption of antibiotics in past 6 months were found to be statistically significant as the risk factor associated with the acquisition of S. aureus/MRSA carriage status among the participants. No vancomycin-resistant S. aureus was reported from the present study.Conclusion: The S. aureus and MRSA nasal carriage rates of clinical postgraduates recorded in this study were significantly high when compared with the general population. This could be due to their continuous exposure to patients in clinical settings. It is desirable that these students must receive sufficient knowledge regarding control measures to avoid the spread of MRSA infection in hospitals.
FIRST REPORT ON FIBRINOLYTIC AND THROMBOLYTIC ACTIVITY OF EUTYPHOEUS GAMMIEI AN EARTHWORM SPECIES COLLECTED FROM TRIPURA, NORTHEAST INDIA
Authors: Debnath Madhusudan , Saha Susmita , Kumar Sil Samir
Published: November 2018

Objective: The present investigation for the first time evaluated the in vitro fibrinolytic and thrombolytic activities of crude extracts from Eutyphoeus gammiei, native, large size earthworm of Tripura, Northeast, India. The present study was designed to evaluate the therapeutic use of the organism E. gammiei as a source of fibrinolytic and thrombolytic agent(s).Methods: The fibrinolytic activity was studied using by fibrin plate and zymography assays. Thrombolytic assay was carried out according to Prasad et al. (2006) using whole blood.Results: The results obtained clearly indicated E. gammiei as a potential source of fibrinolytic and thrombolytic agents. Both in fibrin plate assay and thrombolytic assay with whole blood, E. gammiei crude homogenate showed similar and close results in respect to that of streptokinase. Fibrin zymography also showed antifibrinolytic activity with producing clear bands. Dose and time dependency also is evident from the results.Conclusion: The results of the present study conclude that the studied earthworm species E. gammiei possessed profound fibrinolytic and thrombolytic activity on human blood and E. gammiei might prove to be useful alternative source for the development of new drugs for treatments involving blood coagulation and fibrinolysis.
DEVELOPMENT AND VALIDATION OF A NOVEL METHOD FOR CAUSALITY ASSESSMENT USING SUSPECTED ADVERSE DRUG REACTIONS TO ANGIOTENSIN-CONVERTING ENZYME INHIBITORS
Authors: Goyal Ravi , Kaur Sodhi Rupinder , Gupta Anuj
Published: November 2018

Objectives: The study has been designed to develop, test reliability, and construct validity of a novel versatile causality assessment tool (VCAT) method.Methods: The study included 427 literature case reports of angiotensin-converting enzyme inhibitors with suspected adverse drug reactions from 1990 to February 25, 2016. The causality of these cases was assessed independently by 3 raters in 3 phases of the study. Kappa (k) and intra-class correlation Intraclass Correlation Coefficient (ICC) were used to test reliability and validity of the VCAT method.Results: Intra-rater reliability was high between Phase I and Phase III (k=0.84–0.93; % agreement: 92.3–96.3%). Inter-rater agreement was good in Phase I (k=0.87–0.89, % agreement: 93.7–94.1%, ICC: 0.975) and Phase III (k=0.85–0.89, % agreement: 93–94.4%, ICC: 0.973). Validity was proved by the high agreement observed between Phase I and Phase II (k=0.78–0.94; % agreement: 89.7–97.2%; p<0.001); and between Phase II and Phase III (k=0.8–0.9; % agreement: 90.2–94.8%; p<0.001).Conclusion: VCAT method is a standardized causal assessment tool that gives valid and reproducible results. It has shown good agreement with the expert judgment method. This method may overcome the limitations enthralled with existing methods of causality assessment.
MORTALITY PREVENTION IN SEPTIC MICE WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME: THE OPTIMAL DOSE OF INTRAPERITONEAL HEAT SHOCK PROTEIN 70
Authors: Sukamto Igl , Purwanto Bambang , Mudigdo Ambar , Suroto Suroto , Murti Bhisma , Ayuningrum Ika Yuli
Published: November 2018

Objective: Heat shock protein 70 (HSP70) reduces the expression of cytochrome C, B-cell lymphoma-associated X, and cysteine-aspartic acid protease 3 (Caspase 3), in apoptosis of multiple organ dysfunction syndrome (MODS), and thereby can prevent death. Previous researchers used 226 mg/kgBW/intraperitoneal (ip) of HSP70. This study aimed to determine the lowest effective dose of HSP70 to prevent death in sepsis mice model with MODS.Methods: This was a randomized control trial conducted at Pusat Antar Universitas (PAU), Gadjah Mada University, Yogyakarta, Indonesia, from April 1, 2017 to April 21, 2017. The study subjects were Balb/c strain mice. The drug used to induce death was lipopolysaccharides (LPS). The drug used to prevent death in this study was Rat HSP70. A sample of 25 mice was randomized into five groups with each consisting of five mice: (1) Control group with NaCl, (2) experimental group receiving LPS injection of 0.25 mg/kgBW/i.p, (3) experimental group receiving the same dose of LPS injection with HSP70 injection of 100 μg/kgBW/ip, (4) experimental group receiving the same dose of LPS injection with HSP70 injection of 200 μg/kgBW/ip, and (5) experimental group receiving the same dose of LPS injection with HSP70 injection of 300 μg/kgBW/ip. Percentage of live mice between groups was compared by Chi-square test.Results: 3 days after intervention, 13 (86.7%) live mice in the experimental group with ≥100 μg/kgBW/i.p HSP70 were >2 (40%) live mice in the experimental group with <100 μg/kgBW/i.p HSP70, with p=0.038. All mice receiving ≥200 μg/kgBW/ip HSP70 in the experimental group were Alive 3 days after intervention.Conclusion: The lowest effective dose of HSP70 to prevent death in sepsis mice model with MODS is 200 μg/kgBW/ip. All mice are alive 3 days after receiving ≥200 μg/kgBW/ip HSP70.
PREVALENCE AND SEVERITY OF POSSIBLE DRUG-DRUG INTERACTIONS AMONG THE GERIATRIC PATIENTS AT AN INDIAN TERTIARY CARE TEACHING HOSPITAL
Authors: Sripada Ramam , Kumar Sv Suresh , N Devanna , Ravindra Reddy Kandula
Published: November 2018

Objective: The objective of this study was to study the prevalence and severity of possible drug-drug interactions (DDIs) among the geriatric patients.Methods: The present study was a retrospective cross-sectional study. Case records of geriatric inpatients from the medical records department were included in the study and the case records of all the remaining age group inpatients were excluded from the study. All the collected cases were subjected to check for the DDIs using the software Micromedex 2.0 and were categorized into minor, moderate, and major based on the severity.Results: In this study, a total of 85 cases were screened for possible DDIs, and among them, 54 cases were found to be with 179 possible DDIs. The prevalence was observed to be 63.5%. Most of the possible DDIs were found to be with moderate severity (65.4%) followed by major (25.7%). Majority of the possible DDIs were observed in the Department of General Medicine (83.2%) followed by chest and tuberculosis (7.8%).Conclusion: Majorly, the severity of interactions was found to be moderate in this study. To reduce the DDIs, rationale prescriptions have to be prescribed by considering the risk-benefit ratio. Geriatrics should be prescribed very cautiously because the age-related pharmacokinetics plays a significant role. By taking all the above aspects into consideration, clinical pharmacist should play a crucial role in the prevention and management of DDIs, especially in geriatrics.
EVALUATION OF VITAMIN D SERUM LEVELS IN PATIENTS WITH INSOMNIA
Authors: Jai Joseph Maria , V P Karthik
Published: November 2018

Objectives: The primary objective of the study was to evaluate the link existing between insomnia and low levels of Vitamin D and the secondary objective was to confirm a link between age and insomnia.Methods: The study assessed the Vitamin D serum levels in 50 subjects with insomnia (diagnosed using Pittsburgh Sleep Quality Index [PSQI]) from the outpatient clinic, Department of General Medicine of Sri Ramachandra Medical Center. All subjects fulfilled the eligibility criteria and also signed the informed consent form provided in patient’s native language for their convenience. With all aseptic precautions, 5 ml of blood was collected from the subjects for tyhe measurement of 25-OH Vitamin-D total levels using fully automated chemiluminescent immunoassay. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS 1 7.1). Quantitative variables will be expressed as mean ± standard deviation (SD), and qualitative variables will be expressed as percentage values.Results: All the patients who are insomniacs were deficient of Vitamin D. Of this, 80% were in deficient state (i.e.,>20 ng/ml) and the rest 20% were in the insufficient state (i.e., 20–30 ng/ml). Most of the insomniacs were younger adults. As shown in the graph, 27 patients were in between the age group of 20 and 30 years, 13 patients of 50 patients were between 30 and 40 years of age, 4 patients between 40 and 50 years of age, 4 patients between 50 and 60 years of age, and 2 patients were of age between 60 and 70 years.Conclusion: Our results concluded that insomnia has a direct link with Vitamin D deficiency. Male insomniacs who were Vitamin D deficient were 40% more than female insomniacs with Vitamin D deficiency. It was noted that the incidence of increased body mass index and systolic blood pressure was seen among Vitamin D-deficient insomniacs. Insomnia was more prevalent among younger age groups rather than older adults. Global PSQI value evaluated among all Vitamin D-deficient patients was >5, which indicated poor sleep quality.
ANTIBIOTIC PROPHYLACTICS ON CURETTAGE FOR PREVENTING PELVIC INFLAMMATORY DISEASE EVENTS: IS IT NECESSARY?
Authors: Herawati Fauna , Rahem Abdul , Handayani Dwi , Yulia Rika
Published: November 2018

Objective: This study aimed to compare pelvic inflammatory disease (PID) symptoms in curettage procedure with three antibiotic prophylaxis strategies.Methods: The patients were allocated to three Groups (A, B, and C). Group A was patients receiving prophylactic antibiotics and post-curettage antibiotics, Group B received prophylactic antibiotics without post-curettage antibiotics, and Group C did not receive prophylactic antibiotics but received post-curettage antibiotics. The outcomes measured to identify the occurrence of PID symptoms included leukocytes, erythrocyte sedimentation rate, temperature, pain, vaginal discharge, and bleeding.Results: This study shows that there were no significant differences in any PID symptoms between antibiotic strategies except for pain scale (p=0.03).Conclusion: The PID symptoms between the three strategies of antibiotic prophylaxis were similar.
EFFICACY OF ORMELOXIFENE IN MANAGEMENT OF DYSFUNCTIONAL UTERINE BLEEDING
Authors: Sawarkar Umesh , Deshmukh Sarang , Raut Ashwini , Bhosale Uma , Shenoyk Ashok
Published: November 2018

Objective: The objective was to evaluate the efficacy of ormeloxifene in dysfunctional uterine bleeding (DUB) with respect to bleeding pattern and improvement in hemoglobin (Hb).Methods: This was an interventional study on 99 patients of DUB visiting the gynecology outpatient department over 1 year using semi-structured pro forma. After voluntary participation of patients, tablet ormeloxifene was given at the dose of 30 mg biweekly for 2 months. In case of a therapeutic response as informed by the patient, the dose was reduced to 30 mg weekly for a further period of 4 months. All patients were treated for 6 months. Type, amount, and duration of bleeding, frequency of menstrual cycle, passage of clots, and impact on Hb were assessed.Result and Observations: Menorrhagia was the main type of bleeding. 36–40 years of age group was the most common. After the intervention, 76.8% of women achieved a duration of bleeding of 4–5 days, and in 87% of women, menstrual cycle became regular. Passage of clots was reduced by 71.83%. Mean Hb concentration of study participants increased by 0.5 g/dl at the end of the study.Conclusion: Ormeloxifene is effective alternative and appears to be a promising option for the medical management of DUB.
MANAGEMENT OF RHEUMATOID ARTHRITIS: SPECIAL CONSIDERATION FOR BIOLOGIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS
Authors: Abdul Razak Salmi , Makmor-bakry Mohd , Md Redzuan Adyani
Published: November 2018

Rheumatoid arthritis (RA) is a progressive chronic inflammatory disease affecting 0.5–1.0% of the adult population worldwide. Due to the damages caused by this autoimmune disease, new biologic therapies, particularly the biologic disease-modifying antirheumatic drugs (bDMARDs), are now being the treatment of choice in the management of RA. However, special precaution and prescreening before the usage of bDMARDs are needed to ensure better clinical response and avoiding risk of adverse event during treatment with the selected bDMARDs. In this review paper, we will provide overview on the incidence and pathogenesis of the disease, available pharmacological treatment and emphasizing special consideration in need on initiation of bDMARDs among RA patients. A literature review was performed by searching for relevant articles in Medline database through PubMed using medical subject headings terms and keywords: RA, bDMARDs, special consideration, tumor necrosis factor inhibitor, and non-tumor necrosis factor inhibitor. All papers reviewed were from 1999 to 2017 and were written in English. In this article, use of conventional synthetic DMARDs (csDMARDs), bDMARDs and special consideration to be taken upon initiation of biologic therapies in RA will be reviewed.
EFFECT OF SILYMARIN ON INTESTINAL ALKALINE PHOSPHATASE LEVEL IN A RAT MODEL OF TYPE 2 DIABETES MELLITUS: STREPTOZOTOCIN AND HIGH-FAT DIET TREATED WISTAR RATS
Authors: V Lalitha , T Sivakumar
Published: November 2018

Objective: This research elucidated the role of silymarin on intestinal alkaline phosphatase (IAP) level in type 2 diabetic rats.Methods: The type 2 diabetes mellitus was induced by a high-fat diet (HFD - 58% calories fat) for 2 weeks, and rats were intraperitoneally injected with streptozotocin (STZ) 35 mg/kg. Wistar rats were divided into four groups. Group I served as a non-diabetic (normal), Group II served as diabetic, Group III diabetic animals treated glibenclamide 600 μg/kg for 14 days, and Group IV diabetic animal treated with glibenclamide and silymarin 50 mg/kg/twice/d for 14 days. At the end of the study, blood glucose, lipid profile, and IAP level were measured.Results: A significant decrease in IAP, elevated levels of blood glucose, and lipid profile was seen in diabetic rats when compared with normal. The silymarin treatment showed a significant increase in IAP level, a significant reduction in glucose and lipid profile than diabetic rats.Conclusion: The present study concludes that silymarin treatment enhances the IAP levels which protect against hyperglycemia, hyperlipidemia, and vascular complications in diabetic rats.
STREPTOZOTOCIN-INDUCED OXIDATIVE STRESS IN DIABETIC RATS - A DEFENSIVE EFFECT OF PSYDRAX DICOCCOS
Authors: Kumar V Ravi , Rao P Sailaja
Published: November 2018

Objective: The present study was aimed to evaluate the antihyperglycemic activity and in vivo antioxidant effect of methanolic extract of whole plant of Psydrax dicoccos (MEPD) belonging to the family Rubiaceae.Methods: MEPD was prepared by Soxhlet extraction. Wistar rats weighing (180–200 g) were divided into six groups (n=6), with three doses of 100 mg/kg, 200 mg/kg, and 400 mg/kg of extract. Metformin was used as a standard drug. Diabetes was induced by streptozotocin (STZ) (40–50 mg/kg, i.p) in control group. The animals were treated with different doses of extracts for 21 days, and on the 22nd day, the blood glucose levels along with antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), and lipid peroxidase (LPO) were determined.Results: The phytochemical screening of the extract showed the presence of carbohydrates, phenolics, flavonoids, glycosides, and tannins. The methanolic extract of MEPD at the dose of 200 mg/kg body weight showed a significant reduction in blood glucose levels (**p<0.001) with the value of 151.2 mg/dl on the 22nd day at 8 h. A promising antioxidant effect was also evident from the determination of antioxidant enzymes such as SOD, CAT, and LPO.Conclusion: The P. dicoccos extract revealed a potential effect of antihyperglycemic activity and combating nature on oxidative stress induced by STZ.
ANTIMICROBIAL POTENTIAL OF HERBAL AND CHEMICAL NEONATAL EYE DROPS
Authors: Thakur Nitika , Kumari Jyoti , Sharma Monu
Published: November 2018

Objective: The present study focuses on exploring the antimicrobial potential of chemical (Tobastar and natamycin) and herbal eye drops (Itone) which are specifically preferred against neonatal eye infections.Methods: Well diffusion method (for testing the antimicrobial potential of selected eye drops against different bacterial and fungal strains), minimum inhibitory concentration (MIC) (broth dilution method) for detecting the MIC effective against various strains taken into consideration.Results: The results indicated that Itone and Tobastar are effective against bacterial strains, thus highlighting the importance of these two eye drops against bacterial infections, whereas natamycin is effective against fungal infection.Conclusion: It may be concluded that the herbal eye drop (Itone) and the chemical eye drop (Tobastar) are effective against bacterial infections. The components such as neem, tulsi, kapur, and honey in herbal composition possess good antibacterial activity confirming the great potential of bioactive compounds and are useful for the growth inhibition of the carcinogenic bacterium. The alkaloids, flavonoids and saponins are based on antibiotic principles and are actually the defensive mechanisms of the plant against pathogens and chemical eye drop, that is, natamycin is effective against fungal infections, which may be due to the presence of polyene antifungal agent which works against fungal infections. There is a need to optimize the blending of the different herbal and chemical components to form a single effective antimicrobial formulation (more of herbal component and less chemical components) against neonatal infections.
DISPENSING ERRORS OBSERVED BY COMMUNITY PHARMACY DISPENSERS IN IBB - YEMEN
Authors: Al-worafi Yaser Mohammed
Published: November 2018

Objective: The objective of this study was to determine the dispensing errors, its types, and causes in community pharmacies in Ibb, Yemen.Methods: A prospective study was conducted among community pharmacies in the Ibb, Yemen, over 4 months’ period. Dispensing errors that were detected during the dispensing process were recorded by the pharmacy dispensers using a data collection form. Detecting and reporting of dispensing errors, types, and causes of dispensing errors were explained to the participated pharmacists before starting the study. The data were analyzed using the Statistical Package for the Social Sciences® (IBM SPSS) version 21 for Windows.Results: A total of 35 (0.80%) dispensing errors were reported in this study. Wrong dosage form was the most common dispensing error type reported in this study followed by wrong quantity, wrong strength, and wrong drug. Factors most commonly reported as contributing to dispensing errors in this study were prescriptions poor handwriting, similar medications packaging, more than one patient at the same time, and similar drug names.Conclusion: This study explored the type and causes of dispensing errors at five community pharmacies in the Ibb city, Yemen. Dispensing errors can be prevented by educational interventions about dispensing error’s and its potential causes. Effective collaboration and communication between community pharmacy dispensers and prescribers are an important key to minimize and prevent dispensing errors.
PHYTOCHEMICAL INVESTIGATION OF LEAVES AND SEEDS OF CORCHORUS OLITORIUS L. CULTIVATED IN IRAQ
Authors: Hasan Hayder T , J Kadhim Enas
Published: November 2018

Objective: The aim of this study was to investigate chemical constituents of leaves and seeds of Corchorus olitorius since no phytochemical investigation had been done previously in Iraq.Methods: Leaves and seeds of C. olitorius were defatted by maceration in hexane for 24 h. The defatted plant materials were extracted using Soxhlet apparatus, the aqueous methanol 85% as a solvent extraction for 24 h, and fractionated by petroleum ether, chloroform, ethyl acetate, and n-butanol. The ethyl acetate, n-butanol, and n-butanol after hydrolysis fractions for each part (leaves and seeds) were analyzed by high-performance liquid chromatography (HPLC) and high-performance thin-layer chromatography (HPTLC) for its phenolic acid and flavonoid contents. The petroleum ether fraction from the leaves was analyzed using Gas chromatography/mass spectrometer (GC/MS). Flavonoids and phenolic acid derivative were isolated from the ethyl acetate of leaf fraction and n-butanol after hydrolysis fraction of the seeds and identified by mass spectrometry, infrared, HPLC, and HPTLC.Results: The different chromatographic and spectroscopic results revealed the presence of luteolin, quercetin, astragalin, isoquercetin, catechins, and 3,5-dicaffeoylquinic acid (3,5-DCQA) in both leaves and seeds of C. olitorius and also 17-octadecynoic acid, 9-octadecanoic acid (oleic acid), hexadecenoic acid (palmitic acid), 9,12-octadecanoic acid (linoleic acid), octadecadien-1-ol (β-sitosterol), and α-tocopherol (Vitamin E) in the petroleum ether fraction of C. olitorius leaves.Conclusion: The results of the current study proved the presence of 3,5-DCQA, astragalin, and isoquercetin in the ethyl acetate fraction of C. olitorius leaves and catechin in the n-butanol after hydrolysis fraction of C. olitorius seeds.
ANTI-INFLAMMATORY ACTIVITY OF METHANOLIC EXTRACT OF HIBISCUS PLANTIFOLIUS
Authors: K Sowjanya , S Swati , K Supriyanka , Sk Rajiya , B Meena , P Poojitha
Published: November 2018

Objective: The objective of the present study was to carry out anti-inflammatory activity of methanolic extract of Hibiscus plantifolius (MEHP) belonging to the family Malvaceae.Methods: The shade dried stem part of H. plantifolius (1 kg) was powdered and extracted with methanol using soxhletion. The extract was concentrated using rotary evaporator under reduced pressure at 40°C, till free from the solvents and thereby providing crude methanol extract which was subsequently employed for further studies. Anti-inflammatory effect was studied by carrageenan-induced paw edema model in rats at dose level of 50, 150, and 300 mg/kg. Acute oral toxicity study was also studied.Results: The results indicate that MEHP, 300 mg/kg, exhibited significant inhibition (p<0.001) of increase in paw edema at 4th h.Conclusion: The results of the experimental study confirmed that MEHP possesses significant anti-inflammatory activity.
BIOASSAY-GUIDED ISOLATION OF THE MAJOR COMPOUND WITH ANTIOXIDANT ACTIVITY FROM THE ALGERIAN MEDICINAL PLANT BUBONIUM GRAVEOLENS
Authors: Messaoudi Radja , Cheriti Abdelkrim , Bourmita Younes
Published: November 2018

Objective: The objective of this research was to isolate and identify the major compound from the antioxidant extract obtained from the leaves of Bubonium graveolens.Methods: A bioguided fractionation was done to isolate and identify the major compound responsible of the antioxidant activity. The chemical structure of the isolated natural compound was established by spectroscopic means including UV, Fourier transform infrared, 1H NMR, and13C NMR. The purified compound was accurately tested for its antioxidant activity by the 2, 2-diphenyl-1-picrylhydrazyl assay at 517 nm.Results: The major compound named myricetin 3′-O-rhamnoside was isolated for the 1st time from the leaves of B. graveolens a medicinal specie of Algerian Sahara belonging to the Asteraceae family. The study showed that the myricetin 3ʹ-O-rhamnoside has an antioxidant potential 59% when compared with standard ascorbic acid with an IC 50=0.916 mg/ml.Conclusion: In the present work, it was possible to isolate and identify for the 1st time the major compound from the antioxidant fraction of B. graveolens.
ASSOCIATION OF ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY IN A SAMPLE OF ADULT PATIENTS WITH PSORIASIS AND PSORIATIC ARTHROPATHY
Authors: Al-bedri Khudair , Mahmood Zainab A , Hussein Sadeq Aqeel
Published: November 2018

Objective: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis, a large number of patients with PsA that has persistent inflammation may develop progressive joint damage and disability and have reduced life expectancy. This study aims to determine the associations of anti-cyclic citrullinated peptide (CCP) antibodies in adult patients with psoriasis and PsA.Methods: A case–control study was conducted at Baghdad teaching hospital, Units of Rheumatology and Dermatology, during the period from December 2016 to April 2017 including three groups; 40 patients with psoriasis, 40 patients with PsA fulfilling the CASPAR classification criteria, and 40 healthy control persons.Results: Two patients with psoriasis (5%) and 10 patients with PsA (25%) were seropositive for anti-CCP antibodies (ACPA). Healthy controls were negative for anti-CCPA. Regarding ACPA positivity, a significant difference was found between those three studied groups (p<0.001) and there was a significant difference between positive and negative ACPA in PsA patients regarding disease activity score (p=0.044).Conclusion: Positive ACPA were found more significant with PsA than in patients with psoriasis as well as associated with higher disease activity.
FORMULATION AND EVALUATION OF LIQUID ORAL SUSPENSION OF PARACETAMOL USING NEWLY ISOLATED AND CHARACTERIZED HYGROPHILA SPINOSA SEED MUCILAGE AS SUSPENDING AGENT
Authors: Krishna Anjali , Mohanan Shan
Published: November 2018

Objective: The objective of this study was to demonstrate and evaluate the suspending property of newly isolated, purified, and characterized Hygrophila spinosa seed mucilage in liquid oral suspensions of paracetamol.Methods: Isolation of mucilage from H. spinosa seeds was done by maceration process, and then it was characterized by phytochemical screening, solubility, pH, swelling index, flow rate, viscosity, loss on drying, and cytotoxicity. The characterized mucilage was then used as a suspending agent for the preparation of suspensions containing paracetamol as a model drug. The prepared formulations were then evaluated for different parameters such as sedimentation volume, redispersibility, flow rate, pH, viscosity, and other physical examination.Results: The isolated mucilage is a polysaccharide with no impurities and nontoxic in nature. It has got enough swellability and good viscosity. The prepared suspensions were evaluated, and the results such as sedimentation volume, redispersibility, flow rate, pH, viscosity, and other physical examination showed its suspending property.Conclusion: The study revealed that a lesser amount of H. spinosa seed mucilage can produce a good suspension. By this study, it could be find out that a 1/5th quantity of mucilage (0.2%) is only required to prepare a suspension of paracetamol when compared with suspensions prepared of compound tragacanth (1%) and sodium carboxymethyl cellulose (1%) as suspending agents. Thus, by this study, it can be stated that the mucilage from H. spinosa possesses all the criteria needed by a standard suspending agent.
ANTI-INFERTILITY EFFECTS TEST OF DATE PALM FRUIT EXTRACT (PHOENIX DACTYLIFERA L.) IN FEMALE MICE (MUS MUSCULUS) COMPARED WITH PROPOLIS
Authors: Dillasamola Dwisari , A Almahdy , Anggraini Ria , Diliarosta Skunda , Oktomalio P Biomechy , Noverial Noverial
Published: November 2018

Objective: The date palm (Phoenix dactylifera L) is one of the plants empirically used to increase fertility. The aim of this study was to compare the effect of ethanol extract of date palm fruit and propolis on fertility in female mice.Methods: 5 groups were assigned to 1 control and 4 experimental groups. The experimental group treated by oral administration of 100, 200 and 400 mg/kgBW of khalal date fruit extract and 200 mg/kgBW of propolis for 5, 10 and 15 days. Control groups received no extract. After 5, 10 and 15 days the mice were deeply anesthetized with anesthetic ether and sacrificed. Histological changes in ovary and uterine were measured. The data was analyzed by using two way ANOVA and Duncan test.Results: The results of the study of the effect of the dose and duration of the ethanol extract of khalal date fruit on the histology of ovaries and uterine mice showed that there was an increase in the number of primary, secondary, tertiary, degraaf, and corpus luteum follicles but did not affect the follicle of atresia and myometrial and endometrial thickness. in Propolis a dose of 100mg / kgBW increase occurs only in primary, secondary and corpus luteum follicles.Conclusion: Ethanol extract of khalal date fruit and Propolis can increase the number of ovarian follicles. Ethanol extract of khalal date fruit dose can increase the number of ovarian follicles higher than propolis.
NORMAL FASTING BLOOD SUGAR LEVELS AND MEDICATION ADHERENCE IMPROVE THE QUALITY OF LIFE OF TYPE 2 DIABETES MELLITUS PATIENTS IN PRIMARY HEALTH FACILITIES
Authors: Hidayati Titiek , Fatimah Siti Nur , Iskandar Shelly
Published: November 2018

Objective: The aim of the overall study was to determine the quality of life (QOL) and the factors that influence it in patients with diabetes mellitus (DM) in primary health care (PHC) Jetis 1, Bantul.Methods: This cross-sectional study was conducted on 153 DM patients in PHC Jetis I, Bantul. Respondents were recruited by inclusion and exclusion criteria. Primary data on exposure to cigarette smoke, adherence with physical activity, perception of disease, and QOL are collected through interviews. Data were analyzed by a mean test for ratio scale data and Chi-square test.Results: The results showed that the QOL and the level of adherence of DM patients in Puskesmas Jetis I were classified as very good. Male patients, elementary school graduates, normal body mass index (BMI), normal fasting blood sugar levels, adherent DM medication, and positive disease perception have a greater chance of having a better QOL. The mean of the random blood sugar and the fasting blood sugar levels exceeded the normal values, with 261.70 ± 121.15 mg/dl and 167.43 ± 10.23, respectively.Conclusion: The QOL of DM patients in I Jetis PHC is very good. Men, normal BMI, adherent with medication therapy, and normal fasting sugar levels are associated with an increase in QOL.
THE HEMOSTATIC ACTIVITY OF BIS (2-AMINOETHAN-1-SULFONATE) CALCIUM
Authors: Gurevich Konstantin G , L Urakov Aleksandr , I Bashirova Linara , V Samorodov Aleksandr , P Purygin Peter , A Yermokhin Vladimir , S Gilmutdinova Alfiya , A Bondareva Nataliia
Published: November 2018

Objective: It is known that local or systemic injection of hemostatic drugs is used to reduce blood loss and number of blood transfusions in patients with hypocoagulation and hemorrhagic diathesis. However, the analysis of literature data shows that the drugs applied for the control of bleeding, traditionally used in medical practice, are not effective enough. This study deals with the systemic hemostatic activity of bis (2-aminoethan-1- sulfonate) calcium in the experiment.Methods: Experimental work in vitro is performed on the blood of healthy male donors, under conditions in vivo it is done on intraperitoneal injection in male rats. Thromboelastography was carried out with apparatus Thromboelastography (TEG) 5000 (Haemoscope Corporation, United States). The influence of first synthesized derivative and ethamsylate on functional activity of platelets was studied using a platelet aggregation analyzer “Biola 230LA” (Russia). Experimental evaluation of the system specific hemostatic activity in vivo was carried out using the model of parenchymatous bleeding in mature male rats. The interference came amid registration of bleeding stop time and extent of blood loss.Results: Bis (2-aminoethan-1-sulfonate) calcium shows procoagulation and proaggregant activity both in vitro and in vivo. Proaggregatory effect of bis (2-aminoethan-1-sulfonate) calcium is successfully implemented in the systemic hemostatic activity in terms of parenchymal bleeding, surpassing the control group and the group of etamsylate.Conclusion: The results of these studies reveal potentially high systemic hemostatic activity of bis (2-aminoethan-1-sulfonate) calcium, urging the need for further study on this compound and its analogs to create on their basis highly efficient, selective correctors of the hemostatic system.
EVALUATION OF OSTEOPATHY IN PATIENTS WITH BETA-THALASSEMIA MAJOR USING DIFFERENT IRON CHELATION THERAPIES
Authors: Shawkat Ali Jalal , Jwaid Ahmed Hamed , Marzouq Awad Ghada , Adnan Fawzi Hayder
Published: November 2018

Objective: We aim to assess the bone mineral density (BMD) and bone biochemical parameters in Iraqi patients with β-thalassemia major (β-TM).Methods: Dual-energy X-ray absorptiometry scan was used to evaluate bone density and interpreted about Z-score which compares to the BMD of age-, sex-, and ethnicity-matched reference population. Biochemical parameters such as calcium, 25-OH Vitamin D, parathyroid hormone, and serum ferritin (SF) evaluated.Results: No statistical difference in SF between pediatrics and adults was determined; however, 66 patients were having their SF between 1000 and 2500 ng/ml and 122 patients with SF ˃2500 ng/ml. Calcium and Vitamin D levels are low in both adults and pediatrics. The bone status shows high percentages of osteoporosis 62% and 54.5% for pediatrics and adults, respectively, as well as osteopenia 27% and 34.3% for both pediatric and adults and to a lesser extent normal bone status 11% for each. Conclusion: Osteopathy has a high prevalence in Iraqi patients with β-TM and should receive an optimal transfusion and chelation therapy to prevent bone expansion. Calcium and Vitamin D should be routinely determined to prevent deficiency.