Open Access Original Research Article

Evaluation of an Undocumented Polyherbal (Faradin®) Used for the Treatment of Sickle Cell Disease in West Africa. Part I: Phytochemistry and Ex-vivo Anti-sickling Study

Moji C. Adeyeye, Daniel A. Gbadero, Lawrence O. Farayola, Nikolaos Olalere, Ravikiran Panakanti, Ibraheem Rajab, Sinni Moozhayil, Corinne Renault, Brandon Swinford, Magdalena Bujok

Journal of Pharmaceutical Research International, Page 1-14
DOI: 10.9734/BJPR/2017/33605

Background: An undocumented complementary and alternative medicine (CAM)- Faradin® - was screened for its phytochemicals, anti-sickling effect using a clinical protocol, and toxicity. Faradin is a polyherbal made up of Zanthoxylum zanthoxyloides, Alnus glutinosa and Alchornea cordofolia. Methods: The polyherbal and the individual components (coded V, M, and F) were separately screened for phytochemicals such as alkaloids, phenols, flavonoids, sterols and coumarins, using standard tests. Institutional Review Board approved clinicalprotocolinvolving4 female de-identified sickle cell patients was used for the ex-vivo anti-sickling evaluation. The negative control was phosphate-buffered saline (PBS)-washed erythrocytes treated with 2% sodium metabisulfite (SMB) to cause a hypoxic state and result in HBSS polymerization or sickling. As positive control, 2% w/v p-hydroxy benzoic acid (PHBA) solution was used. The anti-sickling effect was studied by incubating the washed erythrocytes in various concentrations of Faradin - Faradin: water v/v ratios (2.5:1 – 10:1) - for 4 hours followed by further incubation with SMB for 1½ hrs. The respective samples were examined under an optical microscope and the number of sickled cells counted. Cell viability to Faradin was also done using human primary hepatocytes (HPP) and Cell Titer-Glo Luminescent assay.

Results: Faradin tested positive for flavonoids, phenols, coumarins, alkaloids and antioxidants. The V component tested positive for coumarins, alkaloids and antioxidants. The M component was positive for phenols, alkaloids and antioxidants while the F component tested positive for flavonoids, phenols and antioxidants. For the anti-sickling study, the negative control (SMB treated erythrocytes) showed 20-28% increase in sickling relative to the PBS-washed. The positive control caused a reversal of sickling by decreasing the percent sickled cells from 21% to 8%.  There was a dose-dependent decrease in percent sickled cells; the highest dose reduced the percent sickled cells from 21% to 2%. The activity was likely due to the phenols, polyphenols, flavonoids and antioxidants in the CAM. Cell viability of Faradin® was greater than 85%. 

Conclusions: Thecombined phytochemicals in the polyherbal contributed to the reversal of sickling that is similar to the positive control. Faradin has a high potential for clinical effectiveness in the management of SCD.

Open Access Original Research Article

Medical Students Perception and Practice of Self-medication: Vision of Future Practitioner in Pakistan

Sameera Fatima, Akash Syed, Saira Azhar, Muhammad Dawood, Samra Bashir

Journal of Pharmaceutical Research International, Page 1-8
DOI: 10.9734/BJPR/2017/32524

Aims: The present study was conducted to explore self-medication among the medical students and their perception towards self-medication in four medical colleges in Abbottabad, Pakistan.

Study Design:  The study was carried out as a cross sectional survey.

Place and Duration of Study: The study was carried out in four medical colleges during the period from April to September 2016 in Abbottabad, Pakistan.

Methodology: A semi structured questionnaire was developed. The questionnaire consisted of 6 sections. First and second year students were excluded from the study. The collected data of questionnaires was analyzed using the Statistical Package for Social Sciences (SPSS), version 20.

Results: A sample of 403 students completed the questionnaire with a response rate of 80.6%. Majority of students practiced self-medication to save time (77.7% p < 0.001) whereas antipyretics (90.6%) were mainly used as self-medication among those participants. Academic knowledge (80.1%) was mentioned as a main source for information on drugs. The main indication for which participants self-medicated was fever (97%).

Conclusion: The medical students’ practice regarding self-medication is increasing in our population. It was concluded that in order to prevent the growing trend of this self-medication practice, policies should be deployed to prohibit the supply of drugs without prescription

Open Access Original Research Article

A Demographical Assessment of Different Insulin Regimens in Non-insulin Dependent Diabetics

Sajjad Ali, Syed Atif Raza, Humayun Riaz, Mobasher Ahmad Butt, Hamid Saeed, Zikria Saleem, Tanveer Ahmed Khan, Muhammad Ishfaq Ahmad

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/BJPR/2017/33437

Aims: The aim of present study was to evaluate the clinical efficacy of different insulin regimens in non-insulin dependent diabetic patients with respect to their age and gender.

Methodology: A prospective cross-sectional study was conducted for comparing different insulin regimens in type II diabetic patients for better glycemic control with respect to age and gender. A total of 234 consenting, known type II diabetic patients, on any insulin regimens, with at least all relevant medical records of preceding three months participated in the study. Patients were segregated into six treatment arms depending upon type of insulin prescribed i.e., insulin pre-mix 70/30, insulin split mix (N & R), long acting insulin analogue, ultra-short acting insulin analogue, insulin pre-mix 70/30 analogue and insulin pre-mix 50/50 analogue, respectively. Moreover, patients from each group were evaluated regarding diabetes knowledge and medication adherence using Michigan Diabetes Research and Training Center’s Revised Diabetes Knowledge test Performa, 23 items and Morisky medication adherence scale, 4 items, respectively.

Results: Data analysis showed highly significant association among different insulin regimens with respect to the patient education (p=0.000) level. Significant association was found among different insulin regimens and patient’s occupational status (P=0.013). However, Statistically non-significant associations were observed among different insulin regimens with gender (P=0.070), marital status (P=0.183) and age (P=0.084) respectively.

Conclusion: In conclusion, data demonstrated that four treatment groups i.e., long acting insulin analogue, ultra-short acting insulin analogue, insulin premix 70/30 analogue insulin pre-mix 50/50 analogue were more effective than two conventional treatment groups i.e., Insulin pre-mix 70/30 and insulin split mix (N &R) in terms of clinical outcomes in population under study. Furthermore, it was also evident from the data female receiving more insulin than males.

Open Access Original Research Article

Comparative Study for In-vitro Evaluation of Metronidazole Prepared Using Natural Chitosan from Oyster Shells of Egeria radiata

Stephen Olaribigbe Majekodunmi, Ekefre-Abasi Enomfon Akpan

Journal of Pharmaceutical Research International, Page 1-11
DOI: 10.9734/BJPR/2017/33247

Objective: The present study investigates the capability of preparing metronidazole loaded microspheres employing a natural chitosan extracted from oyster shells of Egeria radiata.

Methods: Microspheres were prepared by external gelation technique using tripolyphosphate (TPP) as the cross-linker. The drug to polymer ratio was selected at various levels of polymer-drug quantities with varying amount of TPP. The prepared microspheres were characterized for % yield, drug entrapment efficiency, surface morphology and drug release profile.

Results: Almost spherical, rough and porous microspheres were obtained. % yield and drug entrapment efficiency were found to be in the range of 63.5 – 70.8% and 63.4 – 77.5% respectively; and about 80% of the drug was released in about 6 hours.

Conclusion: The results revealed that formulation of metronidazole loaded microspheres in natural chitosan from an oyster shell can be used as a potential oral drug delivery system. 

Open Access Original Research Article

Enhanced Bio-Adhesion and Sustained Delivery of Clotrimazole Encapsulated Solid Lipid Nanoparticles Loaded in Hyaluronic Acid Gel as Anti- Fungal Therapy

Senthil Venkatachalam, Merikanapalli V. Harsha, M. Pooja, Murali Paranjothy, R. Rajesh Kumar

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/BJPR/2017/34063

Aim: Clotrimazole (CTZ) is a broad spectrum anti-fungal drug which faces inability to retain over skin for longer duration and faces systemic side effects. The rationale behind present research effort was to attain sustained release of drug by lipid nanocarriers, enhance absorption by prolonged retention of gel and improve the patient compliance by reducing the dosing frequency.

Study Design: CTZ solid lipid nanoparticles (SLN) were prepared by solvent emulsification method and loaded into sodium hyaluronate (Na-Hy) gel.

Methodology: CTZ-SLN were formulated and characterized, loaded into sodium hyaluronate (Na-Hy) gel.. Later assessed for in vitro release, in vitro bioadhesion, and in vitro antifungal activity.

Results: FT-IR and DSC studies revealed no chemical changes or interaction occurred. Optimized CTZ-SLN exhibited the particle size 248 ± 1.31 nm, zeta potential 16.2 mv, entrapment efficiency was 80.7±0.7%, and drug loading 21.8±0.5%. The optimized CTZ SLN loaded Na-Hy gel demonstrated prolonged drug release (upto 24 h) than the conventional dosage form Canesten 1%, which got exhausted within 4 h. CTZ-SLN Na-Hy gel exhibited enhanced in vitro bioadhesion and in vitro antifungal action compared to conventional dosage form Canesten ointment against           a) Candida albicans b) Saccharomyces cerevisiae c) Candida glabrata d) Candida tropicalis.

Conclusion: Aforementioned outcomes make the promising applicability of formulated CTZ-SLN Na-Hy gel as a potential drug delivery system for local therapy of vaginal candidiasis and other similar infections.