Open Access Original Research Article

A Cross-sectional Analysis of Prevalence, Coping Strategies and Potential Causes of Depression among Doctors of Karachi

Shahid Bilal, Jaiperkash Dayaram, Ali Nawaz Bijarani, Mariam Muneer, Saba Arshad, Qurat ul Ain Sameed, Sara Sadiq, Mahira Lakhani, Muhammad Fazal Hussain Qureshi

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 1-7
DOI: 10.9734/jpri/2020/v32i4131038

Aims: The aim of current study is to find out the prevalence of depression in doctors in different hospitals of Karachi and its association with lifestyle, the field of specialty and coping mechanisms.

Place and Duration of Study: The sample was collected from 10 different hospitals of Karachi, in a period of one Year i.e., March 2019 to February 2020.

Methodology: A descriptive cross-sectional study design using non-probability consecutive type of sampling technique was used. Sample size was calculated at 95% confidence interval and was found to be 368. The sample was classified in two broader categories Surgery & Allied and Medicine & Allied. For identification of depression level, Public Health Questionnaire (PHQ-9) was used. A 28-item questionnaire Brief COPE was used to asses coping mechanisms.

Results: In total 400 forms were used for data analysis. The mean age of doctors was 35 ± 4 years, 65% were males while 35% were females, there was a statistically significant association of female gender with depression. Chi-Square was applied to determine the association of depression and departments and it was found to be highly significant with a P < .001. Highest level of depression was found in Orthopedics and Psychiatry departments followed by Surgery and Gynecology. While Otolaryngology was the least depressed department. Chi-square was applied and a statistically significant association of low monthly income and depression with a p-value of 0.02. In Surgery and allied there was a statistically significant association of depression with extensive working hours and lack of facilities with a p-value of 0.01 and 0.04. While in Medicine and allied there was a statistically significant association of depression with a harsh attitude of seniors and an uncomfortable working environment with a p-value of 0.02 and 0.03. A linear regression model comparing depression and its associations with coping strategies was applied.

Conclusion: Our study shows that depression is present in a vast majority of doctors from multiple specialties. Various risk factors for depression have also been identified so appropriate coping strategies should be formulated to deal with it.

Open Access Original Research Article

The Awareness and Perception of Health Care Specialists about Precision Medicine

Nehad J. Ahmed, Abdulrahman S. Alrawili, Faisal Z. Alkhawaja, Mohammad Javed Ansari

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 8-14
DOI: 10.9734/jpri/2020/v32i4131039

Aim: There are a small number of studies about the populations' knowledge and perceptions on precision medicine in Saudi Arabia till now. Therefore, this study aimed to assess the awareness and knowledge of health care specialists about precision medicine in Saudi Arabia.

Methodology: This study was a cross sectional study that included an online survey targeting health care specialists. The survey was converted to an online survey using google forms.

Results: More than half of the participants have heard about the different terms of precision medicine. Most of the health care specialists in the present study said that they have an insufficient knowledge about precision medicine (68.00%). Additionally, most of them said that they are interested to learn more about precision medicine and showed a positive attitude about it.

Conclusion: The present study found that health care specialists had a insufficient knowledge about precision medicine but they are interested to learn more about this field. Therefore, more training and awareness programs about precision medicine are needed to ease its introduction in Saudi Arabia.

Open Access Original Research Article

Wound Healing Efficacy of Guava Leaf Extract

Sarah B. Delorino, Madeline L. Ogalesco, Kaye R. Rebadulla, Myrelle Tricia A. Rongcales, Joshua Ismael A. Salubre V, Maria Kristia S. Talacay, Zalde B. Tuballas

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 27-35
DOI: 10.9734/jpri/2020/v32i4131041

A wound is a break in the continuity of the skin. The body’s response to injury and the restoration of the same is healing. Wound healing is a biological process that is initiated by trauma and often terminated by scar formation. In this research, guava leaf extract was used as antiseptic and its efficacy was tested to commercially available products. The result revealed that all mice which received guava leaf extract formed scar earlier as compared to povidone iodine and PNSS. Since maturation phase which also refers to remodeling phase is responsible for the new epithelium and final scar tissue formation, and as the development of these completes the complex process of wound healing, the researchers suggest that the use of guava leaf extract in comparison with povidone iodine and PNSS when it comes to wound healing is the most affordable in treatment and promoting normal and more rapid wound healing.

Open Access Original Research Article

A Novel Antibacterial Topical Gel from Nigella sativa and Achyranthes aspera against Acne Causing Microorganisms

Iqra Rahat, Satish Kumar Sharma

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 57-63
DOI: 10.9734/jpri/2020/v32i4131043

Inflammation in sebaceous follicles leads to skin related maladies more specifically, acne vulgaris. Bacterial species involved in causing such maladies involve P. acnes, S. epidermidis, S. aureus. These microbes have negatively affected the currently available remedies for acne vulgaris. In this research herbal Nigella sativa, Achyranthes aspera seeds were used instead of using any chemical based product on skin. The present study aims to develop novel antibacterial gel using Nigella sativa, Achyranthes aspera seeds to target pathogens that cause dermal acne. To extract the antibacterial property of the seed, they were soaked in desired chemicals individually in a shaker and then evaporated by using a rotary evaporator. After the extraction the extract was screed using the agar gel well diffusion method against P. acnes as well as S. aureus. From the diffusion method it was found that the extract is loaded with antibacterial properties. Now, the extract of N. sativa and A. aspera seeds was further divided into gels of 2 different concentrations and subjected for stability evaluation of antimicrobial activity. In this research it was found that the antibacterial property of the 10% of seed extract used was surpassed the commercial synthetic product. In addition, it was found that there were no changes in colour, pH, odor, consistency, homogeneity, and washing capacity, although the antibacterial potential was physiologically stable during storage time. The strong antimicrobial property produced from the extract in topical gel formulations suggests that the formulation can be a potential alternative to current remedies in the treatment of acne vulgaris.

Open Access Original Research Article

Terminalia arjuna Leaf Gall: The Possible Treatment for Sickle Cell Anaemia

Ankita Singh, Payal Lodha, Archna Sharma

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 64-75
DOI: 10.9734/jpri/2020/v32i4131044

Objective: To check the presence of various secondary metabolites produced in the plant under study Terminalia arjuna (Roxb.) Wight and Arn. post insect attack and gall formation.

Study Design: Terminalia arjuna (Roxb.) Wight and Arn, a well known plant involved in treating heart ailments in the Ayurvedic system of medicine for centuries. The plant’s astringent bark exhibits cardioprotective properties and is commonly used in the treatment of hypertension, angina and coronary artery disease. T. arjuna plant suffers from gall development in its leaves due to the attack of an hemipteran insect Trioza fletcheri minor. Insect attack acts as a stress stimulus for the plant to produce various bio-active compounds as a part of their defence mechanism. The present study was intended for the identification of various compounds present in the crude extract obtained from the healthy and galled leaves of Terminalia arjuna.

Place and Duration of Study: Experiments performed in the Plant pathology and tissue culture laboratory, Department of Botany University of Rajasthan, Jaipur, between April 2018 to March 2019.

Methodology: Various methods are employed for the identification of possible bio-active compounds present in the plant crude extract, GC-MS (Gas Chromatography- Mass Spectroscopy) is one such method. To check the presence of phytochemicals produced post insect attack and infection in T. arjuna normal and galled leaves, Gas Chromatography-Mass Spectroscopy (GC-MS) of the methanolic extract was conducted. The normal healthy leaves and the galled leaves were collected, shade dried, pulverized and then soxhlet extracted for GC-MS analysis.

Results: GC-MS analysis of methanolic extract of Terminalia arjuna leaves and galls confess the presence of 57 compounds in the gall extract while 21 compounds in normal (uninfected) leaf extract. The gall extract revealed the presence of various novel and medicinally important bio-active compounds, one of them was 5-Hydroxy Methyl Furfural (5-HMF). 

Conclusion: 5-HMF, an aromatic aldehyde is an economically important chemical compound and well-known for its wide application in various fields. It is an efficient anti-sickling agent and has undergone pre-clinical testing as a potential treatment for the fatal sickle cell disease. Qualitative phytochemical screening revealed the presence of various bio-active compounds both in leaf and gall methanolic extract of Terminalia arjuna, thus proving the plant’s pharmaceutical importance. This study result will make a way for further research in plant’s pharmacological research.

Open Access Original Research Article

Comparative Evaluation of the Efficacy of Newer Irrigating Solutions in the Removal of Smear Layer Using SEM

Srivalli Podili, Parvataneni Krishna Prasad, T. B. V. G. Raju, Mahendra Varma Nadimpalli, Gowtam Dev Dondapati, Thangi Sowjanya

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 76-83
DOI: 10.9734/jpri/2020/v32i4131045

Aim: To compare the effect of EDTA, Phytic acid and Peracitic acid on smear layer removal by effective conventional irrigation.

Materials and Methodology: A total of 50 extracted mandibular premolars were selected. The canals were instrumented by rotary system up to F2 ProTaper and irrigated with 3% NaOCL simultaneously, teeth were divided into 4 groups according to the final irrigants: 17% EDTA; 2.25% PERACITIC ACID; 1% Phytic Acid; and saline. The canals were irrigated with 25 guage side vented needles for 5 minutes. Specimens were examined under scanning electron microscopy (SEM). Smear layer removal was evaluated at coronal, middle and apical thirds of the root canal. The data is analyzed using the Kruskal-Wallis and Mann-Whitney U tests.

Results: In this study, the control group that is normal saline (4.05 ± 1.06) showed very less amount of smear layer removal. The highest amount of smear layer removal was seen in the group with phytic acid followed by peracitic acid and sodium hypochlorite groups. The apical third showed significantly more smear layer than the coronal and middle thirds (p<0.05). No significant difference was found between the coronal and middle thirds in all experimental groups (p>0.05).

Conclusion: 1% phytic acid was the most effective in removing the smear layer at each level of the root canal followed by 2.5% peracitic and 17% EDTA.

Open Access Original Research Article

Anti-Syncytium (MC99+1A2) and Anti-Bacterial Activities from Twigs and Stems of Ficus dubia

Wilart Pompimon, Phansuang Udomputtimekakul, Aphiruk Chaisena, Saranya Wattananon, Arnuphap Arsa, Kitipong Konsantha, Narong Nuntasaen

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 84-91
DOI: 10.9734/jpri/2020/v32i4131046

Aims: To study the anti-HIVs and anti-bacterial activity and investigate the chemical compositions of the crude extracts and isolated compounds from stems and twig of Ficus dubia.

Methodology: Twigs and stems of Ficus dubia were collected from Si Sawat District, Kanchanaburi Province, Thailand. Bioactivity assay and phytochemical analysis of ficus dubia were processed under standard method including, anti-HIV1-RT, antibacterial activities, and CC chromatography procedures. Structures of the compound were elucidated by spectroscopic techniques.

Results: Bioactivities assay exposed that, the hexane, ethyl acetate, and methanol  extracts of Ficus dubia were verified for anti-HIV and anti-bacterial activities. The ethyl acetate and methanol extract showed evidence of anti-HIVs-1RT inhibition at 69.02 % and   69.24 %, respectively. Anti-syncytium (MC99+1A2) among evaluated all three extracts: it afforded the lowest EC50; hexane 9.65 (TI 4.39), ethyl acetate 11.15 (TI 3.84), and methanol 43.61 (TI 3.04). Moreover, an antibacterial study on extract was also performed. The  antibacterial study was evaluated using nine strains (Staphylococcus aureus, Enterobacter aerogenes, Escherichia coli 0157: H7, Escherichia coli (ETEC), Escherichia coli (EPEC), Proteus mirabilis, Salmonella typhimurium, Shigella flexneri, and Vibrio cholera) by  Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) method. The MeOH extract was the most effective antibacterial with a MIC in the range >0.1 mg/mL and MBC in the range >0.2 mg/mL. However, the isolated compounds from this plant had not been studied in all bioassay. Phytochemical examination of stems and twigs from Ficus dubia had directed to the isolation of four known compounds, epifriedelanol, β-sitosterol, stigmasterol, and bergapten.

Conclusion: The crude extract of twigs and stems of Ficus fubia were specifically active toward MC99+1A2. With these results, it could be concluded that Ficus dubia may be an accomplished candidate in pill and future medicine.

Open Access Original Research Article

An Experience on Pomalidomide in Patients within Relapsed/Refractory Multiple Myeloma - A Multicenter Study in Turkey

Mehmet Ali Erkurt, Fehmi Hindilerden, Omer Ekinci, Jale Yildiz, Mehmet Sinan Dal, Metin Bagci, Tuba Hacibekiroglu, Mehmet Hilmi Dogu, Sinem Namdaroglu, Abdulkadir Basturk, Emine Gulturk, Mustafa Merter, Bugra Saglam, Sinan Demircioglu, Duzgun Ozatli, Ahmet Sarici, Turgay Ulas, Serdal Korkmaz, Bulent Eser, Fevzi Altuntas

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 92-98
DOI: 10.9734/jpri/2020/v32i4131047

Objective: Pomalidomide is a new generation thalidomide analogue. Effectiveness as a single agent or combination with low dose dexamethasone has been in the treatment of relapse/refractory Multiple Myeloma (MM). The aim of the present study was to share the experience of different oncology centres with pomalidomide treatment in patients with relapsed/refractory MM.

Materials and Methods: Seventy-three patients from 16 centres were enrolled into the study. The patients were followed for a median of 6 months. Relapsed/refractory MM patients who received at least one line of treatment before pomalidomide were included into the study.  ISS, R-ISS and Eastern Cooperative Oncology Group (ECOG) scores of the patients and treatment-related side effects were evaluated.

Results: As a result of the median follow-up for 6 months, 36% (26/72) of the patients presented progression. The estimated median PFS was found 29 months. The Cox regression analysis revealed that ECOG affected PFS only, myeloma subtype; ISS and R-ISS scores did not affect PFS. The most common side effects with pomalidomide treatment in our population include neutropenia, infections, anaemia and thrombocytopenia.

Conclusion: In our study, it was statistically shown that the ECOG score was effective in survival in relapsed / refractory MM patients treated by pomalidomide. Therefore, we recommend evaluation of the ECOG score for each patient before treatment in eligible cases.

Open Access Review Article

Medicinal and Nutraceutical Benefits of Chia Seed (Salvia hispanica)

Loai F. Felemban, Atef M. Al- Attar, Isam M. Abu Zeid

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 15-26
DOI: 10.9734/jpri/2020/v32i4131040

Chia seeds (Salvia hispanica L.) are small seeds that develop on an annual herbaceous plant. Recently, there has been tremendous growth in the use of chia seeds because of their associated medicinal as well as high nutritional values. Initially, chia cultivation took place in Mesopotamian cultures, eventually disappearing for some centuries before being rediscovered in the mid-20th Century. In this paper, the main aim has been to provide an overview of chia seed in relation to its perceived medicinal properties. From the majority of scholarly affirmations, it has been established that some of the compounds that chia seeds contain, explain its associated healthful effects include minerals, vitamins, proteins, dietary fiber, polyunsaturated fatty acids, and ω-3 fatty acids. Also, the literature contends that chia seeds are excellent sources of antioxidants and polyphenols, which include quercetin, myricetin, rosmarinic acid, and caffeic acid. Around the world, therefore, more and more scholarly investigations have focused on some of the beneficial effects of chia seeds, including the food, pharmaceutical, and medicinal industries. In this paper, it has been established that chia seeds have their medicinal properties gained in terms of pharmacological activities that include steatohepatitis and acute dyslipidemia improvement, sensory attributes, bioactive peptide and protein source, metabolic profile, and antioxidant and appetite suppressing properties. Important to note is that while most studies concur regarding these medicinal properties, in a few investigations, findings suggest that chia seeds do not pose significant beneficial effects, especially concerning health improvements in human subjects. As such, there is a need for future research to examine some of the parameters that could explain this variation, upon which more valid and informed conclusions and inferences might be made.

Open Access Review Article

Antioxidant Drug Design: Historical and Recent Developments

Melford C. Egbujor, Samuel A. Egu, Vivian I. Okonkwo, Alifa D. Jacob, Pius I. Egwuatu, Ifeanyi S. Amasiatu

Journal of Pharmaceutical Research International, Volume 32, Issue 41, Page 36-56
DOI: 10.9734/jpri/2020/v32i4131042

The sustained interest in the design of potent antioxidants drugs over the years can be attributed to the indispensable roles antioxidants play in the mitigation of oxidative stress and its concomitant diseases. The high demand for exogenous antioxidants has been ascribed to the prevalence of oxidative stress-mediated diseases such as cancer, diabetes, stroke, cell aging, arteriosclerosis and central nervous system disorders occasioned by a biochemical disequilibrium between the production of free radicals and the body’s ability to eliminate these reactive species from the biological system. COVID-19 severity and death have been linked to a free radical generating process known as the cytokine storm. In an attempt to maintain optimal body function, antioxidant supplementation has increasingly become a wide spread practice because of antioxidants’ ability to directly scavenge free radicals, inhibit oxidative chain reactions thereby increasing the antioxidant defenses of the body. Recent data showed that researchers had made significant efforts to demonstrate the importance and timeliness of antioxidant therapy based on drug design from natural and synthetic sources. Therefore this review presents antioxidant drug design methodologies, identifying the lead and hits to provide a historical and up-to-date collection of research briefs on antioxidant drug design into a single piece in order to ensure easy accessibility, motivate readership and inspire future researches.