Open Access Original Research Article

Prevalence of Gram Negative Infections by Acinetobacter and Pseudomonas Severely Resistant to Antibiotic Susceptibility Based on Minimum Growth Inhibitor Concentration

Sahar Defaee, Maryam Farasatinasab, Mahin Jamshidi Makani, Hooman Rahimipour, Pouyan Alinia, Sara Defaee

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2019/v29i330235

Introduction: Currently, we are witnessing the formation of various species of gram-negative microorganisms, including Enterobacteriaceae, Pseudomonas aeruginosa and acinetobacter, resistant to antibiotics such as MDR, XDR and PDR. This study is important to confirm microbial resistance to an antimicrobial agent and also to monitor the activity of new antimicrobial agents. Regarding XDR gram-negative microorganisms isolated from samples, it was considered necessary to determine MIC.

Methods: Patients suspected of various infections with septicemia diagnosed in different wards of the Firoozgar Hospital were enrolled. The quantitative value of minimum growth inhibitor concentration (MIC) was determined for infections caused by highly resistant gram-negative bacteria (acinetobacter and Pseudomonas species) (XDR) reported by antibiogram disk.

Results: sample size was 117, of which 41.9% were female and 58.1% were male. Regarding Colistin, 80% of the cultures were resistant and 12% were intermittent; this value was 52% in the MIC test. Regarding tigecycline, 100% of the acinetobacter samples were susceptible to this antibiotic. Most of cultures which had antibiotic resistance were acinetobacter (61.4%) and pseudomonas (39.6%).

Discussion: Acinetobacter baumannii is susceptible to tigecycline. Emergence of multi-drug resistance in Pseudomonas aeruginosa and A. baumannii is a major concern in the world, because several drugs, except polymyxins, are available to treat these infections. A significant resistance was found in MIC to Colistin (31.1%). Thus, there is resistance to Colistin, which is one of the last lines of antibiotic treatment.

Conclusion: This study shows an increase in percentage resistance of these bacteria to antibiotics. This trend is a worrying process for antibiotic treatment of diseases.

Open Access Original Research Article

The Signs and Symptoms Comparison of Gastrointestinal Diseases between Classic Medicine and Iranian Traditional Medicine: A Hybrid Qualitative Study

Seyyedeh Vajiheh Mirabutalebi, Seyed Saeid Esmaeili Saber, Mohsen Abbasi, Mohammad Gholami Fesharaki

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2019/v29i330236

Background: Iranian traditional medicine is the oldest form of medical structure and is, in fact, an inseparable part of the life of various Iranian societies. On the other hand, gastrointestinal and liver diseases are one of the most common causes of morbidity in the world, including in Iran. Such that 10% of diseases are allocated to them and their diseases are spreading increasingly.

Objective: Considering the mentioned issues and the high prevalence of gastrointestinal symptoms, the aim of this study is to investigate the compliance of the symptoms of gastrointestinal diseases in classical medicine with Iranian traditional medicine from the viewpoint of Iranian traditional medicine experts.

Methods: This is a hybrid qualitative study which was conducted in three phases, including 1- theoretical, 2- field and 3- combinational phases. In the theoretical phase, two types of medical textbooks i.e. Iranian traditional and classic medicine textbooks. In the field stage, 13 academic Iranian traditional medicine experts with at least 5 years of work experiences in Iranian traditional medicine were interviewed. Then, in the combinational phase, the results of two early phases have been summarized using descriptive statistics.

Results: The results of the study show that 12 of the 40 symptoms in this study had a compliance of 100%. These 12 symptoms are Increase of Salivation, Pica, Borborygmi, Hiccups, Abdominal distention, Melena, Anal Fissure, Anal Stenosis, Cryptitis, Anal pruritus, Halitosis, Rectal pain; also, the results showed that 10 of the 40 symptoms in this study had over 70% compliance. These 10 symptoms are as Dysphagia, Belching, Regurgitation, Hematemesis, Flatulence, Increased Bowel sound, Abdominal pain, Diarrhea, Jaundice and Anal prolapse. Also, the percentage of compliance with the other 18 symptoms was less than 70%.

Conclusion: Considering the results of this study and the capabilities of Iranian medicine in relation to symptoms of gastrointestinal diseases with classical medicine, it is possible to design appropriate patterns to expose it. Also, an integrated approach to clinical research is recommended to improve the efficacy and safety of gastrointestinal treatments.

Open Access Original Research Article

Assessment of Knowledge and Competencies of Community Pharmacists for Differentiated HIV Care and Services in Jos, Nigeria

M. L. P. Dapar, B. N. Joseph, P. A. Damun, C. R. Okunlola, P. N. Alphonsus, B. M. Aya

Journal of Pharmaceutical Research International, Page 1-10
DOI: 10.9734/jpri/2019/v29i330237

Background: Knowledge and competence of community pharmacists in HIV care, are essential for translating the goals of differentiated care into improved outcomes.

Aims: To assess the knowledge and competence of community pharmacists in Jos, for differentiated HIV care and services.

Study Design: Cross-sectional questionnaire survey.

Place and Duration of Study: Community pharmacies in Jos North and Jos South local government areas of Plateau state, North-Central Nigeria, between September to November, 2018.

Methodology: We included community pharmacists who responded to six items on knowledge of HIV therapeutics with each correct answer recording a score of 1 and zero for wrong answers. Respondents with a correct score of 5 or 6 represent good knowledge. We examined competence on a 36 item scale graded 1 for weak competence and 5 for strong competence. Factor analysis; reduce the 36 scale items down to competency domains. Frequencies and percentages for reported competencies were presented. In addition, aggregated scores for each of the competency domains were used to compare respondents based on years of experience, educational level and employment status in community pharmacy. All levels of significance were set at p≤ 0.05.

Results: 73 out of 110 community pharmacists responded to the questionnaire. Of these, only 25% reported good level of knowledge in HIV therapeutics. 69% reported strong competency in identifying drug therapy problems, 31% inter-professional and patient communication. There was statistically significant difference in competency domains based on years of practice experience and employment status p<0.05. Respondents with 10 years or less of practice experience recorded higher mean ranked scores compared to those with 11 or more years. Similarly, employed pharmacists recorded higher mean ranked scores than those who owned their business.

Conclusion: Overall, respondents reported low knowledge and weak competency in HIV care emphasizing the need for specialized training before implementation of differentiated care model.

Open Access Original Research Article

Epidemiology and Resistance Levels of Enterobacteriaceae Isolates from Urinary Tract Infections Expressed as Multiple Antibiotic Resistance (MAR) Indices

Márió Gajdács

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2019/v29i330238

Aims: To assess the epidemiology of UTIs affecting inpatients and outpatients and the antibiotic resistance levels, expressed as multiple antibiotic resistance (MAR) indices from the isolated species at a tertiary-care hospital in Hungary, during a 10-year study period.

Study Design: Retrospective microbiological study.

Place and Duration of Study: 1st of January 2008 - 31st of December 2017 at the University of Szeged, which is affiliated with the Albert Szent-Györgyi Clinical Center, a primary- and tertiary-care teaching hospital in the Southern Great Plain of Hungary.

Methodology: Antimicrobial susceptibility testing (AST) was performed using disk diffusion method and when appropriate, E-tests on Mueller–Hinton agar (MHA) plates. The multiple antibiotic resistance (MAR) index of the isolates was determined.

Results: During the 10-year study period, the Institute of Clinical Microbiology received 21,150 urine samples from outpatient clinics and 19,325 samples from inpatient departments that turned out to be positive for a significant urinary pathogen. Out of the positive urine samples, E. coli represented the overwhelming majority of all positive urine samples. The resistance levels in inpatient isolates were higher than in the outpatient isolates (average MAR indices: 0.347 vs. 0.410, 0.267 vs. 0.435 and 0.318 vs. 0.473 for the E. coli/Klebsiella, CES and Proteae group, respectively).

Conclusion: As the therapeutic options are becoming increasingly limited in the current antibiotic resistance climate, more effort should be put into the prudent use of antibiotics and the development of novel antimicrobial agents.

Open Access Original Research Article

Anti-diabetic Effect of Two Medicinal Plants: Cataranthus roseus and Nauclea latifolium on Some Biochemical Indices of Streptozotocin Induced Diabetic Albino Wistar Rats

Eteng Ofem Effiom, Kenyoh Abam, Grace Ekpo, Savour Ufot, Joe Enobong, Eyong Ubana, Tarnando Clement

Journal of Pharmaceutical Research International, Page 1-14
DOI: 10.9734/jpri/2019/v29i330240

The study was carried out to investigate the anti-diabetic effects of two medicinal plants Cataranthus roseus (C.R) and Nauclea latifolium (N.L) on some biochemical indices of streptozotocin induced diabetic albino wistar rats.

Methods: Ethanolic leaf extracts of C.R. and N.L. were given at daily doses of 500 mg/kg body weight in two divided doses each for 14 days. Thirty albino wistar rats were divided into five (5) groups, consisting of 6 rats each viz: Group 1(normal control), Group 2 (diabetic control), Group 3 (insulin treated), Group 4 (received N.L) and Group 5 (received C.R.).

Results: The results of the phytochemical screening contain flavonoids, polyphenols, and alkaloids were found to be present in appreciable amount in N.L while saponins and tannins were found in traceable concentration. Fasting blood glucose levels showed significant decrease (P<0.05) in all the test groups compared to diabetic control and closely related to the insulin treated groups. A significant increase (P<0.05) was observed in (TG) and (TC) concentration of all treated groups compared to the diabetic control group. The concentration of HDL was significantly increased while there was also a significant decreased (P<0.05) in VLDL and LDL in the diabetic control group and insulin group when compared to the normal control group, except for C.R treated group that shows a significant decrease compared with the diabetic control group. Enzymes activities were increased in insulin and diabetic groups. A significant reduction (P<0.05) was observed with the treated group of C.R. and N.L compared to the normal control group. Also, observed was a decrease in albumin level in groups treated with the extracts. Marked reduction in total protein level was observed in groups treated with extracts and insulin, compared to the normal control group. Serum concentrations of Na+, K+, Cl- in diabetic control groups showed a significant increase (P<0.05) compared to the normal control group. K+ concentration was observed to be significantly decreased (P<0.05) in all groups treated with extract and insulin compared to the normal control group.

Conclusions: The results demonstrated that C. roseus and N. latifolium have anti-diabetic and antihepatotoxic properties and could be potential herbal remedy in treating and managing diabetic conditions.

Open Access Original Research Article

Effect of Different Irrigation Solutions on Coronal Microleakage in Endodontically Treated Teeth (An in vitro Study)

Armaghan Alikhani, Mahnoosh Mohammadi, Najme Etemadi, Seyed Alireza Moosavi Azarang

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2019/v29i330242

Background: The coronal microleakage in the endodontically treated teeth causes recurrent caries and can be associated with the restoration and the root canal treatment failures. Intra orifice barrier is an efficient alternative method to decrease coronal leakage in endodotically treated teeth and one of the best barriers is glass ionomer. The current study propose that using different irrigation solutions in root canals effect on coronal microleakage.

Purpose: This study aimed to compare the coronal microleakage in glass ionomer obturated root canals in endodontically treated teeth using different irrigation solutions.

Methods: Sixty extracted human single-rooted teeth with single canals were collected and disinfected with 0.5 choloro amin. After root canal therapy and evacuation of 2 mm coronal gutta percha, the teeth were divided into 3 groups of each 20, based on irrigation solutions. Glass ionomer was used as the coronal barrier and the teeth were stored in distilled water.  The irrigation solutions used were: 17% EDTA, Alcohol and normal saline. Then all the specimen were submerged in 2% methylene blue dye for 24 hours at room temperature and sectioned sagittally and the dye penetration was assessed by stereomicroscope.

Results: There were not penetration of dye only in 3.3% of teeth and all of the teeth that irrigated with saline showed dye penetration. The dye penetration was seen in 95%, 95% and 100% of the EDTA, alcohol and saline groups, respectively. Dye penetration was higher in Saline group than other two groups but coronal microleakage has not shown statistically significant differences in different groups.

Conclusion: The results of current study indicated that using different irrigation solutions may be associated with decrease in coronal microleakage. Although, based on our findings there are not any significant differences among different irrigation solutions but more studies may be needed to confirm this results.