Open Access Case Report

A Giant Solitary Fibrous Tumor of the Liver with Metastasis and Local Recurrence

Mostafa Hoseini, Hossein Fahimi, Mohammad Vaziri, Farnaz Vosough, Borna Farazmand, Fereshteh Vosough, Behnood Farazmand

Journal of Pharmaceutical Research International, Page 18-23
DOI: 10.9734/jpri/2020/v32i430420

Solitary fibrous tumor (SFT) is a rare type of mesenchymal neoplasm. Although the majority of SFTs are benign, some cases have shown characteristics of malignant neoplasms. Weight loss, fatigue, and upper abdominal bloating are the main signs of these lesions. Clinical and radiographic features are not sufficient for the diagnosis of hepatic SFT and the definitive diagnosis depends on histopathological sampling and immunohistochemistry. One of the main issues in the diagnosis of this tumour is the ability of this tumour to grow to large sizes. A 69-year-old male presented to the clinic 2 years earlier with episodes of hypoglycemia and loss of consciousness. The symptoms improved after receiving glucose. The patient diagnosed as rare solitary fibrous tumour of the liver, a giant (10 × 10 cm in diameter) round and well-defined lesion in the left lobe of the liver which was obvious in magnetic resonance imaging (MRI). Surgery is the most common line of treatment for this disease and there is no evidence regarding the effectiveness of other approaches. According to the scarcity of hepatic SFT, long-term prognosis in these patients is highly challenging. Here, we present the case of a 69-year-old male patient with hepatic SFT with metastasis and local recurrence. In the very rare malignant form of liver solitary fibrous tumour which is surgically unresectable, liver transplantation is one of the potential options but maybe not amenable due to the malignant behaviour of the disease. Role of debulking surgery is also not clear in this situation.

Open Access Original Research Article

Exploration of the Chemical Potential and Antioxidant Activity of Some Plants Used in the Treatment of Male Infertility in Southern Benin

Jean Robert Klotoé, Eric Agbodjento, Victorien Tamègnon Dougnon, Mahudro Yovo, Téniola Isabelle Sacramento, Esther Déguénon, Jacques Tossou Dougnon, Jean Marc Atègbo

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/jpri/2020/v32i430418

Antioxidants are a family of substances that can neutralize free radicals and prevent and/or treat diseases associated with oxidative stress such as male’s infertility. Medicinal plants are one of the main sources of antioxidants.

Aim: This work was aimed at evaluating the chemical and antioxidant potential of different extracts from some plants used in traditional Beninese medicine for the treatment of male infertility.

Materials and Methods: The study was carried out on aqueous, hydro-ethanolic and ethanolic extracts from of the roots of Gardenia ternifolia (G. ternifolia), the whole plant of Cassytha filiformis (C. filiformis), the leaves of Rourea coccinea (R. coccinea) and the seed of Garcinia kola (G .kola). Quantification of the total polyphenols and flavonoids content of these extracts was evaluated respectively by the method using Folin Ciocalteu and the method using Aluminum trichloride. The antioxidant activity of the extracts was evaluated by molecular spectrophotometry using the free radical scavenging of DPPH and FRAP methods.

Results: The results obtained indicated a variation of total polyphenols and flavonoids content according to the type of extract. Hydro-ethanolic extract of the various plants studied has a high polyphenols and flavonoids content. In variable proportions, all the extracts tested reduced the DPPH radical and ferric iron, reflecting their antioxidant potential. The best antioxidant activity has been obtained with the hydro-ethanolic extracts.

Conclusion: This study showed that all the plant's extracts studied have antioxidant activity that varies with the type of extract. However, the hydro-ethanolic extractions showed the best antioxidant activities. The data obtained in the present study justified the use of these plants in management of pathologies involving oxidative stress.

Open Access Original Research Article

Outpatient Doxycycline Therapy: Frequency of Its Use and Its Prescribing Patterns in a Public Hospital

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 13-17
DOI: 10.9734/jpri/2020/v32i430419

Aim: The aim of this study was to identify the outpatient doxycycline therapy: Frequency of its use and its prescribing patterns in a public hospital.

Methodology: This was a retrospective study which was conducted in a public hospital in Alkharj City in 2018. The outpatient prescriptions were reviewed to evaluate the prescription patterns of Doxycycline.

Results: The study results found that about 48.38% of the patients were female and about 62.90% were from Saudi Arabia. Doxycycline was prescribed mainly by resident physicians. Doxycycline was prescribed mainly in the emergency department followed by obstetrics & gynecology department.

Conclusion: Doxycycline was prescribed infrequently in the outpatient settings; it is reserved only for specific conditions. It is important to use antibiotics wisely by the patients and to prescribe and dispense antibiotics including doxycycline appropriately by health care professionals.

Open Access Original Research Article

The Prescribing Trends of Metronidazole in The Outpatient Setting

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 24-29
DOI: 10.9734/jpri/2020/v32i430421

Aim: The aim of this study is to characterize the trends of metronidazole prescribing in outpatient setting in Alkharj.

Methodology: This is a retrospective study includes evaluating outpatient antibiotic prescriptions from 01-01-2018 till 31-12-2018 in a public hospital Alkharj. The data were collected and analyzed using excel software and the descriptive data were represented by frequencies and percentages.                             

Results: The majority of the metronidazole prescriptions were regular and only few prescriptions were urgent. The physicians who prescribed metronidazole were mainly residents who don’t have sufficient experience that may results in more inappropriate antibiotic prescribing patterns.

Conclusion: The excessive use of metronidazole in addition to its prescribing by resident may results in inappropriate prescribing pattern that may lead to increase the adverse effect which may lead to increase the rate of bacterial resistance. More efforts are needed, especially by applying antimicrobial stewardship program, to ensure that metronidazole is prescribed correctly.

Open Access Original Research Article

The Impact of Zinc Oxide Nanoparticle on LH, FSH, and Testosterone Hormones in Mature Male NMRI Rats

Ziba Mozaffari, Kazem Parivar, Nasim Hayati Roodbari, Shiva Irani

Journal of Pharmaceutical Research International, Page 30-37
DOI: 10.9734/jpri/2020/v32i430422

Nanoparticles are widely applied in all aspects of modern life because of their unique features such as small size and high surface area. Several types of research have been carried out to discover the feasible detrimental impacts of Nano-particles on human reproduction. The purpose of this study was to examine the impact of zinc oxide nanoparticles in mature male rats through examining LH, FSH, and testosterone sex hormones. Therefore, 30 Naked Mole-Rat Initiative (NMRI) rats were divided into 5 groups. Different doses of zinc oxide nanoparticles (250, 500 and 700 were intra peritoneally injected to animals only once. Then, the serum level of luteinizing hormone (LH), Follicle Stimulating Hormone (FSH), and testosterone hormones were measured using Enzyme-Linked Immunosorbent Assay (ELISA) method after 21 days. The results were analyzed by ANOVA and Tukey tests. The results indicated that zinc oxide nanoparticles doses caused a significant increase in FSH and testosterone level of blood (Respectively) in 250 and in comparison with the control group. Moreover, this research illustrated that zinc oxide nanoparticle can cause a dose-related increase in Testosterone and FSH hormones levels while causing no significant change in LH hormone level.

Open Access Original Research Article

Health-related Quality of Life among Community Pharmacists

Muhammad Shahid Iqbal, Fahad I. Al-Saikhan, Nehad J. Ahmed, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 38-47
DOI: 10.9734/jpri/2020/v32i430424

Introduction: The role of community pharmacists (CPs) has kept on changing. Due to the evolving role of CPs, it is important to know its impact on the health-related quality of life (HRQoL) among CPs. Besides, the literature on the HRQoL of CPs is not being enriched, there is an urge to carry out a study to evaluate the HRQoL among CPs. This study aimed to examine the association between the socio-demographic factors and the HR QoLamong CPs.

Methodology: A set of questions related to the HRQoL has been adopted from a pre-validated questionnaire, the Duke Health Profile and contextualized it to measure study outcomes. The target population in this study was the registered CPs that were practicing. The site of the study included all the chain and independent pharmacies. Statistical Package for Social Science (SPSS) version 22.0 was used to analyze the data and the significance level was set at p≤ 0.05. Various domains of the Duke Health Profile (DHP) were calculated using the provided formula.

Results: A total of 172 respondents were included in this study. Several HRQoL domains were significantly associated with socio-demographic factors. The univariate analysis illustrated that mental and general health state had significant associations with age, practice setting was significantly associated with the mental health state, the salary was significantly associated with self-esteem and mental health was significantly associated with length of service and practice setting. Dysfunction dimensions of anxiety, anxiety-depression, and pain were significantly associated with gender.

Conclusion: Gender, age, length of service, salary and practice setting were the risk factors for  HRQoL among CPs.

Open Access Original Research Article

The Barriers of Child Immunization Completion among Parents in the Community Health Centre, Johor Bahru

Hamidah Bt Hussin, Roy Rillera Marzo, Nurazura Binti Mamat, Nor Faradilla Binti Safee, Norzita Binti Omar, Tan Sin Yin

Journal of Pharmaceutical Research International, Page 48-58
DOI: 10.9734/jpri/2020/v32i430425

Introduction: Immunization is one of the most cost-effective strategies for reducing child mortality. There is a vital need to assess parents’ barriers involving child immunization completion to improve and increase vaccination coverage and completeness.

Objective: To determine the barriers of child immunization completion among parents in the Community Health Centre of Johor Bahru.

Methodology: The Maternal and Child Health Clinic, Jalan Abdul Samad providing primary immunization was selected via non-random and convenience sampling. Children between1 month to 2 years old who were immunized were identified. Data were obtained from parents who brought in their children for primary vaccination at the Maternal and Child Health Clinic, Jalan Abdul Samad.

Results: The response rate for this study was 100% (n=306). All the eligible parents who were approached by the researchers agreed to participate in this research. Out of all respondents, 3 (1.0%) completely refused the immunization of their child, 23 (7.5%) defaulted with the immunization, and 280 (91.5%) completed the immunization. In terms of perception towards immunization, 60 or 19.6% of the total respondents stated that their preference for alternative treatments is their main reason if they decide not to have their children vaccinated. After adjusting for socio-demographic differences, the researchers discovered that parents who have significantly lower coverage for all 10 childhood vaccines themselves were less likely to agree that vaccines are necessary to protect the health of children, to believe that their child might get a disease if they aren't vaccinated, or to believe that vaccines are safe.

Conclusion: This first systematic evaluation of immunization refusal in Malaysia showed that a small number of parents refused immunization.

Open Access Original Research Article

Pharmacoeconomic Analysis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Muhammad Shahid Iqbal, Fahad I. Al-Saikhan, Nehad J. Ahmed, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 59-66
DOI: 10.9734/jpri/2020/v32i430426

Introduction: Chronic obstructive pulmonary disease (COPD) imparts a substantial economic burden on an individual and society. Exacerbation of COPD (ECOPD) is the primary cost driver for this burden as it usually associated with hospital admissions of COPD patients. The present study aimed to determine the direct costs of acute ECOPD among COPD patients.

Methods: A total of 90 eligible patients with acute ECOPD who were admitted to the hospital were involved in this study. A convenient sampling technique was used during data collection. Cost data were collected according to the expenditures and existing information. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0. The Spearman's rank test was used to observe the differences (correlations) between the Govt perspective and the patient perspective.

Results: The direct costs per episode of acute ECOPD were determined according to the Anthonisen criteria for evaluating acute ECOPD. The mean direct costs for severity III, severity II and severity I were 89.1, 134.8 and 178.2 USD respectively. The cost of acute ECOPD was positively associated with disease severity, length of hospital stay and the number of co-morbidities.

Conclusion: Acute ECOPD patients consume a considerable amount of healthcare resources and pose a significant economic burden on the government.

Open Access Original Research Article

How Do Out-of-Pocket Expenditures Affect Healthcare: A Qualitative Insight of Acute Exacerbation among Asthma Patients

Muhammad Shahid Iqbal, Fahad I. Al-Saikhan, Nehad J. Ahmed, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 67-73
DOI: 10.9734/jpri/2020/v32i430427

Introduction: This study was designed to determine the out of pocket costs (OOPCs) of acute exacerbation of asthma (AEA) in asthma patients attending a public hospital.

Methodology: A cross-sectional study was done by interviewing the patients using the convenience sampling technique. Data were obtained based on per episode of AEA. OOPCs were calculated based on direct and indirect costs. A total of 128 patients participated in the study. The data were analyzed with SPSS ver 23.

Results: The study group comprised of 88 males (68.8%), 57 (44.5%) singles and 67 (52.3%) less than 40 years of age. There were considerable differences found between the severity levels and lengths of hospital stay towards the OOPCs.

Conclusion: The severity of the AEA and length of stay in the hospital increase the per episode OOPCs of AEA among asthma patients.

Open Access Original Research Article

Measurement of Homocysteine Levels in Pregnant Women with and Without Preeclampsia

Narjes Noori, Aida Najafian, Samaneh Saberi, Marzieh Ghasemi

Journal of Pharmaceutical Research International, Page 74-80
DOI: 10.9734/jpri/2020/v32i430428

Introduction: Homocysteine is associated with endothelial dysfunction and cardiovascular disease, and elevated concentrations of homocysteine have been found in preeclampsia. The aim of this study was to determine homocysteine levels in pregnant women with and without preeclampsia.

Methods: This descriptive study conducted on pregnant women with preeclampsia (n = 39) and controls (n = 43) was evaluated by the convenience sampling and data were collected through a questionnaire and paraclinical findings. In the present study, 5cc blood samples were taken from the patients after 8 hours of fasting and sent to the laboratory to determine homocysteine and related metabolites levels. Statistical analyses were done using IBM-SPSS 25.0 and Chi-square test was used for data analysis.

Results: The moderate concentrations of homocysteine and uric acid were significantly higher than the control group in maternal plasma with preeclampsia (0.0001).

Conclusion: We found that the blood homocysteine levels were significantly higher in the preeclampsia group compared with the Controls group. Measuring uric acid and blood homocysteine levels in pregnancy may be helpful as diagnostic tests in the early detection of high risk individuals.