Journal of Pharmaceutical Research International

Lead is a highly toxic heavy metal. Chronic exposure to lead levels is responsible for significant health effects, particularly in children. Prevention remains the best option for reducing childhood lead exposure, however the knowledge, attitudes and practices to lead exposure is mainly in developing countries. The aim of this study is to create awareness on lead poisoning among college students. A questionnaire survey was conducted among college students through an online survey planet link. A total of 165 students have responded to the survey, a validated questionnaire consists of 20 questions distributed to assess their knowledge and awareness on lead poisoning among the college students. 67% of the participants were aware of lead poisoning and 33% not aware of it.  60% of the participants agreed that water contains lead. The responses have been taken and results were statistically analysed. Seminars and workshops may be conducted to create awareness on the risk factors of lead poisoning in the community.

Objective: To determine the frequency of carcinoma of Gall Bladder in Hospitalized patients undergoing surgeries for cholelithiasis at tertiary care Hospital.

Study Setting: General surgery department of Muhammad Medical College Mirpurkhas.

Study Design: Descriptive. 

Study Duration: From 2018 to 2019.

Methodology: All the patients of cholelithiasis diagnosed via trans-abdominal ultrasound, those who underwent cholecystectomies and either of gender were included. After surgeries, specimens immediately were sent to the Hospital diagnostic laboratory to evaluate the gall bladder carcinoma. The information obtained was noted on a pre-designed proforma.

Results: A total 200 patient of gall bladder stone disease were observed who underwent cholecystectomies. Average age was 53.8+5.62 years and male to female ratio was 1:2.5.  Incidence of carcinoma of gall bladder was 4%, which was significantly associated to gall bladder mass, chronic calculus cholecystitis and porcelain gall bladder (p=0.001). 

Conclusion: The incidence of the gall bladder cancer in the study population was 4% and its relationship with gall bladder diseases (chronic cholecystitis and porcelain) was found to be significant.

Deducing the molecular pathway underlying the antimicrobial effect of phytocompounds is an inevitable part of drug discovery. Selection of potential targets on the microbial pathogens will eventually lead to eradication of microbes and effective treatment. In this context, the present insilico study identifies vital targets in the dental pathogens interacting with menthol. The STITCHtool was used for identifying the protein drug interaction, VICMPred and VirulentPred tools were used for identifying the functional class and virulence nature of proteins. PSORTb was used to locate the sub-cellular location of the virulent proteins. The study results indicate that menthol interacts with virulence factors of Treponema denticola. These factors play a crucial role in cell survival and hence can be a good target for further in vitro and in vivo studies. To conclude, menthol was found to interact with crucial proteins of dental pathogens which can be targeted to achieve promising results.

In the context of the COVID-19 coronavirus pandemic, the risks of individual pharmaceutical market players or groups of players taking measures to supply medications that may lead to an economically unjustified increase in drug prices or artificially create a shortage of products are increasing worldwide.

Aims: Finding the best way to protecting intellectual property rights for medications in conditions of the COVID-19 coronavirus pandemic.

Methods: The methodological basis of the study was formed by an integral and coordinated system of scientific methods that contributed to the study of such a complex socio-legal phenomenon as the availability of medicinal products in conditions of the COVID-19 coronavirus pandemic. At the same time, a synergistic approach was applied, which combined the special research methods of various branches of law, pharmaceutical science and practice.

Results: The article reveals and identifies the distinctive features of using patent protection measures and parallel imports in the drug markets of various countries of the world and the impact of the TRIPS Agreement on the availability of medications for the public in conditions of the COVID-19.

Conclusion: For many countries, including Ukraine, the introduction of parallel imports can be efficient in the short term. Allowing parallel imports of medications has significantly fewer negative consequences for the copyright holder, since the improper quality of the products, in which the invention is used without the use of a trademark, most often does not affect the business reputation of the patent owner. Nevertheless, the chosen model of permitting the use of parallel imports to ensure the availability of medications in Ukraine remains a topical and controversial issue that requires a lot of professional discussion. Legislators should be very careful and cautious about the development and implementation of the institution of parallel imports of medications to Ukraine paying attention to the development of a whole system of quality and transparency control for procedures related to parallel imports to this country.

Background: A drug-drug interaction arises when the pharmacologic effect of a medication is changed by the action of other medication causing unexpected clinical effects. Drug-drug interactions are widely known but the identification of the consequences of food and drug interactions has been growing slowly.

Aim: The present study aims to describe the occurrence of drug –food and drug-drug interactions in the outpatient settings in Riyadh city.

Methodology: A retrospective study was piloted in Riyadh city. The prescriptions were reviewed to identify potential drug - food and drug–drug interactions using Drug Interactions Checker.

Results: About 16.16% of the prescriptions included a drug - drug interaction. The most frequent interaction was the interaction between ciprofloxacin and metronidazole (25.00%) that is a minor interaction. Regarding drug – food interactions there were 40 interactions, the majority of these interactions were moderate. The most common drug - food interactions were metronidazole with food (20.00%) that is a major interaction.

Conclusion: Drug interactions with other drugs or with foods are common. These interactions could have a beneficial or a harmful effect. Physicians and pharmacists should use programs that detects the drug interactions. 

Enrofloxacin and Ciprofloxacin antibiotics are widely used in chicken production for prophylaxis and therapeutics purposes. Existence of these antibiotic residues in chicken meat can pose hazards to human health. The present study was aimed to assess the residue level of these antibiotics in chicken meat. Chicken meat samples (including muscle, liver, kidney and fat) from poultry farms and retail market were collected. High Performance Liquid Chromatography (HPLC) was used for screening of enrofloxacin and ciprofloxacin residues in chicken meat samples. The analysis revealed that 43.58% meat samples were positive for enrofloxacin and 38.71% for ciprofloxacin residues. Out of it, 45.17% samples were having concentration above the MRL for enrofloxacin and 50.28% for ciprofloxacin. So it can be concluded that the usage of these antimicrobial in chicken lead contamination of meat and it may cause resistance in consumers and seems to be a public health threat.

Aims: The present study assessed the antioxidant and hepatoprotective potentials of the methanolic leaf extract of Lasimorpha senegalensis – a medicinal plant used by the indigenous people of Nigeria to treat hepatitis and feverish conditions.

Place and Duration of Study: The research work was conducted in the Department of Pharmacognosy and Environmental Medicine and Department of Plant Science and Biotechnology, both in the University of Nigeria, Nsukka, from May to August, 2019.

Methodology: Phytochemical analyses and acute toxicity study of the sample followed standard procedures. In vitro antioxidant assay was by DPPH and H₂O₂ models. A total of 25 male Wistar albino rats (120 – 150 g) were grouped into five, each group with five animals. Hepatotoxicity was induced with carbontetrachloride (1 ml/kg). The treatment groups (3-5) received extract (200 and 400 mg/kg) and Silymarin (100 mg/kg). Endogenous antioxidants (superoxide dismutase, catalase, glutathione peroxidase), plasma malondialdehyde and liver enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphate) were determined after treatment.

Results: The results showed the leaf extract had appreciable amounts of bioactive phytochemicals and free radical scavenging activity (IC₅₀ of 0.52 mg/ml and 0.71 mg/ml for DPPH and H₂O₂ respectively) with no toxicity at 5000 mg/kg. The extract also elevated the endogenous antioxidants and significantly (p ≤ .05) reduced lipid peroxidase and liver enzymes.

Conclusion: This report justifies the local use of this plant in the management of various diseases related to oxidative stress and liver damage.

Citrullus vulgaris Schrad, commonly known as “watermelon” and Chrysophyllum albidum G., commonly called ‘‘Udara’’ are two important plants known to possess high antioxidant and therapeutic properties especially antidiabetic properties. The present study is aimed at investigating the blood glucose lowering potentials of both the aqueous and ethanolic extracts of the mixture of rinds of C. vulgaris Schrad and C. albidum in normal and alloxan-induced-diabetic rats. Aqueous and ethanol rinds extracts of the mixture were administered in wistar albino rats of weight range of 150-200g to determine their blood glucose lowering activity. The oral administration of aqueous mixed rinds extracts at dose of 1500 mg/kg body weight (Group 4) for 9 days led to a highly significant blood glucose reduction at P<0.05 when compared to the diabetic control (Group 2) and the ethanol mixed rinds extracts at the same dose (Group 6). There was a significant reduction in blood glucose (P<0.05) by other group dose extracts (Groups 3,5 and 6) compared to diabetic control. Hence, aqueous mixed rinds extracts of Citrullus vulgaris Schrad and C. albidum might be recommended as a potential hypoglycemic drug in the treatment of diabetes mellitus.

Aim: The study of prescribing pattern is essential since it gives an idea to physicians about the process of monitoring and assessment of the drugs and endorses the required modifications. This study aimed to assess the outpatient prescribing pattern of ranitidine in a public hospital in Alkharj.

Methodology: This is a retrospective study was conducted at the outpatient setting in a public hospital in Alkharj. The outpatient electronic prescriptions were reviewed to evaluate the prescription patterns of ranitidine drug by the help of pharmacy department in the hospital.

Results: Throughout the study, 697 patients received ranitidine. About 51.65 % of the patients were females. Most of the patients who were included in the study were in the age level between 20-49 (61.68%). Moreover, most of the prescriptions were prescribed by emergency department (70.30%).

Conclusion: Prescribing of ranitidine drug is indeed popular among outpatients in the study. This study investigated the frequency of ranitidine use but further studies are warranted to investigate the appropriateness of its prescriptions.

Objective: To assess the pharmacists’ perception and knowledge regarding the use of some chronic medication and appropriate administration timing.

Methods: A cross-sectional survey was developed and randomly distributed to local retail pharmacies in the western region of Saudi Arabi between February 2019 to May 2019. We randomly selected 500 pharmacists at different shifts.

Results: The response was 86% of the sample we have selected. 90.7% responded that patients' daily routine plays a major role in their disease statuse such as diabetes, hypertension, and hypercholesterolemia. More than 76.3% of respondents did not know that blood pressure peaks in the mid-morning and in the evening but goes lower early in the morning. Only 40.9% knew that calcium channel blockers will be more effective if given in the late evening than in the morning.

Conclusion: The findings here suggest that more training, education and/or workshops will be beneficial in understanding medication time to produce an optimal effect.

Aim: The objective of this study is to determine the phytochemical constituent and antibacterial effect of fruit extract of Datura metel against Staphylococcus aureus and Escherichia coli.

Methods: The extract of the sample underwent a phytochemical screening to identify the secondary metabolites present. Also, an antibacterial test was carried out to test its effectiveness, it was tested by impregnating the respective disc on Mueller-Hilton agar streaked with Staphylococcus aureus and Escherichia coli.

Results: Datura metel fruit extract was observed to have a good antibacterial activity on the two bacteria and this was due to the presence of the phytochemical compounds terpenoids, saponin, alkaloids, steroid, flavonoids, and tannins.

Conclusion: The sample Datura metel fruit extract could be used in the field of pharmaceutical because of its antimicrobial activity and present secondary metabolites.

Background: Helicobacter pylori is a Gram-negative, winding, microaerophilic human pathogen and have indicated solid relationship with different gastroduodenal illnesses. Its contagion is one of the most widely recognized interminable diseases in humans since the isolation of the pathogen (1–3).

Aim and Objectives: This examination was directed to discover the affectability and particularity of ELISA in distinguishing H. pylori.

Materials and Methods: The investigation was completed in the Department of Pathology, Sri Balaji Medical College and Hospital, Chennai for a period from November 2016 to October 2018. The research was planned as Prospective study. The study recruited two population of respondents comprising of 50 symptomatic clinicians and 50 infection populations of either sex, over 18 years of age. Patients with signs identified with the upper gastrointestinal tract prompted by endoscopic examination and identified as having gastritis, peptic ulcer (PU) and those patients were recalled for this investigation. Patients who took treatment of pylori destruction and use of antimicrobial agents, neutron siphon agonists, bismuth containing mixtures during the month prior to endometrial biopsy were removed from the inquiry. All essential history, clinical breakthroughs and research facility records of each subject were methodically documented in Microsoft windows sensitive Excel sheet for the consequent examination. Arterial blood samples were collected for the Enzyme Linked Immunosorbent Assay (ELISA) test. For this, 50 people of either sex matured over 18 years of age were considered.

Results: It was observed that, the normal age of the patient was 40 to 60 years, 56% of them were male and 44% female. In this examination, serology tests to recognize IgG counter acting agent demonstrated the affectability of (60%). By and large, low precision and affectability of IgG serological tests is because of the failure to separate among present and past disease. Conclusion: These examinations show that H. pylori contamination is a typical issue among individuals in tamilnadu, India. The titer of IgG antibodies to H. pylori in serum can be utilized as non-intrusive tests for the presence of gastritis.

Background: Stomach adenocarcinoma has been a major source of malignant development through the greater part of the 20th century. In different parts of the world, the prevalence of this disease has decreased, mostly due to changes in diet and some other natural constituents.

Aim: To examine the clinical pathology of patients with proximal and distal gastric adenocarcinomas.

Methodology: This was the prospective work carried out with gastric adenocarcinoma patients treated at Sree Balaji Medical College and Hospital (SBMCH), Chennai, Tamilnadu, India. All patients were undergone upper gastrointestinal endoscopy and an imaging. In endoscopy, biopsies will be taken from the lesion and biopsies were subjected to histopathological examination.

Results: The most striking epidemiologic perceptions were the increasing frequency of adenocarcinomas of the proximal stomach and distal throat. We found that the occurrence of proximal gastric adenocarcinomas isn't expanding in our populace when contrasted with the rising rate of such proximal tumors in the Western Hemisphere.

Conclusion: In our investigation distal gastric adenocarcinomas were a more incessant finding than the proximal gastric adenocarcinomas.

Background: Lack of adherence to anti-diabetic medications use is linked with suboptimal glycemic control which in turn leads to increase rate of diabetic complications. The adherence to anti-diabetic medications among adult diabetic patients in Sana'a city has not been yet evaluated.

Objective: This study, therefore, assessed the extent to which diabetic patients are adherent to their antidiabetic medications and explored the factors underlying such adherence attitude in Sana’a City, Yemen.

Methods: A cross-sectional method was conducted among a sample of 365 diabetic patients attending public and private hospitals from March to April 2017 in Sana'a City-Yemen. Random patients were selected and data regarding their treatment adherence were obtained using a questionnaire. Adherence to diabetes medications was measured using medication adherence index followed by structured interviews. Descriptive analysis was used to compare between different groups of diabetic patients. Bivariate analyses were conducted to evaluate the associations between clinical variables.

Results: The cross-sectional study included 365 patients (263 males; 102 females). A high level of medication adherence rate to anti-diabetic drugs in the present study was (70%). The adherence rate was not similar in both genders where males were more adherent than females. The most common reason for non-adherence was forgetfulness (n= 67; 61%). While the lowest factor for non-adherence was associated with ineffective (n= 7; 6%). Adherence was strongly associated with diabetes duration, monthly income, blood sugar monitoring, communication with physician, and patient’s knowledge regarding importance of medication use (p <0.05).

Conclusions: The degree of adherence in patients with diabetes in Sana’a to anti-diabetic medication was shown to be mostly suboptimal. The medication adherence levels are still crucial strategy for optimal treatment against diabetes. However, additional studies on strategies to improve adherence rate and health care should be carried out in the future.

Antimicrobial or antibiotic resistance has become a leading cause of the death of millions of patients around the globe, including in the Kingdom of Saudi Arabia. Misuse of antibiotics has been identified as one of the main contributing factors to the emergence of antibiotic resistance. Therefore, it is essential to assess the awareness and knowledge of antibiotic misuse among global antibiotic users. The present study aimed to evaluate the awareness and understanding of antibiotic misuse among the people of Rafha city of Saudi Arabia. A questionnaire was used to perform this cross-sectional study, which was carried out from September 2019 to February 2020. The results of this study have revealed that most of the young people discontinue their antibiotic course after symptomatic relief; they are not aware of the antibiotic sensitivity; they do not adhere to the antibiotic schedule, and they prefer readily available cheaper antibiotics. All these significant findings are related to the development of antibiotic resistance. Therefore, there is a need to address these issues to the concerned health care authority of this region. However, further studies that can correlate the cause-effect relationships among the factors and the misuse of the antibiotic are also recommended.

Pharmaceutical products of standard quality are very important in appropriate management of diseases. However, substandard drugs are failing to achieve the therapeutic outcomes. In this study, six brands of Captopril tables having two strengths (three brands of 50 mg, and three brands of 25 mg), were collected from local pharmacies of Sindh. Standards of United States of Pharmacopeia (USP) were used for comparison of Captopril brands. Wide ranges of physicochemical standard quality control tests of USP were performed and results were recorded. All six brands of captopril tablets met the standard of aesthetic test, and weight uniformity test, diameter test and thickness test and disintegration test in which dissolved within fifteen minutes. Four brands of captopril tablet meet the standard of hardness test, whereas two brands fails to meet the standard with average hardness in brand C25-2 (3.05 ± 0.32), and brand C25-3 (2.28 ± 0.40). Five brands of captopril tablet meet the standard of friability test whereas one brand C25-3 fail to meet the standard with average loss of 6.22%. All six brands of captopril tablet meet the standard of dissolution test and dissolved not < 80% in 20 minutes. In last all six brands of captopril tablet meet the standard of assay test and contain the captopril within 90-110%. It was concluded that all brands of Captopril tablets meet the standard of USP and are therapeutically equivalent, so Physicians can prescribe them cost-effectively and interchangeably.

Aims: This aimed to determine the prevalence of burnout syndrome and its associated factors among Saudi board residents in Saudi Arabia in 2019

Methods: The Cross-Sectional Study in all accredited training centers all over Saudi Arabia in 700 training centers accredited by SCFHS. The Study Population constitutes residents trained in the Saudi board residency programs all over the country. Inclusion criteria were A Resident in an accredited training center under the umbrella of SCFHS. A Saudi resident and A resident still in the training program. The exclusion criteria were Fellows or Diplomas, or are not under the SCFHS residency programs Non-Saudi residents and any resident having psychiatric disorders or chronic diseases. The required sample size was 369 residents. All residents were about [9000] in all training centers all over Saudi Arabia. The total number to invite was 1845 residents who asked to participate in this study. The data checked for completeness and accuracy. Handling and storing data on my personal computer, it was edited, coded, and entered on SPSS for IBM version 22.

Results: The majority of this study participants as shown from (Table 1), were male and from those participants married residents were more, 60.7%, 53.1 % respectively. 62.6% of them are from the Central and western regions in KSA. Between those residents, we found that the majority of their specialties were internal medicine, surgeries, family medicine then pediatrics respectively. 21.4% of them were obese while 35.8% are overweight and the rest were normal. about 53.9% of the respondents had a high score of emotional exhaustion, 50.1% had a high score of depersonalization and 21.4% had a low score of personal accomplishment. 32.8% (n=121) are smokers, and 47.4% (n=175) had sleep disorder, while 35.5% (n=131) of those residents are doing exercise. Just 2 residents have chronic diseases and 18 residents requested mental health assessment. Chi-square test showed internal medicine, as well as other specialties, are more affected than surgical, pediatrics, and family medicine. Through the regression model, it was shown that Depersonalization was the best predictor of the Burnout index, after adjusting for the rest of the covariates (beta=1.87; p<0.001). EE was the second-best predictor of the Burnout index, after adjusting for the rest of the covariates (beta=0.12; p<0.001).

Conclusion: There is a high rate of burnout among doctors of internal medicine. Significant correlation factors were working hours and the number of working days per week. Trainees reported the highest frequency of burnout. Multidimensional interventions, which can target a wide range of burnout triggers, incorporating various therapeutic tools, can help reduce burnout rates in healthcare providers.

The research was done to evaluate the levels of IFN-γ, IL-6, IL- 10, iron status, hepcidin and haematological parameters of patients with pulmonary tuberculosis and human immunodeficiency virus in a tertiary hospital, Southeast, Nigeria. Four hundred (400) subjects aged 18-60 years were selected for this study. The participants comprised of PTB (200 subjects) and HIV (200 subjects). Whole blood of 7ml was collected from each participant; 4.5ml of blood was added to plain tubes for assay of cytokines, hepcidin and iron and 2.5ml for FBC, CD4 count and HIV screening. The cytokines and hepcidin were determined using Melsin ELISA Kits and Teco Diagnostics kits used for iron. Full blood count was determined by automation using Mindray BC-5300. The study revealed significant difference in IFN-γ (P=0.000), IL-6 (P=0.000) IL-10 (P=0.001), hepcidin (P=0.016), TIBC (P=0.005), %TSA  (P=0.001), WBC (P=0.000), Neutrophils (P=0.000), Lymphocytes (P=0.000), Monocytes (,P=0.000), RBC (P=0.000), Haemoglobin (P=0.000), PCV (P=0.000), MCV (P=0.000), MCH (P=0.000), MCHC (P=0.000), Platelets (P=0.000), ESR (P=0.000)  and no significant difference in CD4 (P=0.605), Iron (P=0.787),Eosinophils (P=0.724), Basophil (P=0.869) when compared between  control and HIV subjects respectively. There were changes in the cytokines, hepcidin, TIBC, %TSA and haematological parameters studied in the subjects. There were increase in the levels of cytokines studied in patients with Pulmonary TB and HIV. The cytokines and hepcidin can be used as adjuncts to prognostic and diagnostic indicators as their levels decreased with increased duration of treatment of the patients.

Klebsiella are one among the group of gram negative rod shaped bacilli of family Enterobacteriaceae. Klebsiella are normal inhabitants of the intestinal tract of humans, animals, and environment. Klebsiella pneumoniae subspecies pneumoniae a most common gram negative lactose fermenting non motile, aerobic rod shaped bacilli, is second most common next to E. coli. They are facultative anaerobic bacterial vegetation of digestive tract of man and normal medical clinic procured pathogen, causing urinary tract contamination, nosocomial pneumonia and intra-stomach disease. Disease brought about by multidrug safe gram negative bacilli that produce broadened range beta-lactamase (ESBL) proteins have been accounted for with expanding recurrence in escalated care units related with noteworthy grimness and mortality.

The immune system protects us by producing antibodies against viruses and diseases. Currently,  there is no cure in treating patients infected with COVID-19.  Even though many nations declared extrapolate findings on the COVID-19 vaccine trial, this will require months to develop an effective vaccine successfully. Meanwhile, an immune-enhancing preventive approach can be considered in order to strengthen the immune system that would enhance the host's resistance to infection. Although the leading health authorities of national and international health institutions, the Centers for Disease Control and Prevention (CDCP), and the World Health Organization (WHO) consistently providing standard guidelines focusing on treatment, prevention, and promotion perspectives, this article discussed the promising alternative prophylactic solutions in enhancing host immunity with a highly valuable supplements Zinc, Vitamin D to protect human beings from COVID-19 pandemic disease.