Journal of Pharmaceutical Research International

Introduction: Hypertension is considered one of the most significant risk factors for mortality and morbidity worldwide. There are major clinical implications for gender-specific pharmacokinetics and pharmacodynamics. It is important to know the potential gender differences in hypertension treatment and to know the prescribing trends in male and female hypertensive patients in order to optimize the treatment of hypertension.

Aim: This is a retrospective study that aims to describe the difference in prescribing antihypertensive drugs between male and female patients.

Methodology: This is a retrospective study that includes the revision of patient electronic records of outpatients with hypertension in 2018 in Alkharj.

Results: The total number of prescribed antihypertensive drugs was 1838 drugs. The calcium channel blocker was the most commonly prescribed antihypertensive class (27.86%). The study showed that there are different patterns of antihypertensive drug use among hypertensive men and women and showed that female patients are more frequently treated with diuretics and less frequently with angiotensin-converting enzyme inhibitors and angiotensin receptors blockers than male patients.

Conclusion: Stratified guidelines and policies based on gender will be appropriate if more studies show a difference in the efficacy and safety of antihypertensive drugs between male and female patients. It is important to conduct more studies about these differences.

Aims: To determine the phytochemical composition and evaluate the antioxidant and anti-inflammatory properties of methanolic and aqueous extracts from Ampelocissus africana (Lour) Merr rhizomes.

Study Design: Phytochemical content and screening, in vitro antioxidant and anti-inflammatory assays.

Place and Duration of Study: Department of Traditional Pharmacopoeia and Pharmacy (MEPHATRA / PH) of the Institute for Research in Health Sciences (IRSS) and Laboratory of Applied Biochemistry and Chemistry (LABIOCA), University Joseph KI-ZERBO in Ouagadougou between April and August 2020.

Methodology: The antioxidant activity of both extracts of the plant was assessed using DPPH radical scavenging, ABTS+ radical cation decolorization, ferric ion reduction and lipid peroxidation inhibition in rat liver assays. The anti-inflammatory activities in vitro were measured on the ability of the extract to inhibit the activity of enzymes such as 15-lipoxygenase, phospholipase A2 (PLA2) and cyclooxygenases (COX-1 and COX-2).

Results: This study revealed that the total phenolic contents of the extracts varied from 471.79 ± 1.71 mg GAE/g to 173.88 ± 1.71 mg GAE/g for methanolic and aqueous extract respectively. The extracts were also rich in flavonoids and tannins. The methanolic extract possessed better antioxidant activity with an IC₅₀ of 2.32 ± 0.18 µg/ml for the ABTS, 1.71 ± 0.05 µg/mL for the DPPH, a reducing power agent of 87.44 ± 0.5 mmol AAE /100 g and a percentage inhibition of lipid peroxidation of 52.21%. The methanolic and aqueous extract of A. africana has an inhibitory action on activity of lipoxygenase with IC₅₀ values of 26.09 ± 1.83 μg/mL to 34.32 ± 1.60 μg/mL, respectively. The methanolic extract caused COX-1 inhibition of 36.07%, COX-2 inhibition of 38.31% and PLA2 inhibition of 26.9%.

Conclusion: These results showed that the methanolic and aqueous extract from the rhizomes of Ampelocissus africana possessed antioxidant power, inhibitor effect against proinflammatory enzymes.

Introduction: Atorvastatin is one of the frequently used Statins. If it is used inappropriately it could lead to several adverse effects, interactions and efficacy will be decreased.

Aim: This study aims to monitor the prescribing pattern of atorvastatin at a public hospital in Alkharj.

Methodology: This is a cross-sectional study was conducted at a public hospital in Alkharj. The data were extracted from the electronic records of 564 patients who received antihyperlipidemic drugs.

Results: The majority of the prescribing physicians were residents. The majority of the prescriptions were prescribed by the internal medicine department. Antiplatelet agents were the most common classes of cardiovascular drugs that were combined with atorvastatin.

Conclusion: It is important to prescribe atorvastatin appropriately to increase its efficacy and to decrease its adverse drug reactions. There are several strategies to improve atorvastatin use including increase the awareness of the health-care professionals and by implementing checking practice before dispensing the prescriptions.

Background: Both periodontal disease and hypertension individually, have been found to be linked to certain blood groups. However, the association of the blood groups to abnormal blood pressure and co-existing periodontal disease has not yet been explored. The objective of this study was to explore a possible association, if any among the three conditions.

Materials and Methods: In this pilot project, a total of 300 patients were screened initially, of which, 270 patients (205 males and 65 females) with mean age range of 34.5 years from various ABO blood groups, with gingivitis / periodontitis were selected and their blood pressure was measured in a standardized manner with a digital automated BP monitor. Patients with any systemic disease or condition or consuming any kind of medications and smokers were excluded from the study. The data thus obtained was statistically analyzed to assess prevalence and associations.

Results: Overall, blood group O(29.26%) reported the highest number of patients with abnormal blood pressure in the presence of periodontal disease followed by B(18.89%) and A(17.03%). No association was found with abnormal blood pressure and blood groups in the individual gingivitis and periodontitis groups. However, a significant association with abnormal blood pressure in males over females in blood group A and B in the gingivitis group and in blood group A in the periodontitis group was observed.(P<0.05).

Conclusion: The presence of periodontal disease in certain ABO blood groups may predispose to abnormal blood pressure values or hypertension.

Objective: The study was aimed to evaluate utilization and adherence to guidelines recommended in the use of statins for management of cholesterol and their cost utility analysis in a clinical setting in Saudi Arabia.

Materials: A cross-sectional retrospective study was conducted in a private hospital in Saudi Arabia. World Health Organization (WHO) Defined Daily Dose (DDD) was used to compute the Daily price of each statins. 

Results: The utilization of statins is higher in males, Saudis and people with the age group 40-59 as compared to females or non-Saudis or other age groups. Over all, Atorvastatin was the most preferred statin therapy followed by Rosuvastatin, Simvastatin and Fluvastatin. The average cost unit wise was found to be highest for Atorvastatin SR 5.58 (USD 1.49) being lowest for Rosuvastatin SR 4.02 (USD1.07).

Conclusion: The study aimed to evaluate the use of statins for management of cholesterol is found to be consistent with international guidelines given by ACC/AHS. Our study suggests having further research to fully understand the barriers to guideline adherence to have improved utilization and considerably neutral cost effects of statins for all.

Background: Despite the active study of the main pathogenetic mechanisms of benign breast diseases, there is still insufficient information on the lipid peroxidation – antioxidant defense processes activity in women with diffuse mastopathy in the course of menstrual cycle. Such knowledge is necessary for the early detection and prevention of hyperplastic processes and for the development of pathogenically based antioxidant therapy. Research hypothesis: the parameters of the lipid peroxidation – antioxidant defense system in women with diffuse mastopathy vary depending on the period of the menstrual cycle.

Objective: to assess the activity of lipid peroxidation and antioxidant system reactions in women with diffuse mastopathy during the menstrual cycle.

Materials and Methodology: The study included 29 women: 12 healthy ones (mean age 29.6 ± 2.32 years) and 17 women with diffuse mastopathy (mean age 28.8 ± 3.2 years). All women underwent standard collection of anamnesis and clinical examinations. For all women laboratory tests were performed to determine the concentration of lipid peroxidation products and antioxidant defense components. The tests were conducted every 3 days – on days 1–3, 4–6, 7–9, 10–12, 13–15, 16–18, 19–21, 22–24, and on days 25–28. Spectrophotometric and fluorometric methods were used.

Results: Patients with diffuse mastopathy showed an increase in double bonds on days 1–3 (by 1.3 times), days 7–9 (by 1.22 times), 19–21 (by 1.19 times), and on days 22–24 (by 1.53 times); in conjugated dienes – on days 1–3 (by 1.4 times), 4–6 (by 1.2 times), 7–9 (by 1.47 times), 16–18 (by 1.48 times; P = .02), and on days 19–21 (by 1.38 times); in ketodienes and conjugated trienes (during the whole cycle) – on days 1–3 (by 2.64 times), 4–6 (by 1.6 times), 7–9 (by 1.72 times), 10–12 (by 1.39 times), 13–15 (by 1.36 times), 16–18 (by 3.46 times), 19–21 (by 2 times), 22–24 (by 2.54 times), and on days 25–28 (by 3.1 times); in thiobarbituric acid reactants – on days 19–21 (by 1.36 times) and 22–24 (by 1.27 times) compared with the control group. Patients with diffuse mastopathy showed an increase in total antioxidant activity on days 10–12 (by 1.67 times) and 16–18 (by 1.5 times); a decrease in superoxide dismutase activity – on days 16–18 (by 1.09 times) and 25–28 (by 1.25 times), in oxidized glutathione levels – on days 16–18 (by 1.23 times), 22–24 (by 1.14 times), and days 25–28 (by 1.25 times); an increase in reduced glutathione – on days 1–3 (by 1.3 times); a decrease in retinol content – on days 1–3 (by 1.64 times), 4–6 (by 1.2 times; P = .044), 10–12 (by 1.36 times), 19–21 (by 1.24 times) and on days 25–28 (by 1.18 times), and in ascorbate content – on days 7–9 (by 1.11 times) and 10–12 (by 1.16 times).

Conclusion: During our study, we revealed an imbalance of lipid peroxidation – antioxidant defense system. For normalizing the balance in lipid peroxidation – antioxidant defense system, patients with diffuse mastopathy in the luteal phase of the menstrual cycle are recommended to use antioxidant drugs. To prove the general hypothesis further clinical trials are warranted.

Objective: Chief aim of the current study was to draw attention in the prescribing pattern and utilization of PPIs in one year at a single private hospital of Saudi Arabia.

Methods: This is a cross-sectional, retrospective drug utilization research on Proton pump inhibitors (PPIs). The PPI usage pattern of in- and out- patients of Al-Mana Group of Hospital (AGH) Al-Khobar between January 1, 2019 and December 31, 2019 were investigated, including incidence, prevalence, and duration.

Results: We observed 27229 items of PPI were dispensed in the inpatient and outpatient pharmacy department of AGH-Al-khobar. Among all the PPI user more than the half {(52.98%, n = 14426), 95%CI (52.0-53.5)} were male. Nearly equal number of PPI users belongs between 18-40 years {(39.22%, n =10680), 95%CI (38.64-39.80)} and 41-60 years {(39.15%, n =10662), 95%CI (38.6-39.75)}. Among all the PPI users 61.46% (n=16736) were from community of Saudi Arabia while 38.53% (n=10493) from Non-Saudi. Among all the dispensed PPIs drugs Pantoprazole is dispensed to the highest number of patients {79% (95%CI, 78.53-79.50) (n=21515), p<0.05} while their average duration of therapy was 18.78 days. All the PPI prescribed to the AGH-Al-khobar patients adhere to the NICE guideline (p-value <0.05).

Conclusions: We also observed that PPIs was prescribed in AGH Al-khobar adhere to clinical guidelines. In our study among all the PPI Pantoprazole was prescribed to the highest number of patients, hence their safe and effective use must be warranted.

Background: World health organization announced COVID-19 as a pandemic crisis in march 2020. As of WHO statistics 2020 September, the incidence appears to be accelerating globally, with the soaring of new cases since the last one week. Even though worldwide incidence and further deaths have decreased in recent weeks across a few nations, the panic situation has caused unprecedented stress among frontline healthcare workers. Nurses fall into the category of full-blown anxiety responses syndrome to undergo burnout post-traumatic stress disorder.

Purpose: This research aimed to explore the perceptions of frontline healthcare workers (Nurses)’ and their opinion about healthcare resources while caring for COVID-19 patients.

Methodology: The study adopted a mixed-method where the quantitative data collected using a google document questionnaire related to healthcare resources followed by a qualitative method of online individual interview method to explore the in-depth analysis of nurses’ perceptions of caring for coronaviruses infected patients.

Results: The results revealed the nurses’ concerns about the everyday routine of delivering care to COVID-19 patients, including a moderate level of resilience in healthcare resources authorities. The barriers faced by nurses in the journey of a pandemic crisis were also discussed in this study that could also render substantial support in establishing policies and guidelines to meet the needed population’s healthcare needs.

Conclusions: Health care workers, including nurses, tend to experience work-related stress that could be alleviated by the appropriate staffing, equipment and supplies, training programs, and staff welfare programs.

Background: Hepatitis C virus (HCV) infection is associated with significant morbidity and mortality. The effectiveness of sofosbuvir, as a new direct-acting antiviral (DAA) for chronic HCV infection, needs to be assessed and evaluated among patients with or without cirrhosis with all HCV genotypes.

Aims: This study was conducted to determine the effectiveness of chronic HCV treatment as part of a combination therapy for all HCV genotypes in patients with or without cirrhosis.

Study Design: A retrospective observational study.

Methodology: All patients who received sofosbuvir treatment from the Pharmacy Department of Hamad General Hospital during a 12-month period (between 2014 and 2015) were included. Patients were observed up to 12 weeks after treatment course completion. Data were analyzed descriptively and compared using a paired t-test (alpha=0.05).

Results: A total of 95 patients received sofosbuvir. All of these patients received sofosbuvir in combination with other antiviral medications. All HCV genotypes were included; 1a and 4 were the most dominant genotypes (37% and 30.5%, respectively). Half of the patients were treatment naïve. All patients achieved undetectable virus ribonucleic acid (RNA) starting from week 4 of the treatment. A sustained virological response at 12 weeks (SVR12) after completion of the treatment period was maintained in 95% of patients. Relapse was mostly observed in patients with genotype 1a (40%); no patients with HCV genotype 3 exhibited relapse.

Conclusion: The SVR12 after sofosbuvir treatment was maintained in most patients, regardless of genotype, HCV complications HCV or co-administered drugs.

Aim: Functional food and their bioactive compounds have been considered as a new approach for the prevention and management of type 2 diabetes and its complications. According to this approach current study was carried out as an elucidation of antidiabetic properties of Corchorus capsularis and Corchorus olitorius varieties of jute leaf (ethanolic extract) on nSTZ-induced type-2 diabetic rats.

Methodology: The type-2 diabetic model rat was developed by a single intraperitoneal injection of freshly prepared STZ (90 mg/kg/10 ml) in sterile citrate buffer (0.1 M, pH 4.5) to rat pups (48 hour old). After three months, OGTT was performed to select diabetic (FSG > 6.5mmol/L and after 90 min of glucose load > 14 mmol/L) experimental rats. The rats were randomly divided into four groups [DWC, GT, Ext-1 and Ext-2 represent, diabetic water control, glybenclamide treated (20 mg/5 ml/kg body weight), C. capsularis treated and C. olitorius treated group (1.25 g/10 ml/kg body weight) respectively]. One group was kept with normal rats [normal water control, NWC]. The treatment was given once daily or 28 consecutive days. Fasting serum glucose, liver glycogen and lipid profile were estimated by using standard methods.

Results: The results showed that Ext-1 and Ext-2 treated groups gradually decreased serum glucose level (7.15 ±0.67 to 5.94 ± 1.19 and 7.20 ± 0.93 to 5.28 ±1.03 respectively) and reducing effect by Ext-2 was significant (p=0.001). Both extract showed lower liver glycogen level compared with GT group [5.0±2.5 Vs 17.7±6.5 (Ext-1 vs GT) and 7.5±6.4 Vs 17.7±6.5 (Ext-2 vs GT)] and even Ext-1 manifested significant effect (p=0.05). Additionally, lipid profile estimation revealed no significant improvement by the consumption of both the extracts.

Conclusion: On the basis of current investigations, it may be concluded that both variety of jute’s leaf demonstrated hypoglycemic properties in Type 2 diabetic model rats; further in-depth studies are recommended to explore the exact mechanism(s) of hypoglycemic effect.

Rhazya stricta is an important medicinal plant used as native herbal drug to cure various diseases across Asia. Plant-microbe interactions represented by different environment abiotic stress factors that shows effects also on the host plants or on the associated microbial communities. Soil microorganism can be adapted to specific stress conditions and evolve tolerance to this stress. The adjustment of the plant microbiome can productively improve the yield production of essential crops. In the present study, metagenomics analysis of bacterial communities associated with five desert plants (Rhazya stricta, Enneapogon desvauxii, Citrullus colocynthis, Senna italica, and Zygophyllum simplex) was used to highlights the bacterial diversity in the communities of these desert plants, as they also have an importance as folkloric medicinal plants, in addition to their important roles in the ecological and agricultural applications. The results of the bacterial community’s taxonomy showed eleven phyla in each sample, and the most abundant were highlighted for further analysis as it was unassigned phyla. Results indicated that the most commonlyknownphylawere; Actinobacteria, Proteobacteria, Chloroflexi, Firmicutes, Acidobacteria, Gemmatimonadetes, and Bacteroidetes. Further bioinformatics and functional analysis of bacteria are needed to investigate their effectiveness in promoting plant growth and understanding symbiotic relationships under drought-stress conditions, meanwhile, introducing the pinpointed ones in this study will help in achieving this task.

The was a case control and comparative study aimed at investigating the possible effects of injectable and skin patch contraceptives on selected haematologic and haemostatic parameters in women attending primary healthcare centre at Eleme, Rivers State The study population consists of seventy-five (75) apparently healthy, non-pregnant, non- smoking women, aged between 25 and 45years; (31 women on DEPO-PROVERA contraceptive, 14 women on Implanon, and 30 apparently healthy non-contraceptive users as control group). Fibrinogen, antithrombin, tissue plasminogen activator was analysed with reagents prepared by Elabscience, Wuhan, China, using an ELISA machine (STAT FAX-2100). Prothrombin time and activated partial thromboplastin time was done manually with reagents prepared by Quimica Clinica Aplicada S.A, Spain. Haematologic parameters were analysed using SYSMEX KX-21-N auto analyser.  Graph-pad Prism 5.0 was used in analysing all data, p < 0.05 was considered statistically significant. For haemostatic parameters, results showed that there was statistically significant increase in mean values of antithrombin (38.48 ± 17.48/ml versus 21.02 ± 15.54ng/ml, p=0.0011) and tissue plasminogen activator (1.34 ± 1.35ng/ml versus 0.28 ± 0.46ng/ml, p=0.0047) in women using the two types of contraceptive, while activated partial thromboplastin time (28.11± 2.37s versus 29.87 ± 2.77s, p=0.0205) was statistically decreased in women on the investigated contraceptives, other haemostatic parameters were not statistically significant. For haematological parameters, the results showed that there was statistically significant increase in mean values of packed cell volume 38.13 ± 2.28% versus 36.21 ± 3.07% (p=0.0126), haemoglobin 12.35 ± 0.79g/dL versus 11.56 ± 0.99g/dL (p=0.0028), white blood cells 6.17 ± 1.22 x109/L versus 5.26 ± 1.18 x109/L (p=0.0143) in women using injectable (DEPO-PROVERA) and skin patch (IMPLANON) contraceptive, other parameters showed no statistically significance. Based on duration of use of contraceptive, there was no statistically significant difference (p>0.05) in women using skin patch; while for injectable, platelet count was high in those who had used it for more than a year. Comparing values obtained from using injectable and skin patch, there was no statistical significant difference in all the parameters. Using analysis of variance to compare values based on parity, there was no statistical significant difference. Conclusively, increase in antithrombin and tissue plasminogen activator, and a decrease in activated partial thromboplastin time in women using IMPLANON (skin patch) and DEPO-PROVERA (injectable) are the haemostatic changes that occurs while using contraceptives and these changes may likely predispose them to bleeding, therefore adequate monitoring of the blood haemostatic processes while taking these contraceptives is critical in order not to expose users to haemorrhage.

Background: There is increasing concern that the depression may be associated with infertility.

Objective: The current research was aimed to explore the frequency of depression in infertile males.

Study Design: This was a cross sectional study.

Duration: March 2016 to September 2018.

Place: Department of Medicine, PUMHS Nawabshah, Pakistan.

Materials and Methods: A total of 385 infertile male subjects who reported for the semen analysis at young age group were included in the study. Depression was assessed by using Hamilton Depression Rating Scale. Data was collected via self-made proforma and analyzed by using SPSS version 20.

Results: A total of 385 infertile males were studied. Mean age of individuals was 30.28+6.18 years. Mild depression was found in 34.8% patients, moderate depression was seen in 18.2% patients, severe depression was in 8.1% patients and very severe depression was in 9(2.3%) patients. Moderate and severe depression was higher in cases of Oligospermia and Azoospermia as compared to those having normal sperm count, while results were statistically insignificant (p=0.747).

Conclusions: In the observation of this study, there was a significant relationship between infertility and depression in infertile males. Depression was found in 64.6% of infertile males, ranging from mild to very severe levels.

Objective: To determine the clinical presentation and mortality of women presented with puerperal sepsis at tertiary care Hospital.

Materials and Methods: This cross-sectional study was conducted at obstetrics and gynaecology department of Liaquat University of medical and health Sciences, from April 2018 to march 2019. Women having age more than 15 years and presented with sepsis after birth followed by spontaneous vaginal delivery, instrumental or episiotomy vaginal delivery or caesarean section were included. All the data including clinical features and mortality were recorded by study proforma. Data was analyzed by using SPSS version 20.

Results: Most of the patients 46.6%, having age between 26 to 35 years. Majority of the patients 48.3% were delivered by normal vaginal delivery (NVD) and 37.9% underwent caesarean section, while 13.8% given birth as NVD with episiotomy. Almost all cases presented with fever and other common clinical features were abdominal pain, vaginal discharge, wound infection and breast tenderness. According to the maternal outcome 24.1% patients were shifted to intensive care unit (ICU), 34.5% had prolonged hospital stay and mortality rate was 10.3%. There was no significant difference in maternal outcome according to mod of delivery; p-values were quite insignificant.

Conclusion: It was concluded that puerperal sepsis is a major contributing factor of  maternal adverse outcome. Common clinical features were fever, abdominal pain and vaginal discharge.

Erythroferrone (ERFE) is a hormone produced by erythroblasts in the bone marrow in response to erythropoietin controlling iron storage release through its actions on hepcidin, which acts on hepatocytes to suppress expression of the hormone hepcidin. Erythroferrone now considered is one of potential clinical biomarkers for assessing erythropoiesis activity in patients with blood disorders regarding to iron imbalance. Since discovery of in 2014 by Dr. Leon Kautz and colleagues and till now no more enough studies in Erythroferrone among human, most studies are conducted in animals. In this review we briefly address the Role of Erythroferrone hormone as erythroid regulator of hepcidin and iron metabolism during thalassemia and in iron deficiency anemia. Studies in this review were identified through a search using the following electronic databases: PubMed, Academia, Scopus, Google Scholar, and another open database source. Conclusion: Most of studies concluded that, in people with thalassemia and iron deficiency anemia, erythroferrone levels in the blood are higher than in people without thalassemia and iron deficiency anemia. Knowing the mechanisms of erythroferrone as erythroid regulator of hepcidin and iron metabolism during thalassemia and in iron deficiency anemia important in the diagnosis and treatment for both conditions. The erythroferrone hormone may act as potential factor in physiological hepcidin suppressor in cases with iron deficiency anemia and thalassemia disease and play a key role in treatment process among those patients in status of iron deficiency                    or iron overload. However, till now few studies of the function of ERFE in humans because is recently discovered and remains to be investigated and most studies are conducted among animals.