Open Access Systematic Review Article

Role and Complication of Existing and Newer Calcium Channel Blockers in Hypertension Treatment

Salman Abdulaziz Aljehani, Khalid Ahmed Alshahrani, Pharma D. Nidaa Turki Alhumidi, Alya Saeed Al Ghamdi, Mohammed Ahmed Alishaq, Buthaynah Ahmed Alawad, Areej Habib Albishi, Mohammad Ahmad Albalawi, Ahmed Hassan Alkhayri, Turkiyah Sharar Alotaibi, Ashwaq Abdulhamid Alahmadi

Journal of Pharmaceutical Research International, Volume 34, Issue 54A, Page 9-15
DOI: 10.9734/jpri/2022/v34i54A7235

Hypertension is the major risk factor for cardiovascular disease and early death worldwide. Early and prompt management of hypertension can significantly prevent complications. Owing to the extensive usage of antihypertensive drugs, worldwide mean blood pressure has stayed constant or declined to some extent during the previous four decades although high prevalence in reported in developing countries. CCBs are a class of drugs that are commonly used to lower blood pressure and are structurally and functionally diverse. They are generally well accepted and have less adverse effects. The purpose of this research is to review the available information about role and complication of existing and newer CCBs in hypertension treatment. As soon as CCBs were utilized to treat hypertension, they earned a reputation as potent antihypertensives that significantly and consistently lowered blood pressure in people of all ages and races in mono and combination therapy. CCBs work by reducing peripheral vascular resistance. Newly available CCBs may be therapeutically more effective in treatment of hypertensive individuals with chronic kidney disease than the L-type CCB. Lercanidipine is a third generation CCB that has fewer side effects and is used in people with a high risk of target organ damage and elderly patients. CCBs are associated with certain side effects including peripheral edema, hypotension, headaches, conduction abnormalities among various others. Some studies have also associated use of CCBs with modest risk increase for myocardial infarction and heart failure. Further clinical research is required to elaborately study the efficacy of CCBs in management of hypertension.

Open Access Original Research Article

Assessment of Awareness and Nutritional Status of Rural Community: A Cross Sectional Study

Asavari Amar Deshmukh, S. G. Choudhari

Journal of Pharmaceutical Research International, Volume 34, Issue 54A, Page 1-8
DOI: 10.9734/jpri/2022/v34i54A7234

Background: COVID-19 Pandemic had led to an unprecedented emergency which led to many transformations in all aspects of life including dietary practices. A good and balanced die played a crucial role in prevention of disease and faster recovery. For a good dietary practice, knowledge and awareness is needed. Even the SDG 2 deals with food, nutrition and curbing with hunger. The purpose of this study was to explore the awareness of good dietary habits and the nutritional content of everyday meals among rural communities as well as to assess the nutritional status and physical activity.

Methods: This was a observational cross-sectional study conducted amongst the community of from two rural zones in Jalgaon district, Maharashtra in April to June 2022. Convenience sampling with the sample size as 40 households residing in the community was used.  The head of the family of each household were surveyed using a pre-designed and pre-tested structured questionnaire. The tool used to explore the daily food consumption, assessment of nutritional status and physical activities of the participants. The study also determined at people's awareness of what a balanced diet is and the concept/effects of malnutrition in addition to anthropometric measurements. Data was entered in spreadsheet and analysis was done with the Microsoft excel using descriptive statistics.

Results: Of those surveyed, regarding nutritional awareness, it was found that 92% and 82% of the subjects have not even heard of the term "Balanced diet" and “Malnutrition” respectively. The BMI ranges of the study subjects, showed that majority (22, 55%) of the study participants had normal BMI, followed by (13, 32.5%) as underweight i.e. BMI below 18.5 and (5; 12.5%) as pre-obese category, i.e. BMI above 25. It was observed that the individuals used to undertake around 8 hrs of physical activity per day on an average. Regarding the diet pattern, it was noted that rural communities still follow follows traditional wisdom of a balanced diet from ancestral roots. Due to poverty and lack of resources, they tend to stick to whatever is affordable and locally available.

Conclusion: Considering the significant unawareness regarding nutrition and balanced diet as observed, we conclude that the Government’ plans and efforts around food security will be more successful if raising public awareness about the significance of nutrition and food is the first step in this regard. The right to food and the right to health can only reach the rural areas when the awareness index in these areas is enhanced by utilizing all available tools and approaches.

Open Access Original Research Article

Susceptibility and Resistance Patterns of Bacteria Isolated from Infected Wounds, Burn, Medical Device Tips and Blood to Doxycycline and Septrin from Patients in the City of Benghazi

Ahmed A. Ben Yousef, Noor Alhooda M. Alawkally, Aisha O. Elasmer, Mabroka Faraj Al Tahir, Ahmed Abouserwel, Abdlmanam Fakron, Sara El-Warred, Maree Al Douakali Ali

Journal of Pharmaceutical Research International, Volume 34, Issue 54A, Page 16-25
DOI: 10.9734/jpri/2022/v34i54A7236

Wound infections and septicemia with drug-resistant bacteria lead to higher mortality and morbidity and increased healthcare costs. We aimed to evaluate the prevalence rate of nosocomial bacterial agents with antimicrobial susceptibility patterns in hospitalized and non-hospitalized patients. Samples are collected from the wound pus, burn; medical device tip and blood of male and female patients and are sent for culture and sensitivity to the Microbiology Department of Al Saleem medical laboratory, Benghazi, Libya, from October 2021 to January 2022. Collected blood samples were directly inoculated into brain heart infusion (BHI) broth, while various swabs were collected by Transport medium and both are cultured on Blood agar, Chocolate agar, MacConkey - aerobic and anaerobic blood agar at 35°C, with CO2. The wound pus was the most samples from which bacteria were isolated, followed by medical device tip swabs, and the least isolation was from a blood specimen. 47 of the specimens were culture-positive. Of these Staph aureus, Strep pneumonia and E. coli were the most abundant bacterial identified in clinical samples. According to susceptibility testing results, antibiotic resistance patterns of Gram-negative bacteria showed that the highest resistance rate was against Septrin (74.4%) and the lowest rate, 17.8%, was related to Doxycycline (44.6%) respectively. The isolates from the nosocomial infection in these patients are resistant to Septrin and Doxycycline antibiotics. We recommend that whenever the diagnosis of nosocomial infection is made, a more effective antibiotic treatment be instituted until the susceptibility of the strain is identified.

Open Access Original Research Article

Evaluation of In-vivo Anticancer Activity Choerospondias axillaris in Swiss Albino Mice Models

Zohreh Elyasi, U. Rajashekhar, Deepak Kumar Jha, Jeevan Khadka

Journal of Pharmaceutical Research International, Volume 34, Issue 54A, Page 26-50
DOI: 10.9734/jpri/2022/v34i54A7237

Background and Objective: The fruits of the plant, Choerospondias axillaris are one of the richest sources of flavonoids phenol and vitamin C that have been shown to possess a variety of biological activities. The present study was aimed to study the potential anti-cancer activity of the methanolic extract of fruit of Choerospondias axillaris using the in-vivo model to scientifically validate the folkloric use of the Choerospondias axillaris.

Study Design: In-vivo model.

Place and Duration of the Study: Department of pharmacology, Karnataka College of pharmacy, Bangalore India, between October 2021 to June 2022.

Methods: Anti-cancer property of Choerospondias axillaris was evaluated against DMBA/croton oil induced skin tumorigenesis in Swiss albino mice. A single topical application of DMBA (100g/100l of acetone), followed 2 weeks later by repeated application of croton oil (1% in acetone three times a week) for 16 weeks. In contrast, animals treated orally with Choerospondias axillaris 200mg/kg/b.w. (group IV) and orally with Choerospondias axillaris 400mg/kg/b.w. (group V) and 5 Flu 10mg/kg (group III). The following  parameters like; body weight, tumor incidence, cumulative number of tumors, tumor yield, average latency period, number of papillomas, haematological parameters, Serum Zinc and C-Reactive Protein, anti-oxidants enzyme, pro-inflammatory cytokines & Histopathological of Tumor skin studies were observed.

Results: 100 percent tumor incidence exhibited in group II (DMBA/croton oil) whereas the group IV (Choerospondias axillaris 200mg/kg) and group V (Choerospondias axillaris 400mg/kg) and group III (5 Flu 10mg/kg) exhibited 50, 33.7 and 42.5% tumor incidence, which significantly lesser when compared to than group II (Toxic control). The cumulative number of papillomas during the observation period of 16 weeks was significantly decreased in the Choerospondias axillaris treated groups IV, V and III (9, 4 and 6 no’s tumor respectively) in comparison to 18 cumulative numbers of papillomas in carcinogen control group. The average latent period significantly increased in the Toxic control group to 3.2, 4.3, 6.5 and 5.4 in group II, IV, V and III respectively. Tumor yield were significantly lesser (1.5, 0.66 and 1.0) as compared to DMBA/Croton oil treated control. Furthermore, the level of LPO was significantly increased whereas, the activity of CAT level were significantly decreased in skin tissue of DMBA/Croton oil treated animals compared Choerospondias axillaris treated animals. Similarly, NLR (< 3.0), ESR, Serum Zinc and CRP have got improved in treated with Choerospondias axillaris. Protein expression of TGF-beta, IFN-G, TNF-alpha and IL-6 have shown Improvement in markers indicating a reduction in inflammation and immune imbalance in treated with Choerospondias axillaris compared with DMBA/Croton oil where shown moderate immune suppression.

Conclusion: Based on the results it can be concluded that the test drug Choerospondias axillaris could be a potential candidate for the treatment of skin cancer.

Open Access Original Research Article

Factors Affecting Recurrence Rate of Urethral Stricture Following Internal Urethrotomy

Sajan Khan, Ahmed Fawad, Atif Javed

Journal of Pharmaceutical Research International, Volume 34, Issue 54A, Page 51-58
DOI: 10.9734/jpri/2022/v34i54A7238

Background: Urethral stricture (post-scarring contraction in the urethral mucosa) is among the most challenging clinical conditions in urology. In Pakistan, Urethral stricture is a high-volume disease and constitutes 4-5% of urology workload (majority of them being in the 3rd to 5th decade of life). Different urethral strictures have different management option depending upon site, size and number of recurrences. OIU is indicated for urethral stricture for small (1.5 cm) bulbar and membranous urethral stricture. However, recurrence of strictures after OIU is quite common                (4 to 5%). It has been proposed that duration and size of catheter after OIU effects the recurrence rate. The foremost management choice is internal urethrotomy, but recurrences are common, and many believe that the duration and size of catheterization post internal urethrotomy may affect the recurrence rate.

Objective: To determine the factors affecting recurrence rates of urethral stricture after internal urethrotomy.

Methodology: It was Quasi Experimental Study conducted in Urology ward of Dr. Ziauddin University Hospital, Karachi from 10th March 2020 to 31 december 2021. Total 60 patients were included; all of the patients were divided into four equal groups. All the patients were followed quarterly for 12 months and data was recorded for urinary flow, retention, burning sensation during urination. UFM, Cystoscopy and urethrogram were done once indicated. Symptomatic patients or patients with UFM 15ml/sec were checked for recurrence followed by cystoscopy if needed. The data analysis was obtained using SPSS v. 21.0.

Results: The mean age of the sample stood at 27 (SD ± 4) years (range: 20 to 40) years were enrolled in the study. Urethral stricture disease recurred cumulatively in 24 (40%) patients within 12 months. Mean duration of catheterization was 8.71 ± 1.1 and 2.97 ± 0.91 days in patients with and without recurrences, respectively (p=0.001). Catheter dwell times for ≥7 days was associated with increased recurrence (p=0.039). Of the patients with recurrent strictures, increased catheter diameter was also associated with higher recurrence rates (p=0.041).

Conclusion: After careful consideration, it can be concluded that longer catheter in-dwell time and greater catheter diameter lead to a greater probability of stricture recurrence and hence the indwell time should be limited to ≤ 3 days and the catheter size chosen to be no more than 16Fr.