Open Access Systematic Review Article

Barriers to Antidiabetic Medication Adherence among Patients with Diabetes Mellitus in Saudi Arabia: A Systematic Review

Mukhtar Ansari

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/jpri/2021/v33i331154

This systematic review was conducted with aim of determining different types of barriers that interfere with the adherence to antidiabetic medications among diabetes mellitus patients in Saudi Arabia. A comprehensive systematic literature exploration was performed via databases and search engines as Science Direct, PubMed, Medline, Google Scholar, Scopus, Cochrane Library, and EBSCO. The review includes 20 original research studies on adherence to antidiabetic medications and their associated factors. The review of the studies reveals that the most prominent barriers to antidiabetic medication adherence were forgetfulness, polypharmacy and complexity of regimen, side effects, low perceived self-efficacy of the medications, and feeling better. Likewise, frequent dosing, long history of diabetes, comorbidities, cost of medication or financial issue, disruption of normal routine, carelessness, busy schedule, God centered locus of control, and food habits were among the others. The identified multifaceted barriers can serve as a potential target for interventions to improve adherence to antidiabetic medications and health related quality of life.

Open Access Case Study

Complete Treatment of a Case of Medically Refractory Ulcerative Colitis with Adoption of the Health Triangle Methods for Lifestyle Modification

Hassan Akbari, Malihe Ramezani

Journal of Pharmaceutical Research International, Page 54-58
DOI: 10.9734/jpri/2021/v33i331160

Ulcerative colitis (UC) is an inflammatory disease affecting the mucosa in the colon. Despite significant progress and expansion of the therapeutic armamentarium for UC, there are currently no curative medications available and some cases require colectomy. In this communication, we report the case of a 38 years old male patients with a five-year history of UC who had involvement of the entire colon and was medically refractory. The patient had received treatment with steroids, mesalazine, infliximab, and adalimumab, but failed to achieve remission in the process. He had non-remitting symptoms with endoscopic and histologic evidence of severe disease, and experienced episodes of significant lower gastrointestinal bleeding. Ultimately, the patient was advised to undergo colectomy, but he refused; instead, he adopted a lifestyle modification approach—the health triangle method. In short, this approach emphasizes three aspects of nutrition, use of herbal medicines, and interventions (called aamal-e-yadavi in Traditional Iranian Medicine) like oiling, cupping, and phlebotomy (hejamat). These interventions can improve the cellular energy balance and truly cure the autoimmune disease if adopted over the long term. After three years, the patient reported substantial improvement in symptoms, and the colonoscopy and histology showed evidence of remission. This case indicated the potential efficacy and safety of complementary and alternative approaches in patients with UC; however, the health triangle method needs to be investigated in randomized controlled trials.

Open Access Original Research Article

Knowledge and Attitude of Dental Students and Interns in Saudi Arabia (Riyadh Region) among Hepatitis C Virus Infection

Faisal Suliman Alhedyan, Nasser Alqhtani, Abdulaziz Rabah Alharbi, Khalid Saud Alasimi, Ahmad Ibrahim Alomran, Ali Othman Aldibas, Abdulrhman Motlaq Alotibi

Journal of Pharmaceutical Research International, Page 13-26
DOI: 10.9734/jpri/2021/v33i331155

Introduction: Hepatitis C virus (HCV) is considered one of the leading causes of chronic liver conditions in the world. The primary route of transmission of HCV can be by exposure of infected blood or sharing a contamination syringe during the injection of drugs. the purpose of this research to evaluate and assess the knowledge and attitude of HCV infection among dental students and interns in Saudi Arabia population specially Riyadh region.

Materials and Methods: This is a cross sectional-based survey, using a questionnaire which was divided into two parts, first covering sociodemographic information of the participant regards gender, demographic variable, academic level of the participant and the University. Second part of the questionnaire was established based on the knowledge and attitude of the participant in regard to HCV.

Results: A total of 218 students participated in this study. The responses of participants differed in various academic levels with a statistically significant difference in only two questions; in question 10 when they were asked whether or not they knew that a vaccine for HCV exists (p = 0.02) and question 20, if they believed that dental staff would be afraid to treat a patient if they found out his/her positive HCV status (p = 0.02).

Conclusions: The present study showed that knowledge, among the dental students and interns in the Riyadh region was not adequate in regard to HCV, and their attitude toward HCV patients was inequitable.

Open Access Original Research Article

Analysis of Benzodiazepines Utilization Other than Mental Disorder at District Sukkur Pakistan

Nisar Khan, Sajid Ali, Zuheeb Ahmed, Marvi Metlo, Asif Ali, Shaib Muhammad, Niaz Hussain Jamali, Arslan Ahmer, Salman Khan, Ata-ur- Rehman, Tahseen Ahmed, Shumaila Parveen Arain

Journal of Pharmaceutical Research International, Page 27-32
DOI: 10.9734/jpri/2021/v33i331156

The main objective of this research was to evaluate the prescribing ratio of benzodiazepines in the patients suffering from a disease other than a mental disorder. A prospective cross-sectional study was conducted at 24 different community pharmacies and medical stores of District Sukkur. Participants with age more than 18 years and using Benzodiazepines were included in this study. Average age of the Participants, who were participated, was 38 ± 20 years. From the 177 study subjects who visited the community pharmacies or medical stores for the purchase of benzodiazepines 104 were male and remaining 73 were female. From 177 patients 132 were married and remaining 45 were unmarried or widow. It was concluded that the consumption of benzodiazepine drugs is terrifyingly very high, especially as a self-medication without any prescription.

Open Access Original Research Article

Evaluation of Lactulose Prescribing Pattern in Outpatient Setting

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 33-37
DOI: 10.9734/jpri/2021/v33i331157

Aim: This study aims to describe the prescribing pattern of lactulose in the outpatient setting of a public hospital.

Methodology: This is a cross-sectional study that was conducted in Alkharj city. Prescription data were collected retrospectively from electronic medical records in the outpatient setting of the hospital.

Results: A total of 113 patients received lactulose in the outpatient setting of the hospital. Most of them were males (66.37%). Approximately 24% of the patients aged between 30-39 years and about 20.35% of them aged between 20-29. Most of the patients received lactulose for 7 days (70.8%). Most of the prescriptions were written by the Emergency department (84.07%).

Conclusion: Lactulose prescribing was uncommon in the present study. Nevertheless, it is important to use it appropriately to increase its efficacy and safety. The patient should take it as recommended, and the health care professionals should counsel patients about their medications.

Open Access Original Research Article

Frequency, Associated Symptoms and Prognosis of Intussusception in Tertiary Care Hospital of Province Sindh

Noor Ahmed Shaikh, Nabi Bux Napar, Zulfiqar Ali Bhatti, Hameed Ur Rahman, Ishrat Mahtam, Syed Sohail Abbas

Journal of Pharmaceutical Research International, Page 38-44
DOI: 10.9734/jpri/2021/v33i331158

Background: Intussusception is an important disease of childhood & has been recognized since ancient time. It commonly involves young infants of 3 ½ months to 10 months of age. Diagnosis is mostly clinical on the basis of classical triad or quarter of pain in abdomen, vomiting palpable abdominal mass and currant red jelly stools. It is confirmed by ultrasound, barium enema which also has a therapeutic potential. The parents in our region lacks awareness regarding the intussusception. They usually bring the child to hospitals after trying various homemade or herbal remedies. The delay in diagnosis always results in severity in symptoms and aggressive mode of treatment.

Objective: The current study was aimed to identify the Frequency, associated symptoms and post-operative complications of intussusception in tertiary care hospital of Province Sindh

Methodology: It was a cross sectional study conducted from July 2017 to June 2020 at department of Pediatric Surgery Ghulam Mohammad Mahar Medical College Teaching Hospital Sukkur. Data regarding symptoms and prognosis was noted on the file of patient and written informed consent was taken from parents. Data was analyzed by using SPSS version 20. Chi square was applied as test of significance at 95%confidance interval and p-value less than 0.05 was considered as significant.

Results: Fourty patients of intussusceptions were reported the mean age was 5.88 ± 1.5 months while 8 (20%) patients were 1to10 years with mean age of 3.88± 3.18 years. Thirteen (32.5%) patients presented within 24 hours of onset of symptoms and 27 (67.5%) presented after 24 hours 19 (47.5%) patients had history of diarrhea while 6 (15%) patients had respiratory tract infection. The most common postoperative complication was gut gangrene.

Conclusion: In three years of study we found only 40 children who came to our hospital with diarrhea and the triad i.e. abdominal pain, abdominal mass and bleeding per rectum. Ultrasound abdomen was found to be best diagnostic modality with impressive accuracy rate at our setup. Gut gangrene was postoperative complication and recurrence was uncommon.

Open Access Original Research Article

Bio Active Compound Analysis of Croton scabiosus Bedd: By HPTLC, GC-MS and Evaluation of Anthelmintic Activity and Anticancer Potential on Lung (A549) and Breast (MCF-7) Cancer Cell Lines

E. Bhargav, S. Salamma, B. Chandana, S. Harika, M. Vijaya Jyothi, B. Ravi Prasad Rao

Journal of Pharmaceutical Research International, Page 45-53
DOI: 10.9734/jpri/2021/v33i331159

Croton scabiosus Bedd. (Euphorbiaceae) is an endemic plant of Andhra Pradesh, India. Local communities use the verdant parts of this plant as an antidote to treat snake bites and as a remedy to heal leucorrhoea in the form of decoction. In the present study the author found to have a perceptible range of alkaloids, coumarins, glycosides, flavonoids, steroids and gallic tannins as secondary metabolites by phytochemical and spectral studies. Since flavonoids and alkaloids are known for remarkable anticancer and anthelmintic activities respectively, the researcher is interested to document the research findings on these activities.The present research is aimed to evaluate bioactive principles present in acetone, chloroform and ethyl acetate extracts of Croton scabiosus Bedd. by chemical tests and spectral analysis. It is also aimed to study the anthelmintic and anticancer potential of these extracts.Acetone, chloroform and ethyl acetate extracts of Croton scabiosus Bedd. were prepared by triple maceration technique. GC-MS and HPTLC analysis were performed to identify chemical constituents.  Anthelmintic and anticancer potential was assessed for the three extracts. Owing to the positive results of chemical constituents, the researcher made an attempt to evaluate anthelmintic, cytotoxic potential and anticancer activity on breast adenocarcinoma cells (MCF-7) and lung adenocarcinoma cell line (A549). It was pointed to appraise Croton scabiosus Bedd. extracts have considerable Anthelmintic, cytotoxic and anticancer potential.

Open Access Original Research Article

Statistical Optimization of Temperature, Concentration, RPM and pH for the Surface Tension of Biosurfactant by Achromobacter Xylos GSR21

Balaji Somesam Upadhyaya, Golamari Siva Reddy, Mallu Maheshwara Reddy, Sohom Adhikari, S. D. Rajkumar, Akula Niranjan Babu, Vanga Manav Goud, Chelikani Sidhartha, Varakala Nikhil Reddy, Divyanshu Dhakate, N. Konda Reddy

Journal of Pharmaceutical Research International, Page 59-66
DOI: 10.9734/jpri/2021/v33i331161

Achromobacter xylos strain GSR21 plays a crucial role in bioremediation of fossil fuel contamination, biopharmaceutical, cosmetics, chemical, petroleum refining, petrochemical, food industries and tertiary oil recovery (Microbial enhanced oil recovery). Response surface quadratic models (RSQM) was applied to reinforce the censorious operating conditions for the assembly of Achromobacter xylos strain GSR21. The Response surface method (RSM) was application to determine the best degrees of cycle factors (Temperature, Concentration, RPM, pH). Central composite design (CCD) of RSM was used to contemplate the four factors at five levels, and strain GSR21 Achromobacter xylos fixation was approximate as a reaction. Relapse coefficients predicted by examination and therefore the model was settled. R2 value regard for bio-surfactant (mN/m) attempted to be 0.81, showing that the model fitted well with the explorative results. The mathematical model predicted by simulation of the foreseen updated values, and bio-surfactant surface tension was found 50 mN/m. The foreseen model was matched at 98.8% with the test outcomes coordinated under the perfect conditions. Based on the finding research, temperature-40°C, concentration-1.8 g/l, RPM-180 rev/mint and pH-4 was perceived as compelling fragments for Achromobacter xylos GSR21.

Open Access Original Research Article

Comparison of the Efficacy of Intravenous Ketorolac to that of Intravenous Pethidine in Pain Suppression in Patients with Biliary Colic

Amir Masoud Hashemian, Omid Bameri, Roohie Farzaneh, Amir Rahmanian Sharifabad, Fatemeh Maleki, Mahdi Foroughian, Mohammad Davood Sharifi

Journal of Pharmaceutical Research International, Page 67-73
DOI: 10.9734/jpri/2021/v33i331162

Aim: The study aimed to compare the effect of intravenous administration of the NSAID (Non-steroidal anti-inflammatory drugs) ketorolac to that of intravenous administration of the opioid pethidine in the suppression of pain in patients with biliary colic.

Methodology: The present study is a trial study. Among all the biliary colic patients in Mashhad Referral Hospital Emergency in Iran, 58 patients with inclusion criteria were selected using convenience sampling. They were randomly divided into two groups of 29 patients. In the first group, 1 mg/kg IV pethidine, and in the second group, 30 mg IV ketorolac was injected. The pain severity was assessed prior to the treatment and 15, 30, and 60 minutes after the onset of the treatment using the Visual Analogue Scale (VAS). The data were analyzed using SPSS 20 and Chi-square tests.

Findings: The patients' mean age was 45±15 years old (age ranged from 30 to 60 years old). The results showed no significant relationship between pain suppression and medicine type after 15 minutes (P=0.5), 30 minutes (P=0.6), and 1 hour (P=0.7). It means that pethidine and ketorolac have an equal effect on pain suppression in patients with biliary colic. Also, the more time passes from the injection, the more the medicines suppress pain.

Conclusion: the results of this study show that the efficacy of NSAIDs in the suppression of moderate to severe pain; therefore, a plan to use NSAIDs instead of narcotics for this purpose is essential.

Open Access Original Research Article

Scopoletin Ameliorates Lipopolysaccharide Induced Neuroinflammation, Oxidative Stress and Cognitive Dysfunction in Mice: A Mechanistic Study

Malvika Gursahani, Nitin Gawali, Sarayu Pai, Snehal Mestry, Archana Juvekar

Journal of Pharmaceutical Research International, Page 74-90
DOI: 10.9734/jpri/2021/v33i331164

Background: Alzheimer’s disease (AD), a progressive neuropsychiatric disorder, is characterized by neuroinflammation, β-amyloid plaques and neurofibrillary tangles. It has been demonstrated that systemic inflammation and neuroinflammation caused by lipopolysaccharide (LPS) injections in rodents leads to elevation in Aβ levels and neuronal cell death, finally resulting in cognitive impairment.

Methods: Animals received the experimental compound – Scopoletin (2.5, 5 or 10 mg/kg, i.p) for 31 days. Initially for 14 days, they received only the experimental drug; thereafter for the next 7 days they received LPS (0.25 mg/kg i.p) along with the experimental molecules.

Treatment with the experimental molecules was continued for the next 10 days and behavioural tests were performed. Animals were sacrificed on day 32 and biochemical tests were performed on brain tissue homogenate.

Results: Scopoletin administration improved memory and cognition as indicated by reduction of escape latency in Morris water maze test and increased number of entries in Y maze test. Malondialdehyde was significantly increased after LPS administration and reduced glutathione, catalyse and superoxide dismutase were significantly reduced in mice brains. Treatment with scopoletin significantly reduced oxidative stress. Inflammatory markers. β-secretase and apoptotic markers were also markedly reduced.

Conclusion: At medium and high dose, Scopoletin showed promise response as a prophylactic entity in the LPS induced neuroinflamation and cognitive dysfunction model in mice.