Open Access Original Research Article

Prevalence, Distribution and Antibiotic Susceptibilities of Nosocomial Infections at a Tertiary Hospital in Port Harcourt, Nigeria

Catherine N. Stanley, Inimuvie Ekada

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/jpri/2021/v33i731195

Background: Many infections could previously be treated effectively based on the clinicians past clinical experience. The development of resistance to essentially all of the antimicrobial agents currently in use in clinical practice has made this scenario more of the exception than the norm. Selecting an appropriate antimicrobial agent has become increasingly more challenging as the clinician has to navigate through the variety of available agents in the face of increasing antimicrobial resistance. The diagnostic laboratory plays very important role in clinical practice.   To ensure safe and effective empirical treatment, a surveillance study of the susceptibility pattern of common pathogens and appropriate use of antibiotics is imperative. This current study reports on the prevalence, distribution and antibiotic susceptibility patterns of nosocomial pathogens isolated at the University of Port Harcourt Teaching Hospital (UPTH) and the effectiveness of the antibiotics commonly prescribed at the hospital in treating these infections.

Methods: A retrospective cross-sectional study of specimens received at the Microbiology Laboratory was conducted over a six-month period, from October 2015 to March 2016 using urine, blood and semen specimens respectively. A total of 5,160 samples received and analyzed at the laboratory within the study period were assessed.

Results: Out of the 5160 specimens analyzed, 881(17.07%) were positive for bacteria out of which 691(78.43%), 86(9.76%), 104 (11. 81%) were from urine, blood and semen respectively. Escherichia coli (35.74%), Klebsiella pneumoniae (52.33%) and Staphylococcus aureus (65.4%) were the most frequently isolated pathogens from urine, blood and semen respectively. Wide spread multiple-drug resistance was observed among the organisms. Klebsiella pneumoniae, S. aureus, and E. coli isolated from urine were resistant to amoxicillin/clavulanate, cefuroxime, ceftazidime, ciprofloxacin, ampicillin, gentamycin and ceftriaxone. A review of the pattern of prescribing antibiotics revealed that in the Accidents and Emergency unit, ceftriaxone (34.09%) and metronidazole (30.09%) were most frequently prescribed while in the General Out-Patient Department, metronidazole (19.09%), amoxicillin (16.61%), amoxicillin/clavulanate (9.39%) and ofloxacin (9.39%) were often prescribed. S. aureus was susceptible to only ceftriaxone while K. pneumoniae and E. coli were susceptible only to ofloxacin.

Conclusion: Most of the isolated pathogens were not susceptible to the frequently prescribed antibiotics. Empirical prescribing of antibiotics without current epidemiological data of pathogens in the hospital can only further exacerbate the problem of antimicrobial resistance. The need for epidemiological surveillance and rational use of antibiotics in the Hospital is therefore strongly recommended.

Open Access Original Research Article

Knowledge and Attitude of Medical Students towards COVID-19 Pandemic

Haris Hirani, Rabia Khurram, Nasima Iqbal, Ali Nawaz Bijarani, Afreen Bhatty, Tayyaba Mumtaz

Journal of Pharmaceutical Research International, Page 13-19
DOI: 10.9734/jpri/2021/v33i731196

Aim: To determine the knowledge and attitude of medical undergraduates towards COVID-19.

Study Design: Cross-sectional.

Place and Duration of Study: Study was conducted at Quaid-e Azam medical college from June 2020 to August 2020.

Methodology: The undergraduate students enrolled in 1st year to final year of MBBS were included in the study. A proforma was prepared by using the Google Docs and validated before starting the study. The reliability of the questionnaire was 0.78. Data was analyzed by using Statistical Package for the Social Sciences (SPSS) version-20. All the qualitative variables were presented as frequency and percentages while quantitative as mean and standard deviation. Knowledge score was compared with demographic variables by using independent t-test and one-way ANOVA test, as appropriate. p-value less than 0.05 was considered as significant.

Results: About 56% of the participants were female while remaining 44% were male, majority of them i.e. 51.6% were mediocre. Majority were from 3rd year and final year i.e. 25.2% and 24.4% respectively. Looking over the mean knowledge score the final year students having more knowledge about COVID-19 then the other students from different years, among them the female participants were having more knowledge score then their male counterparts with significant highly p-value. Comparing knowledge score with socioeconomic status reported that upper class was having higher score. Over-all 74% of final year students answered correctly to all of the questions regarding knowledge towards COVID-19. Considering specifically the attitude of medical students towards COVID-19, majority of the students including all years of MBBS, like to get more information about COVID-19.

Conclusion: It can be concluded that Pakistani undergraduate students of MBBS are having good knowledge about COVID-19. They are also well-aware of the protective measures which should be taken. In comparison, final year students having the higher level of knowledge then the students of other years of MBBS. All the students having positive attitude for stopping COVID-19.

Open Access Original Research Article

Evaluating the Frequency of Histopathological Features of Oral and Cutaneous Lichen Planus Lesions: A Retrospective- Comparative Study

Maryam Zamanzadeh, Fatemeh Montazer, Atena Shiva, Mahmood Moosazadeh, Taravat Sadeghi, Mohammad Koochak Dezfouli

Journal of Pharmaceutical Research International, Page 20-26
DOI: 10.9734/jpri/2021/v33i731197

Background and Aim: Lichen planus (LP) is an immunological disease of skin and mucous membranes. Cutaneous and oral LP (CLP and OLP) have almost similar histopathological changes determined microscopically with symptoms such as basal cell layer degeneration, hyperkeratosis, band-like infiltration of lymphocytes, and saw tooth ridges. The present study aimed to determine the frequency and compare the histopathological features of OLP and CLP samples.

Materials and Methods: This was a descriptive-analytical, and cross-sectional research performed on 91 paraffin-embedded tissue blocks (41 OLP lesions and 50 CLP lesions). The frequency of histopathological features was determined by an optical microscope, and data analysis was performed in SPSS version 21 using descriptive statistics (frequency and percentage) and Chi-square.

Results: In this study, the frequency of LPs was higher in female subjects, compared to male participants. The frequency of histopathological features of hyperkeratosis, acanthosis, spongiosis, and epithelial hypertrophy was significantly higher in CLP samples, compared to OLP lesions (P<0.005). Meanwhile, the frequency of saw tooth ridges was higher in OLP lesions, compared to CLP samples (P<0.008).

Moreover, there was a severe frequency of basal cell layer degeneration and the presence of civatte bodies (CBs) in most CLP lesions while they were moderate in most OLP samples.

Conclusion: According to the results of the study, histopathological features of OLP and CLP lesions were not completely similar and had different frequencies in the two groups. It is recommended that more comprehensive studies be performed on these differences and their causes.

Open Access Original Research Article

Barriers Influencing COVID-19 Vaccination Uptake among the Public in Saudi Arabia

Nehad J. Ahmed, Faisal Z. Alkhawaja, Abdulrahman S. Alrawili

Journal of Pharmaceutical Research International, Page 27-32
DOI: 10.9734/jpri/2021/v33i731198

Aim: The aim of this study is to explore barriers that influence COVID-19 vaccination uptake among the public in Saudi Arabia.

Methods: This study included an online questionnaire that was prepared using questionnaire of previous study. After that, it was converted using Google® forms to an online form and was disseminated by social media platforms to be completed by the public.

Results: Only 13.37% of the respondents believe that COVID-19 is not serious enough to warrant vaccination, about 14.71% agreed that the vaccine does not provide benefit, about 17.64% agreed that the chance of getting COVID-19 disease is low. About 31.37% of them said that they don’t have the time to get vaccinated. About 60.78% of the respondents said that they concerned about the vaccine side effects.

Conclusion: The main barrier of COVID-19 vaccination uptake was the vaccine side effects concerns. Health care provider should provide open and transparent information about vaccine safety and the potential vaccine side effects. Health education programs could change people’s thoughts and feelings towards vaccination.

Open Access Original Research Article

The Effect of COVID-19 Infection on Human Blood Ghrelin Hormone: A Pilot Study

Nora Y. Hakami, Wafaa A. Alhazmi, Eman O. Taibah, Mamdouh M. Sindi, Ohoud F. Alotaibi, Hajed M. Al-Otaibi, Hani A. Alhadrami

Journal of Pharmaceutical Research International, Page 33-38
DOI: 10.9734/jpri/2021/v33i731199

Objectives: The pandemic of coronavirus disease 2019 (COVID-19) has been one of the major health concerns for all the countries around the globe. This study was aimed to study the potential effect of COVID-19 virus on the level of blood ghrelin appetite hormone in order to determine the influence of this infection on the patient appetite.

Methods: This is a cross-sectional study was conducted between July and the end of August 2020 in the western region of Saudi Arabia. A total of 50 confirmed positive patients with COVID-19 (positive group) and 30 control healthy subjects with negative blood samples (negative group) were collected to determine the level of ghrelin appetite hormone using the human ghrelin (GHRL) ELISA technique. A student’s t-test was carried out to find out the statistical change between different study groups.

Results: The serum total ghrelin concentrations, on average, were 51.32 pg/mL on positive group and 50.37 pg/mL on negative group, respectively. The difference of ghrelin was statistically insignificant between the two groups (P >0.05). Although the sample size of the study was small, the results showed high number of COVID-19 cases in male than female.

Conclusion: The current data shows that there are no significant changes in the level of serum ghrelin hormone in COVID-19 patients. Consequently, it might be possible that the ghrelin hormone showed potential changes in the saliva compared to the effect in the blood. Thus, a further analysis of the ghrelin hormone in the saliva of COVID-19 patients will be conducted in the near future.

Open Access Original Research Article

Betanin and Allicin Ameliorate Adriamycin-Induced Cardiotoxicity in Rats by Ameliorating Cardiac Ischemia and Improving Antioxidant Efficiency

W. S. Al-Thubiani, O. A. H. Abuzinadah, G. S. Abd El-Aziz

Journal of Pharmaceutical Research International, Page 39-56
DOI: 10.9734/jpri/2021/v33i731200

Aims: To investigate the protective effects of betanin and allicin against adriamycin (ADR)-induced cardiotoxicity.

Study Design: Experimental animal model.

Place and Duration of Study: King Abdul-Aziz University, Jeddah, Saudi Arabia; 10 days.

Methodology: Adult female Wistar rats were allocated to the following groups (n = 10 per group): Control, received water, a standard diet for 10 days and i.p normal saline on day 8; ADR, intraperitoneal injection with 15 mg/kg ADR as a single dose on day 8; ADR+BE, betanin (20 mg/kg) administration followed by i.p. injection of ADR (15 mg/kg); ADR+ALL, allicin (20 mg/kg) administration followed by i.p. injection of ADR; and ADR+BE+ALL, equal volumes of betanin and allicin followed by ADR (15 mg/kg). Hemodynamic characteristics of the cardiovascular system and electrocardiography were evaluated. Blood samples were obtained to assess cardiac enzymes; cardiac homogenates were processed to analyze oxidative and antioxidant parameters and low-grade inflammatory indicators. Histopathological evaluation of heart tissues was also conducted.

Results: Rats pre-administered betanin and allicin were protected from ADR-associated ischemia based on the significant (P < .05) shortening of QT, QTC interval, QRS, and T peak Tend interval compared with the ADR group. Betanin and allicin pre-treatment significantly decreased the ADR-induced elevated serum creatine kinase-MB and lactate dehydrogenase levels. ADR-elevated cardiac oxidative parameters, along with the serum concentrations of the tumor necrosis factor-alpha and the cardiac transforming growth factor-beta, were significantly inhibited by betanin and allicin. Histopathological findings confirmed the biochemical results. Betanin and allicin reduced ADR-induced heart damage by inhibiting several pathways, including those of oxidative stress and inflammation.

Conclusion: Betanin and allicin may be promising cardioprotective agents owing to their antioxidant and cytoprotective properties and could thus be used as adjuvant treatment for cancer therapy.

Open Access Original Research Article

Exploration of Perception, Need and Barriers against Pharmacovigilance and Adverse Drug Reactions Reporting: Healthcare Professionals’ Insight

Qurratul-ain Leghari, Soraj Kishan Chand, Rabia Bushra, Mehwish Rizvi, Maria Khan, Saira Shahnaz, Rida Naseem, Shaheryar Masood, Imran Ali, Rabya Munawar, Sharmeen Bawani

Journal of Pharmaceutical Research International, Page 78-86
DOI: 10.9734/jpri/2021/v33i731204

Objective: The present study was designed to assess the perception, need and the barriers of PV and ADRs reporting in the hospital settings of Karachi, Pakistan.

Methods: A cross-sectional survey was conducted from October 2019 to February 2020 by the random sampling in the healthcare professionals including physicians, pharmacists and nurses. Questionnaire was distributed to 525 participants (n=175 from each group) being serving for one or more year in hospitals and clinics. Overall, 425 participants were responded having 138 physicians, 143 pharmacists and 145 nurses.

Results: Perception of pharmacovigilance was found to be 81.02%, 73.40% and 35.17% respectively in physicians, pharmacists and nurses. Overall, 80.70% of respondents were felt the need of drug monitoring system in each hospital to improve patients’ responses against treatment. The main hindrance for PV in our society was the lacking/ absence of the ADRs monitoring and reporting system marked by the physicians and pharmacists.

Conclusion: ADRs reporting and pharmacovigilance are not practiced properly in our region. It’s a time to pay attention to this neglected area not only to strengthen the infra structure of healthcare units but also to increase the patient compliance and to avoid any drug associated disaster in future.

Open Access Original Research Article

Assessment of the Anemic Conditions among the Females with Pregnancy at Tertiary Care Hospitals of Sindh Pakistan

Nusrat Fozia Pathan, Bushra Noor, Fozia Unar, Sadaf Chandio, Fareeda Wagan, Tabinda Taqi

Journal of Pharmaceutical Research International, Page 87-92
DOI: 10.9734/jpri/2021/v33i731205

Anemia is pathological disorder usually caused by mal nutrition and it was very common among feminine gender during gestational period, number of disease and death are also associated with this type of disorder during pregnancy. The major theme of the study is to evaluate the anemic condition along with prescribed medication among females during the period of pregnancy. Descriptive cross-sectional study was carried out for the period of 9 months at various tertiary care hospitals situated in rural areas of Sindh province. Total 273 females with pregnancy along with anemic condition, were selected by purposive sampling method. From total number of study subjects 71% females were diagnosed as anemic, that were further categorized as mild, moderate and severe, depend on their medical condition. It was observed that anemic condition was more common among infancy pregnant females with ages 20-29 years, the number of patients were 209 (76.5%). females with primary or secondary education had more problem of anemia as compared to females with intermediate or graduation. Anemic females with primary education (126), secondary education (73) whereas anemic female with intermediate (46) and with graduation anemic females were only (28). Females with multipara had severe anemic condition as females with primigravida. Anemic condition becomes more severe among females with second or third trimester. Anemic condition among females with 1st trimester was 37, in second trimester 109 whereas in 3rd trimester 127 anemic females were reported. For management of anemia among females with pregnancy depends upon the medication taking by them, number of females was 142, which were taking 3 or 4 medicine, while females with mono pharmacy were 95 and only 36 females were taking various multi vitamin, intravenous Iron supplement and it was concluded that anemia was more common among females resident of rural area due to unawareness regarding anemia and its associated complication. Another major cause was observed was mal nutrition.

Open Access Original Research Article

Phytochemical and Antibiofilm Activity of Aloe barbadensismiller (Aloe vera) on Candida albicans Isolated from Urinary Catheter

Galleh, P. Raphael, Nwosisi, C. Favour, Mohammed, F. Aisha

Journal of Pharmaceutical Research International, Page 93-103
DOI: 10.9734/jpri/2021/v33i731206

Aims: To screen for phytochemicals present in Aloe barbadensismiller (Aloe vera) growing within the Main Campus of Nasarawa State University Keffi (NSUK), determine biofilm forming ability, and to investigate the antibiofilm activity of the plant extracts on biofilm formed by clinical isolates of Candida isolated from urinary catheters.

Study Design: The leaf of Aloe vera were collected and maceration method was used to extract the plant materials used for the screening of bioactive components. Swab samples were collected from the surfaces of patients’ urinary catheters presenting at Federal Medical Centre and Nagari Hospital, Keffi respectively, irrespective of their ages and sexes. Biofilm forming ability of the isolates was investigated and the antibiofilm activity of the plant extracts determined. Ordinary   one-way ANOVA was used to analyze the data where P = .05.

Place and Duration of Study: The research was carried out in the Microbiology Laboratory of NSUK, using the Aloe vera plant collected within the University community and the biofilm analysis was conducted at National Veterinary Research Institute, Vom Plateau State, between                 October 2018 to March 2019.

Methodology: Both the aqueous and ethanolic extracts were screened for aloin, tannins, saponins, glycosides, flavonoids, phenols, alkaloids etc, and the Candida species were subjected to biofilm formation in a flat bottom 96-well microtiter polystyrene plate using crystal violet assay. Broth microdilution method was used to determine the minimum inhibitory concentrations (MIC) of the extracts whereas, antibiofilm activity of the extracts was investigated by growing biofilms in the presence of Aloe vera leaf extracts.

Results: The presence of tannin, saponins, phenols, reducing sugars and aloin were found in the leaf aqueous extract while alkaloid, flavonoid, glycoside, tannin, phenols, reducing sugars, terpenoids, quinones and aloin in the ethanolic extract. Clinical isolates of Candida were found to be strong biofilm formers (70%). Both the aqueous and ethanolic extracts had significant effects on initial cell attachment where P = .05, however, none was able to achieve complete biofilm eradication, including the positive control ketoconazole. Ethanolic extract inhibits C. albicans cell attachment by 54.25%, aqueous extract 25.68% and ketoconazole has 48.54% percentage inhibition, respectively. Interestingly, ethanolic extracts showed a better antibiofilm property (37.38%) compared to ketoconazole that had 33.98% biofilm inhibition.

Conclusion: The leaf extracts of Aloe barbadensismiller has significantly reduced biofilm formed by clinical isolates of Candida. Coating of urinary catheters with A. vera extracts can decrease nosocomial infections, morbidity, and high mortality as well as financial burden, hence, serving as an alternative treatment for urinary tract infections.

Open Access Review Article

A Comprehensive Review on Natural Products and Anti-Inflammatory Activity

Faruk Alam, Ruhul Amin, Biplab Kumar Dey

Journal of Pharmaceutical Research International, Page 57-77
DOI: 10.9734/jpri/2021/v33i731201

Natural plants various metabolites are widely utilized in a different kind of infections and inflammation as traditional medication. The inflammatory response is a reaction always effects in daily life and physical issue and activity of herbal complex act through of blood vessels. Inflammation is a pathologic issue that incorporates a wide scope of sicknesses, for example rheumatic, diabetes, cardiovascular accident and chronic kidney disease. We present a few herbal spices which their metabolites that have been assessed in clinical and test. The review includes number of various herbal plants with their families, parts utilized, k concentrate utilized, bioassay models and their usages in medicinal activities.