Open Access Original Research Article

Comparison on Safety and Efficacy of Telmisartan and Losartan with their Effects on Cardiovascular – A Single Centre Study

T. Chandrasekar, M. Muniappan, N. S. Muthiah

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/jpri/2021/v33i23A31404

Two of the major determinants of cardiovascular disease, hypertension and hyperlipidemia, commonly coexist. There is high prevalence (5 -25%) of low high  density lipoprotein (HDL) cholesterol and a higher  prevalence of elevated Triglyceride (TGL) levels in hypertensive compared to normotensive  individuals. Elevated total cholesterol (TC) levels augment the risk of cardiovascular disease associated with hypertension. This study aimed to determine the antihypertensive & pleiotropic effects of telmisartan and losartan in patients with mild to moderate hypertension. All the subjects were between the ages of 18 -65 years. 100 subjects were selected for the study and their serum total cholesterol, HDL, LDL, VLDL, Triglyceride, Systolic blood pressure, diastolic blood pressure, heart rate were analyzed at  the beginning of the study and 12th  and  24 the week. Adverse events are also noted in each visit. All data entered in SPSS 10 version and scores obtained were statistically evaluated using student t test, chi square test and ANOVA. The study showed both telmisartan and losartan good control over hypertension in patients. Telmisartan has pleiotropic positive effect on lipid profile.

Open Access Original Research Article

Knowledge, Attitudes and Practices Survey of Medication Safety among Community Pharmacists in Aden-Yemen

Mohammed Alshakka, Wafa Badulla, Mohamed Izham Mohamed Ibrahim

Journal of Pharmaceutical Research International, Page 13-27
DOI: 10.9734/jpri/2021/v33i23A31405

Introduction: All health professionals' participation is essential for ensuring quality and successful national post-marketing surveillance programs. This study aimed to assess the knowledge, attitudes, and practices (KAP) among Yemeni community pharmacists (CPs) regarding medication safety in a poor-resource setting.

Methods: A survey was conducted among CPs in Aden governorate. The tool comprised of demographic profile, knowledge, attitude, and practice aspects of medication safety. The survey also studied the opinion about the future and benefits of Adverse Drug Reaction (ADR) reporting in Yemen. The data collected was analyzed using descriptive statistics such as frequencies, percentages, and means (SD).

Results: A total of 450 CPs were enrolled in the study. Most of the participants were males (75%) with a bachelor's degree (91.9%) and between 3-6 years of experience (28%). The majority of CPs had good knowledge regarding the perception and objectives of Pharmacovigilance (PV) and ADRs. Approximately 41% of participants knew the purpose of PV as an essential system for public health and safety concerning drug use. Additionally, the Yemeni pharmacists had a positive attitude towards the reporting system. Approximately 84% of responders admitted that PV is the responsibility of the pharmacists. The majority of the participants (80%) declared no reporting form available at their workplace. According to CPs, 59% said that relevant authorities do not widely promote ADR reporting in Yemen, and 57% replied that the patient's lack of information is an obstacle in the reporting system. Approximately 89% of the CPs believed that reporting ADRs would improve patient safety.

Conclusions: The CPs have a positive attitude towards PV and an acceptable degree of knowledge. However, the practice level should be upraised.

Open Access Original Research Article

Efficacy and Safety of Topical Calcipotriol Plus Betamethasone Dipropionate Versus Topical Betamethasone Dipropionate Alone in Mild to Moderate Psoriasis

M. Sindhuja, N. S. Muthiah

Journal of Pharmaceutical Research International, Page 28-38
DOI: 10.9734/jpri/2021/v33i23A31406

Psoriasis is one of the prototypic papulosquamous skin diseases characterized by erythematous papules or plaques. This disease is chronic in nature with a tendency to relapse. Betamethasone dipropionate binds to specific intracellular glucocorticoid receptors and subsequently binds to DNA to modify gene expression. The study duration was 6 weeks. A total of 60 study participants of both sexes diagnosed with mild to moderate psoriasis were included in the study. They were randomized into two groups. Group A – topical calcipotriol plus betamethasone treatment group consisting of 30 patients and Group B – topical betamethasone alone also consisting of 30 patients and a total of 28 patients in topical calcipotriol plus betamethasone treatment group and 28 patients in topical betamethasone group completed the study. A total of 98 patients were screened for this study, out of which 38 patients were excluded where 11 patients refused to participate and 27 patients didn’t meet the inclusion criteria of our study. These results shows that there is statistically significant percentage reduction in PASI score after 2 weeks (p=0.01) and 4weeks (p<0.001) of treatment in both groups. As a conclusion, the combination therapy of topical calcipotriol plus betamethasone provided a promising strategy for the treatment of mild to moderate psoriasis.

Open Access Original Research Article

Study of Serum Adenosine Deaminase Level in Type 2 Diabetes Mellitus and its Correlation with Glycemic Control

D. Hemalatha, J. Manjula Devi, P. R. Kalaiselvi

Journal of Pharmaceutical Research International, Page 39-49
DOI: 10.9734/jpri/2021/v33i23A31407

Diabetes mellitus is a cluster of abnormal metabolic disorder having common features of hyperglycaemia with a state of increased free radical activity. Chronic hyperglycemic status favours auto-oxidation and the formation of advanced glycation end products. Adenosine deaminase (ADA) is considered as a good marker of cell mediated immunity. Increased ADA activity in diabetic individuals could be due to altered insulin related T-lymphocyte function. Hyperglycaemia is associated with increased level of (ADA), which is one of the factor which leads to increase oxidative stress level by generatingthe reactve oxygen species (ROS) leading to insulin resistance. In our study, ADA level was significantly high in controlled diabetes mellitus type 2 (group II with HbA1c < 7) and was much higher in uncontrolled diabetics (group III with HbA1c > 7) compared to healthy controls (group I). The present study was aimed to find the level of Serum (ADA) among the patients with type 2 diabetes mellitus through a case control study and correlation of Adenosine deaminase with glycemic control (HbA1c). Comparison of the parameters fasting plasma glucose (FPG), post prandial plasma glucose (PPPG) HbA1c, and ADA between the 3 groups were done using Student t test and was statistically significant. Pearson’s coefficient correlation was done between ADA and HbA1c and a positive correlaion was seen that was also statistically significant. This indicates that ADA ses with the extent of severity of type 2 diabetes. Positive correlation of ADA with HbA1c provides the information that ADA can be considered to reflect the glycemic status of the individual.

Open Access Original Research Article

To Evaluate the Outcome of Epididymal Cystectomy at Liaquat Medical College Hospital Jamshoro Pakistan

Zameer Husaain Laghari, Qumber Laghari, Ahsan Ali Laghari, Ambreen Munir, Sheeraz Ahmed Shaikh, Faiza Hameed, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 50-54
DOI: 10.9734/jpri/2021/v33i23A31408

Introduction: Epididymal cystectomy is the procedure in which removal of cyst attached to epididymis is done. The cyst contains cleat/straw colored fluid. It is excised because of its increasing size causing discomfort or pain to patient.

Methodology: A Cross sectional observational study was conducted at Surgical Unit 1, Department of of Surgery LMC Hospital Jamshoro from January 2020 to January 2021. All the patients were admitted through Surgical OPD (SOPD) with cystic swellings in scrotum. History and clinical examination of inguino-scrotal region was done. Transillimination test was also done. Ultrasound was obtained to confirm the diagnosis, number of cysts, sizes and site of cyst. Hydrocele, spermatocele and testicular malignancies were ruled out through investigations. Surgery was planned after getting cardiac and anesthesia fitness. The surgery was done. Patients were shifted to ward and assessed for 3 to 5 days. Patient was called for follow up for 6 months. Results were analyzed using statistical package for social sciences (SPSS) version 23.

Results: Total patients included in our study are 49.32 (65%) patients had solitary cyst and 17 (35%) had multiple cysts. 30 (61.2%) patients had left sided epididymal cysts and 19 (38.7%) had right sided cysts. Hematoma was developed by 6.1%, chronic pain by 12.2%, infection by 8.1%, scrotal edema by 10.2% and recurrence by 6.1% patients.

Conclusion: Epididymal cystectomy is the procedure with better outcome and least complications rate.

Open Access Original Research Article

An Immunohistochemical Study of Estrogen and Progesterone Receptors in Endometrium of Women with Dysfunctional Uterine Bleeding

A. Kavitha, J. Thanka

Journal of Pharmaceutical Research International, Page 55-65
DOI: 10.9734/jpri/2021/v33i23A31409

Abnormal Uterine Bleeding (AUB) is a common complaint that affects large numbers of women from puberty to menopause. It negatively affects health and quality of life of women affected. AUB also has an economic impact for both women and society Abnormal uterine bleeding in premenopausal women is one of the most frequent problems in gynecological practice. Although some of the cases may be due to an organic cause, over 50% of the patients undergoing hysterectomy for menorrhagia have dysfunctional uterine bleeding (DUB). To analyze the percentage and intensity of estrogen receptors (ER) and progesterone receptors (PR) in endometrium of patients with DUB. This study suggests that estrogen and progesterone receptors have an important role in etiopathogenesis of dysfunctional uterine bleeding and alteration in the morphology of endometrium such as development of endometrial hyperplasia. Women in the reproductive age who are complaining of abnormal uterine bleeding, usually have an increase in ER alpha and PR expression in their endometrium.

Open Access Original Research Article

Curcumin Scavenges Peroxynitrite in RAW 264.7 Macrophages through Phenolic Hydroxyl Groups

Mustafa Kassim, Nazeh M Al-abd, Mohd Shahnaz Hasan, Marzida Mansor, Mohamed Izham Mohamed Ibrahim

Journal of Pharmaceutical Research International, Page 66-77
DOI: 10.9734/jpri/2021/v33i23A31414

Background: Overproduction of free radicals is implicated in cell death and tissue injury. Peroxynitrite (PN) is a highly oxidizing and short-lived free radical that is formed by the interaction of nitric oxide (NO) with superoxide. Curcumin is a natural compound obtained from Curcuma longa and has high antioxidant and anti-inflammatory activities.

Aim: We investigated the PN scavenging ability of curcumin to determine its potential as a therapeutic agent for chronic diseases caused by highly oxidative molecules.

Methodology: We examined the PN scavenging ability of curcumin either by directly incubating lipopolysaccharide (LPS)+interferon (IFN)-γ-stimulated RAW 264.7 murinacrophages with PN or indirectly through incubation with a PN donor (the artificial substrate SIN-1). Student t-test and one-way ANOVA were used to determine the statistical significance of differences between the experimental and control groups. 

Results: The results demonstrate that curcumin inhibits PN and the synthesis of PN from SIN-1. Curcumin also significantly improved the viability of LPS+IFN-γ-treated RAW 264.7 macrophages and inhibited NO production. In macrophages, curcumin inhibited cellular PN synthesis, as evidenced by the absence of 3-nitrotyrosine, a marker of PN-oxidized proteins. 

Conclusion: Curcumin attenuates the immune responses that lead to cellular damage and cell death through suppression or scavenging of cytotoxic molecules such as NO and PN. The role of the phenolic hydroxyl of curcumin is critical in PN scavenging.

Open Access Original Research Article

Isolation, Identification, Speciation and Antibiotic Susceptibility Pattern of Klebsiella Species among Various Clinical Samples at Tertiary Care Hospital

K. Sathyavathy, B. Kiran Madhusudhan

Journal of Pharmaceutical Research International, Page 78-87
DOI: 10.9734/jpri/2021/v33i23A31415

To isolate, identify and speciate Klebsiella from various clinical samples and their Antimicrobial susceptibility pattern at tertiary care hospital, Chennai. Out of this 76 ESBL producing Klebsiella pneumoniae, 64(84%) were positive by Double Disc Synergy Test (DDST), 71(93%) by phenotypic confirmatory disc diffusion test (PCDDT) and 69(90.7%) by Etest strip method. Sensitivity was found to be maximum (93%) by PCDDT method, compared to other phenotypic methods such as DDST and Etest strip method. The Present study also highlights the need for the continued monitoring of Antimicrobial susceptibility patterns of important bacterial pathogens, so that rational antibiotic policies can be formulated.

Open Access Original Research Article

Awareness and Utilization Pattern of Over-the-Counter Painkillers amongst Health professional Students in a Medical University

Abir Al-Azi, Aya Dzhakha, Subish Palaian

Journal of Pharmaceutical Research International, Page 88-104
DOI: 10.9734/jpri/2021/v33i23A31416

Objective: Pain relievers are one of the most frequently purchased over-the-counter medications and are vulnerable to be misused, leading to safety concerns. This study was conducted to assess the awareness and self-medication practices of over-the-counter analgesics amongst health professions students in a medical university.

Methods: A cross-sectional study was conducted, after obtaining ethical approval, using a self-developed, pilot tested (n=40), valid questionnaire comprising three sections; sociodemography, student awareness, analgesic use pattern. A sample of 379 (calculated sample size, n=400) covering all health stream students proportionately from Gulf Medical University, Ajman, UAE, were studied during October-December 2018 and data analysed using descriptive statistics (Mean±SD, frequency), Chi square test, and independent t test at alpha =0.05.

Results: Total 379 respondents (male 38.5%; n=146, female 61.5%; n=233 with mean ± SD age of 19.76±2.109 years) were enrolled. Commonly used painkillers were paracetamol 47.3% (n=187), ibuprofen 24% (n=95) and aspirin 14.4% (n=57).  Information available on package inserts were the source of information for 54.1% (n=119) respondents. Family and friends’ recommendations was reason for use of painkillers in 27.3% (n=93) of the students. Adverse effects mostly known were nausea 11.5% (n=92), drowsiness 8.9% (n=71) and vomiting 7.2% (n=58). Contraindications known were pregnancy 14.5% (n=225), liver disease 13.4% (n=208) and bleeding 13.3% (n=207). Findings showed 61.5% (n=233) were not aware of painkillers’ interactions with other medications. 

Conclusion: Though students were aware of the usage of analgesics, the utilization pattern is high, suggesting the need for further in-depth investigations.  Findings also showed the need for creating awareness among the students. 

Open Access Original Research Article

Status of Transferrin Saturation in Diabetic Nephropathypatients

R. Dinesh Kumar, A. J. Manjula, B. Shanthi

Journal of Pharmaceutical Research International, Page 105-118
DOI: 10.9734/jpri/2021/v33i23A31417

Serum transferrin saturation (TSAT%) ratio is a commonly used laboratory measure of iron deficiency and iron overload in clinical practice. It has  become a  first step in the routine screening of iron deficiency anaemia in  patients with chronic kidney disease  and  for  the  detection of pathological iron overload in assessment for hemochromatosis. Used alone or in combination with other measures of iron metabolism, low levels of TSAT (typically<20%) reflect a state of iron deficiency whereas levels in excess of 50% indicate an excess of total body iron. In our study, transferring saturation levels was significantly high in diabetic Nephropathy (group I). Comparison of the parameters serum iron, Urine Albumin, TIBC, Trasferrin saturation, glycated hemoglobin (HbA1C), Fasting plasma glucose(FBS) between the 3 group was done using Student t test and was statistically significant.Pearson’s coefficient correlation was done between transferrin saturation and serum iron, Urine microalbumin, TIBC, Trasferrin saturation, glycated hemoglobin (HbA1C), Fasting blood sugar (FBS) and found a positive correlation between them and had a statistical significance.  This indicates that transferrin saturation levels increases with the extent of severity of diabetic Nephropathy. Positive correlation provides the information that transferrin saturation can be considered to reflect the iron depletion of an individual.