Open Access Original Research Article

Comparative Study of Compliance between Sofosbuvir and Interferon in the Management of Viral Hepatitis at Tertiary Care Hospital of Gambat, Sindh, Pakistan

Sajid Ali, Zuheeb Ahmed, Marvi Metlo, Tahseen Ahmed, Shahzad Ali, Arslan Ahmer, Muhammad Murtaza Qureshi, Syed Adeel Ahmed Shah

Journal of Pharmaceutical Research International, Page 1-8
DOI: 10.9734/jpri/2021/v33i24A31425

Introduction: Hepatitis can be defined as inflammation of the liver. Hepatitis may be acute or chronic. It is estimated that in 2017, approximately 15 million people suffered from Hepatitis in Pakistan suffering from hepatitis. 150–200 million people, or approximately ~3% of the world's population, are living with chronic Hepatitis C.

Methodology: A descriptive cross-sectional study was conducted on 300 patients selected by purposive sampling who were reported with Hepatitis-C and co infection of Hepatitis-C + Hepatitis-B, at a tertiary care hospital Gambat. A series of questions were asked from reported patients regarding symptoms and compliance.

Results: The results were analyzed by using SPSS-22. Among the 300 patients some were on sofosbuvir (n=150, 50%), which the others were on interferon (n=150, 50%). The findings showed that most of the patients on interferon were non-compliant (n=125,83.3%), and only (n=25, 16.7%) are compliant. Among non-compliant factors, fear from injection was reported in (n=42, 33.6), technique for injection (n=38, 30.4%), prolong duration of action (n=35, 28%), adverse drug reaction (n=26, 20.8%). Better compliance was observed with sofosbuvir (n=93, 62.8%) and non-compliant were (57, 38%).

Conclusion: This study concluded that better compliance was achieved with sofosbuvir as compared to interferon, rate of ADR’S were also less with sofosbuvir.

Open Access Original Research Article

Pharmaceutical Consultation in Hospitals at Northern Border Region, Saudi Arabia

Nawaf M. Alotaibi

Journal of Pharmaceutical Research International, Page 9-14
DOI: 10.9734/jpri/2021/v33i24A31426

Background: Pharmacists' traditional position as drug dispensers has recently developed into a more active role in risk evaluation and management. Dispensing is often handled by pharmacy technicians in Saudi Arabia because pharmacists are so preoccupied with their managerial and administrative responsibilities. Pharmacists' meetings with patients are limited to medication dosage and frequency, as well as rare adverse effects and drug interactions.

Methods: We conducted a quantitative questionnaire study in Saudi Arabia to look into the role of hospital pharmacists in patient counseling, the assessment of pharmacists' patient counseling opinions, and the possible determinants of personal consultation.

Results: The number of patient inquiries was found to be very low, ranging from 5 to 20 per month. The amount of private pharmaceutical consultations was also poor. This finding showed that people trust pharmacists.

Conclusion: Reorganizing the pharmacist's operations will help to enhance pharmaceutical consultations. This will help patients make better decisions about their medications and improve their quality of life.

Open Access Original Research Article

Identifying the Risk Factors and the Prevalence of Poor Glycemic Control among Diabetic Outpatients in a Rural Region in Saudi Arabia

Ziyad S. Almalki, Nehad Jaser Ahmed, Abdullah K. Alahmari, Ahmed M. Alshehri, Sheikah Abdullah Alyahya, Abdulhadi Alqahtani, Mohammed Alhajri

Journal of Pharmaceutical Research International, Page 15-23
DOI: 10.9734/jpri/2021/v33i24A31427

Aim: This cross-sectional study aimed to assess the prevalence of poor glycemic control and risk factors associated with it among diabetic patients in the central rural region of Saudi Arabia.

Methods: The study included a review of diabetic patients’ medical record in King Khaled Hospital in Al-Kharj from the beginning of January 2019 to the end of June 2019. Poor glycemic control was defined as the current use of diabetic-lowering medication associated with HbA1c levels ≥7%. Multivariate analysis was done to identify the associated factors of poor glycemic control.

Results: Of 1,010 consecutive outpatients’ diabetic patients were involved in the study sample, poor glycemic control presented in 496 (49.1%). Individuals who were at risk to have poor glycemic control those between 45 and 65 years with odds ratio (OR) of 1.927 (95% CI: 1.143–3.248), obese 1.496 (95% CI: 1.085–2.063) and diagnosed with asthma 2.062 (95% CI: 1.637–3.504).

Conclusion: The extent of poor glycemic control in the study sample was found high. Age, obesity, and having asthma are the most important factors of increased risk of poor glycemic control. Improving glycemic control would need rigorous efforts by addressing these factors.

Open Access Original Research Article

The Preventive Effects and Mode of Actions of Ulva Fasciata Synthesized Silver Nanoparticles in Doxorubicin-Induced Hepatotoxicity in Wistar Rats

Asmaa M. Mahmoud, Osama M. Ahmed, Ibraheem B. Mohamed, Hanan A. Soliman, Basant M. Mohamed

Journal of Pharmaceutical Research International, Page 24-48
DOI: 10.9734/jpri/2021/v33i24A31429

Background: Hepatotoxicity was one of the major side effects associated with doxorubicin treatment in cancer chemotherapy. The synthesized silver nanoparticles (AgNPs) from natural products such as algae especially green algae is one of the favorable means to minimize the deleterious effects of the chemotherapy. Thus, this study aimed to evaluate the preventive role of AgNPs synthesized by Ulva fasciata (U. fasciata) against doxorubicin-induced hepatotoxicity and oxidative stress in the liver of male Wistar rats. 

Materials and Methods: In the present study, the green macroalga U. fasciata ethanolic extract was used as reducing agents to reduce Ag ions to Ag0. Doxorubicin-injected male Wistar rats were concomitantly treated with U. fasciata ethanolic extract and AgNPs synthesized by U. fasciata extract (AgNPs/U. fasciata) 3 times/week by oral gavage for 6 weeks.

Results: The results showed that male Wistar rats injected with doxorubicin showed a significant increase in ALT, ALP and GGT activities and total bilirubin level as well as a reduction in the serum albumin level. The concurrent treatments of doxorubicin-injected rats with U. fasciata ethanolic extract and AgNPs/U. fasciata significantly abrogate these alterations. The altered levels of tumor biomarkers CA19.9 and AFP as well as pro-inflammatory cytokine, TNF-α, and anti-inflammatory cytokine, IL-4, in doxorubicin-injected animals were significantly ameliorated by concurrent treatment with U. fasciata and AgNPs/U. fasciata. Moreover, the elevated mRNA expression of p53 significantly decreased by treatment. In association, the doxorubicin-induced deleterious histological changes represented by severe hydropic degenerative changes, steatosis, inflammatory cell infiltration, Kupffer cell proliferation and apoptosis were remarkably improved by concurrent treatment with U. fasciata extract and AgNPs/U. fasciata which was more potent.

Conclusion: Based on results of this study, it can be concluded that U. fasciata extract and AgNPs/U. fasciata counteracts doxorubicin-induced toxicity by suppression of inflammation, oxidative stress and apoptosis. AgNPs/U. fasciata was the most potent in improving hepatocyte integrity and liver histological architecture. 

Graphical Abstract



Open Access Original Research Article

Isolation and Identification of Uropathogenic E. coli and its Antimicrobial Susceptibility Pattern with Special Reference to Extended Spectrum Beta-Lactamases (Esbl)

V. Naveen Kumar, Chitralekha Saikumar

Journal of Pharmaceutical Research International, Page 56-67
DOI: 10.9734/jpri/2021/v33i24A31431

Urinary tract infections (UTI) are the most common bacterial infection among the humans. One of the most important factors impacting the management of UTI over the past decade is emergence of anti-microbial resistance among uropathogens. ESBL production is one of the most common mechanisms of anti-microbial resistance, the other being Amp C β-lactamases in gram negative bacteria. This study was undertaken to establish the prevalence of ESBL producing strains and their anti-microbial susceptibility pattern to newer agents to guide therapy for urinary tract infection. The present studies isolates and identify Uropathogenic Escherichia coli and its antibiotic susceptibility pattern with special reference to ESBL. The emergence of β-lactamase is a Metter of serious concern .The drug resistance in gram negative bacilli is due to production of β-lactamases, AmpC lactamases, Efflux mechanisms and Porin deficiency. Out of the total 3580 urine samples, 987 samples (27.56%) showed No growth, 1786 (49.88%) showed the presence of Gram negative bacteria. Totally, 1081 E. coli species were isolated and < 30% of them were found to be ESBL positive. Uropathogenic E. coli   isolates are highly susceptible towards Meropenem and Imipenem antibiotics and highly resistant towards β-lactam and Cephalosporins antibiotics. Hence, the present study urged to implement the management plan for using those antibiotics in patients for preventing the antibiotic resistance.

Open Access Original Research Article

Study of the Bacteriological Profile and Their Antimicrobial Susceptibility Pattern in Patients with Skin Infections

M. Nandini, S. B. Kiran Madhusudhan

Journal of Pharmaceutical Research International, Page 77-84
DOI: 10.9734/jpri/2021/v33i24A31433

The study group consisted of 150 patients both male and female between 1 – 80 years, with primary and secondary skin infections who attended the out- patient department of Dermatology and surgery at Sree Balaji medical college and hospital a tertiary care hospital in Chennai, Tamilnadu, South India. Patients admitted as in patients in the above two department were also taken for this study. 28 out of 150 cases had primary bacterial and 122 had secondary bacterial skin infections. In this study the prevalence of Methicillin resistant Staphylococcus aureus (MRSA) (40.8%) and Extended spectrum beta-lactamases (ESBL) (40.5%) producers among Enterobacteriaceae was higher. Estimation of MRSA and ESBL has to be done in tertiary care hospital to prevent and curtail further spread of these strains in hospital acquired infections. These isolates pose a serious threat for use of routine groups of antimicrobials.

Open Access Original Research Article

Neuroprotective Propensity of 4-Allylpyrocatechol Derivatives against Oxaliplatin Induced Peripheral Neuropathy

Tirupathi Rao Annavarapu, Sujana Kamepalli, Vijay Kotra, G. Venkata Rao

Journal of Pharmaceutical Research International, Page 92-100
DOI: 10.9734/jpri/2021/v33i24A31436

Chemotherapy is used for the treatment of rapidly growing cell diseases in the body. It is most used for the treatment of different kinds of tumors. It can develop neuropathic pain due to damage of peripheral nerve cells and it is called Chemotherapy-Induced Peripheral Neuropathy (CIPN). In this study, we have reported the protective effects of 4-allyl pyrocatechol (4-APC) and its derivatives from biochemical and functional deficits associated with oxaliplatin (OP) induced neuropathy. The animals were submitted to mechanical and thermal hyperalgesia tests, after treatment with OP three times weekly at 0.20 mg/kg and 4-APC and derivatives (10 mg/kg & 30 mg/kg). The pain parameters were evaluated during the treatment period and at the end of treatment. 4-APC significantly prevented the mice from behavioural and biochemical alterations associated with OP-induced neuropathy. Thus, we conclude from this study, the use of 4-APC and its derivatives with OP might reduce the number of patients who develop painful peripheral neuropathy.

Open Access Review Article

Features of Anesthesia in Minimally Invasive Surgery

Muslim Khamidovich Didiev, Khava Abdullaevna Edilsultanova, Timofei Alekseyevich Rakitin, Ivan Sergeevich Matveichev, Oleg Vladimirovich Kleimenov, Vitaly V. Goncharov

Journal of Pharmaceutical Research International, Page 49-55
DOI: 10.9734/jpri/2021/v33i24A31430

Minimally invasive surgery is usually performed due to various benefits, such as reduced postoperative pain, faster recovery, and reduced postoperative pulmonary complications. Combining different surgical interventions into one group on the principle of technological generality, and not depending on the etiopathogenesis of the patient or the operated organ from the point of view of the anesthesiologist is quite justified, since it allows us to develop a single methodological approach to intraoperative protection of the patient. This approach is formed on the basis of taking into account both general anaesthetic and specific requirements for this type of operation. At the same time, the procedure should be painless and comfortably tolerated by the patient, as well as anesthesia should contribute to the fastest possible rehabilitation of the patient and his social rehabilitation.

Naturally, the implementation of the above requirements should not be at the expense of the effectiveness, safety and reliability of anesthetic during the perioperative period.

The purpose of the work is to consider the features of anesthesia in minimally invasive surgery.

Open Access Review Article

Effect of Mushroom against Extended Spectrum Beta Lactamase (ESBL) Producing Microorganisms

Hema Priyaa Vijayan, Farzana Yasmin, Asita Elengoe

Journal of Pharmaceutical Research International, Page 68-76
DOI: 10.9734/jpri/2021/v33i24A31432

According to the WHO global report, ESBL (Extended-Spectrum Beta-Lactamase)-producing microorganisms is the most common cause of urinary tract infection; hospital-acquired infection as well as a foodborne infection. These include Escherichia coli, Salmonella, Shigella and Vibrio cholera. The carbapenems which include doripenem, ertapenem, imipenem and meropenem are the known choice of medication for life-threatening infections which is caused by ESBL-producing microorganisms. Recently there is the emergence of carbapenem-resistant Enterobacteriaceae and Pseudomonas which makes treatment an obstacle for the medical personnel for various infections. Natural products have been reported to be emerged as a potential possibility to be explored as antimicrobial drugs. The plant extracts could serve as an alternate source of resistance modifying agents owing to the wide variety of secondary metabolites (eg. flavonoids, phenols, tannins, alkaloids, etc). Mushroom are have been considered as a source that attracts the researchers to explore its properties as it has been established with various bioactive components that possess many health beneficial effects such as antimicrobial and antifungal compounds. In this paper, we summarizes the information available in the literature on the ESBL, mushroom and current treatment, with a special focus on the three different types of mushrooms (Fistulina hepatica, Leucopaxillus giganteus and Pleurotus Ostreatus) against spectrum beta-lactamase (ESBL) producing microorganisms. Electronic databases including SciFinder, Web of Science, Science Direct, PubMed, and Google Scholar were screened using the following keywords: “antibacterial, antimicrobial, mushroom, ESBL, Enterobacter, Fistulina hepatica, Leucopaxillus giganteus and Pleurotus Ostreatus”. We intend to enhance understanding in the field and promote further work on the development of phytocomponent based antimicrobial compounds.

Open Access Review Article

COVID-19's Economic Impact on the Global Health Systems: Time to Respond to New Realities

Ziyad S. Almalki

Journal of Pharmaceutical Research International, Page 85-91
DOI: 10.9734/jpri/2021/v33i24A31434

Around six months have passed since the emergence of an ongoing coronavirus-related health pandemic. In resource-limited countries, healthcare systems with fewer options for intervention are likely to face more economic difficulties. The goal of this review is to summarize and explore the cost and economic effect of COVID-19 on global health systems. The study starts with a crisis synopsis and costs of COVID-19 treatment, then discusses how health has been affected and approaches to alleviating the burden while at the same time limiting an inevitable income loss.

Even if it is difficult to project COVID-19 spending because there are many uncertainties about the disease and its future course, various reports have quantified the amounts spent on direct COVID-19 treatment in different countries. The healthcare sector around the world has faced catastrophic financial challenges and experienced the largest global recession in history. Most governments in the world cannot avoid the devastating economic impact of COVID-19 on the healthcare sector, but they can try to avert the worst effects. With the spread of the coronavirus, the healthcare systems are facing a financial crisis as a result of actions that countries have adopted to mitigate the spread of the virus. Therefore, it is crucial to act swiftly and in meaningful ways to minimize the fallout from this shock.