Open Access Systematic Review Article

Primary Health Care Physician’s Role in Return to Work after Cancer: A Systematic Review

Manal Murad, Sultan Almuhaysin, Ahmed Alkhatem, Azzam Alsharif, Samaher Afif, Ahmad AlJafen, Raad Alamri, Sultan Alsulami, Khaled Arishi, Suliman Al-Aqeel, Raed Aljohani

Journal of Pharmaceutical Research International, Page 86-98
DOI: 10.9734/jpri/2021/v33i25A31455

Cancer is considered one of the most debilitating diseases as it affects all aspects of patients' life. One of the most neglected aspects is the ability to return to work during or after cancer treatment. General practitioners were considered the most common visited physicians after cancer treatment. However, their role in this critical problem to cancer patients is not well established. That is why we have done this review to investigate the role of general practitioners and primary health care in cancer care and how it should be reinforced. Six databases were searched using specific search terms. We included any study that assessed the role of general practitioners to help cancer patients return to work. In addition, we included studies that assessed the difficulties towards the integration of general physicians into the plan of care of cancer patients. The studies were assessed for the quality of evidence using the NIH quality assessment tool before being included for the review. Seven studies fulfilled our inclusion criteria and had passed the quality assessment to be included for the qualitative evidence synthesis. Based on these studies, the patients reported the lack of support from the general practitioners in the primary health care, and they found the attitude of the general practitioners not encouraging to ask for support from them. For general practitioners, they acknowledged their lack of support towards cancer patients and they needed more resources so they can counsel the patient regarding their work environment. General practitioners lacked the necessary knowledge and resources required to help patients to get back to their workplace. More plans are required to help them understand the problems of cancer survivors so they can counsel them properly.

Open Access Minireview Article

Brazilian Nursing and Production in Palliative Care: A Bibliometric Study

Dayara de Nazaré Rosa de Carvalho, Viviane Ferraz Ferreira de Aguiar, Manuela Furtado Veloso de Oliveira, Monique Lindsy Silva de Souza, Sandra Suely Silva de Oliveira, Paula Andreza Viana Lima, Tainan Fabrício da Silva, Natalie Kesle Costa Tavares, Mainessa da Guia Rodrigues, Fernanda de Nazaré Almeida Costa, Marcela Raíssa Asevedo Dergan, Dandara de Fátima Ribeiro Bendelaque, Marcia Helena Machado Nascimento, Antônia Margareth Moita Sá, Ivonete Vieira Pereira Peixoto

Journal of Pharmaceutical Research International, Page 1-9
DOI: 10.9734/jpri/2021/v33i25A31446

Objective: This study aims to quantify and describe the characteristics of scientific production in Brazilian Nursing on Palliative Care between the years 2015-2020.

Methodology: This is a descriptive, bibliometric study. At the end of the selection stage, the final sample of 98 publications emerged.

Results: Of the total number of publications, 28 (28.57%) in the VHL database and 70 (71.43%) in SciELO. Most publications occurred in 2018 with 26 (26.53%) and 2016 with 19 (19.39%) publications, followed by 2017 with 16 (15.36%) publications.

Conclusion: The findings in this study show that in the past 5 years, Brazilian nursing has been discussing and researching palliative care. However, it was also observed that the concentration of Brazilian nursing publications in palliative care is in the Southeast and South regions of Brazil, with the North region falling far short of study in the area.

Open Access Original Research Article

Association of Vitamin D Deficiency with Hepatitis B and C Virus Infection

Darshan Kumar, Muhammad Umar Khan, Syed Mohammad Kashif, Majid Ahmed Shaikh, Zunaira Nawaz, Ubedullah Shaikh

Journal of Pharmaceutical Research International, Page 10-14
DOI: 10.9734/jpri/2021/v33i25A31447

Objective: To evaluate the association of vitamin D deficiency with hepatitis B and C virus Infection.

Study Design: This is a prospective study.

Setting: Study carried out at Medicine department Civil Hospital Karachi, from March, 2018 to December, 2019.

Materials and Methods:  266 Participants of the study included patients with active hepatitis B or hepatitis C infection visiting OPD of the hospital. Vitamin D levels of 14-30 ng/ml have been described as insufficient and levels <14 ng/ml are labelled as deficient. Vitamin D level of >30 nm/ml have been defined as sufficient according to our study. Diagnosis of Hepatitis B is confirmed by HBV DNA and HBsAg serum levels and of Hepatitis C by HCV RNA levels.

Results: We received 70.6% (n=266) males and 29.3% females. After serological tests 34.9% (n=93) patients were positive for HBV DNA whereas 47.7% (n=127) patients were positive for HCV DNA. Coinfection with hepatitis B and C was present in 17.2% (n=46) of patients. Amongst total 266 participants 54.31% patients have been vitamin D deficient and 32.7% have insufficient vitamin D levels.

Conclusion: Genetic and metabolic factors linked to hepatitis B and C with vitamin D deficiency should be studied on large scale. In our study patients infected with HBV and HCV have been vitamin D deficient, supplementation needs to be added to the treatment regimen.

Open Access Original Research Article

In-vivo Hepatoprotective and Antioxidant Activities of Sphaeranthus amaranthoides Burm.f. Against Anti-Tubercular Drugs Induced Hepatotoxicity in Rats

M. R. Vinayakamurthi, J. Anbu Jeba Sunilson, A. V. Anita Gnana Kumari, U. Aathilakshmi

Journal of Pharmaceutical Research International, Page 15-23
DOI: 10.9734/jpri/2021/v33i25A31448

Aim: To evaluate the hepatoprotective and antioxidant activity of Sphaeranthus amaranthoides Burm.f. against isoniazid (INH) and rifampicin (RIF) induced hepatotoxicity in rats.

Study Design: Experimental study.

Place and Duration: Research lab, Department of Siddha Medicine, Tamil University, Thanjavur, India, between March 2018 and November 2019.

Methodology: Liver toxicity was induced by antitubercular drugs (Isoniazid; INH+Rifampicin; RIF) at a dose level of 50+100 mg/kg each, p.o for 15 days. Petroleum ether, Chloroform, Methanol, Aqueous extracts of Sphaeranthus amaranthoides Burm.f. (S. amaranthoides) (200 and 400 mg/kg bt.wt.) were administered orally once daily for 15 days. The hepatoprotective activity was assessed using various biochemical parameters SGOT, SGPT, ALP, bilirubin, total protein, albumin, total cholesterol, total bilirubin, direct bilirubin and LDH. The antioxidant activities such as the enzymatic activity of superoxide dismutase (SOD), and catalase (CAT), and the level of lipidperoxidation as thiobarbituric acid reactive substance (TBA-RS) were measured in liver homogenates and histological examinations were carried out to assess hepatoprotective activity. For Statistical analysis, the values were subjected to one way analysis of variance (ANOVA) followed by Tukey multiple compare test. Results were considered statistically significant when P<0.05.

Results: The treatment with methanolic extract (400 mg/kg bt.wt.) of S. amaranthoides significantly prevented drug-induced increase in serum levels of liver enzymes (P<0.001). The antioxidant activity of a dose of 400 mg/kg of S. amaranthoides significantly prevented the decreases in the activity of enzymatic antioxidants (CAT & SOD) (P<0.01 and P<0.001) and inhibited the elevation of lipid peroxidation (TBA-RS) in the liver homogenate. Histopathology of liver tissue showed that S. amaranthoides attenuated the hepatocellular necrosis, regeneration and repair of cells toward normal.

Conclusion: The methanolic extract of S. amaranthoides showed significant hepatoprotectivity and antioxidant activity against INH + RIF Anti TB drugs.

Open Access Original Research Article

Cubosomes Dispersions as Enhanced Indomethacin Oral Delivery Systems: In vitro and Stability Evaluation

Iman M. Alfagih, Bushra AlQuadeib, Basmah Aldosari, Alanood Almurshedi, Mohamed M. Badran, Eram Eltahir, Khadijh A. Alnakhli

Journal of Pharmaceutical Research International, Page 24-35
DOI: 10.9734/jpri/2021/v33i25A31449

Aims: To improve the dissolution of indomethacin through developing liquid indomethacin loaded cubosomes dispersion for oral delivery.

Methodology: Glyceryl monooleate based indomethacin loaded cubosomes dispersion were prepared using Taguchi design to study the effect of indomethacin to the disperse phase ratio and poloxamer 407 (PLX%) concentrations on the particle size and entrapment efficiency (%EE). Furthermore, in vitro release in phosphate buffer (pH 6.8), and morphology were investigated. Also, the stability of indomethacin loaded cubosomes dispersions was examined after 6 months storage at 25°C in the dark.

Results: The prepared indomethacin cubosomes dispersions were in the nanoscale (184.53±0.7 to 261.33±0.8 nm) with reasonable %EE (49.30±2.6 to 95.55±3.4 %). Moreover, a biphasic release profile was predominant for all formulations, up to 50% of payload released after 2h followed by a second continuous sustained release phase over 24h. The kinetics of indomethacin release was best explained by Higuchi model and the mechanism of drug release from these cubosomes dispersions was by fickian diffusion mechanism. In general, the indomethacin loaded cubosomes dispersions were stable after 6 months storage at 25°C in the dark.

Conclusion: Indomethacin loaded cubosomes dispersions proved to be a successful platform to encapsulate and enhance the release of indomethacin with a good stability profile over 6 months.

Open Access Original Research Article

Antipyretic activity of Nilavembu Kudineer – A Siddha System of Medicine

Asali Ahamed Abdul Sukkur, Anbu Jeba Sunilson John Samuel, Anita Gnana Kumari Anpumoni Vimala, Shankar Ravichandran

Journal of Pharmaceutical Research International, Page 36-47
DOI: 10.9734/jpri/2021/v33i25A31450

Aim: To evaluate the antipyretic activity of Nilavembu kudineer against yeast induced pyrexia in Albino rats.

Study Design: Experimental study

Place and Duration: Research lab, Department of Siddha Medicine, Tamil University, Thanjavur, India and KPJ Healthcare University College, Nilai, Malaysia between March 2018 and July 2019.

Methodology: The Nilavembu kudineer powder was extracted by using acetone, methanol and aqueous solvents. The acute toxicity study was carried on swiss albino mice using acetone, methanolic and aqueous extracts of Nilavembu kudineer. From this, the LD50 value was determined and 1/10th of the LD50 value was taken as ED50 value and selected for the antipyretic studies. The Pyrexia was induced by 20% suspension of Brewers’ yeast at a dose level of 20 mg/kg on Albino rats. The test extracts (200mg/kg), Standard Paracetamol (150 mg/kg) and control saline vehicle were administered orally. The phytochemical parameters such as carbohydrates, proteins, lipid, oil, amino acid, glycosides, tannins, phenolic compounds, triterpenoids, flavones, flavanones and alkaloids were tested using standard procedures. Statistical analysis, the values were subjected to one way analysis of variance (ANOVA) followed by Dennett’s test.

Results: LD50 value of various extracts of Nilavembu kudineer was 2000 mg/kg and 1\10th of ED50 as 200 mg/kg was selected for screening of various pharmacological activities. The treatment with methanolic extract of Nilavembu kudineer at a dose of 200mg/kg significantly (p<0.001) decreased the elevated rectal temperature after 2 hr of administration. Yeast-instigated pyrexia rodents had been controlled with Nilavembu kudineer at a dose of 200 mg/kg to decide the Tamil traditional claim about this plant for its antipyretic property.

Conclusion: The methanolic extract of Nilavembu kudineer (200 mg/kg) possess potent fever reducing agent in various types of fever. The phytoconstituents such as Flavonoids, Alkaloids, Glycosides, Tannins and Phenolic compounds may be responsible for controlling the elevation of body temperature.

Open Access Original Research Article

Urinary Isolates and Antifungal Susceptibility Pattern of Candida species Isolated from Patients in Tertiary Care

A. Arasi Samyuktha, V. Illamani, Chitralekha Saikumar

Journal of Pharmaceutical Research International, Page 48-56
DOI: 10.9734/jpri/2021/v33i25A31451

Community-acquired urinary tract infections (UTIs) are fastidious growing infections caused by Candida fungal overgrowth that frequently occur in immunosuppressed hospital patients. Although many factors account for the increases in these fungal infections, the leading causes include the rise in medical device usage, immunosuppressant drugs, and interventional procedures. The emergence of drug resistant in Candidal species, which is largely attributed to use of prolonged and inappropriate empirical therapy, has further complicated patient management. The regularity of urinary tract infections (UTIs) due to Candida species is growing and these infections are most common clinical outcome, particularly in hospitalized patients. The microbiological invasions in any tissue of the urinary tract extend from the renal cortex to the urethral meatus. Candida UTI or candiduria is a common finding in hospitalized patients. To find out the ratio of Candida albicans to non- albicans Candida species to correlate the risk factors to the Candida species associated and to analyze the speciation of Candida isolates using the Chrom agar is a differential culture media, with sugar assimilation test. Constant surveillance of candiduria is important as C. tropicalis is more invasive, can lead to fatal candidemia. Identification of Candida up to species level is essential, as it can give an idea to the clinicians about appropriate antifungal therapy. Our study showed a predominance of non-albicans Candida spp. of about 86%. C. tropicalis (62%) was the most common isolate obtained followed by C. albicans (14%), C. glabrata (10%), C. krusei (9%) and C. parapsilosis (5%). Indwelling urinary catheter was an important associated risk factor for non-albicans candiduria.

Open Access Original Research Article

Detection of Human Papillomaviruses (HPVs) by Immunohistochemistry (P16ink4a) In Verrucous Skin Lesions

Shone Thomas Babu, Mary Lilly

Journal of Pharmaceutical Research International, Page 57-68
DOI: 10.9734/jpri/2021/v33i25A31452

Even though the p16 marker allows us to distinguish between benign and malignant verrucous skin lesions, we are unable to determine the patient's Human Papillomaviruses (HPVs) status despite the existence of recognized histopathological features that indicate its presence like koilocytic change, since a proper correlation couldn’t be made between this feature and p16 expression. Even though PV type 16 and 18 are a risk factor for developments of anogenital skin lesion diffuse p16 expression cannot always be attributed to HPVs as there may be several other risk factors causing skin lesions, unlike in cervical lesions such as squamous cell carcinomas, many studies have established the role of oncogenic HPVs with its carcinogenesis. This marker cannot be used as a surrogate for detection of HPV infection. The present study was the expression of p16INK4A in histological sections of verrucous skin lesions. To compare the expression of p16INK4a in benign, premalignant and malignant lesions involving the  skin and  comparing the  pattern of expression of p16INK4a in skin lesions  by  immunohistochemistry  and correlating the results with certain histological parameters that might indicate HPV infection.

Open Access Original Research Article

Health-Care Students' Perception on the Role and Contribution of Pharmacists: A Case Study in Ghana

Adelaide Ampofo-Asiama, Mercy Opare-Addo, Afia Frimpomaa Asare-Marfo

Journal of Pharmaceutical Research International, Page 69-78
DOI: 10.9734/jpri/2021/v33i25A31453

Objective: The objective of this study was to access the perception of non-pharmacy health-care students on the role and contribution of pharmacists in to health-care delivery in Ghana. Furthermore, the influence of factors such as sex, program of study and frequency of interaction with pharmacists on this perception was determined.

Methods: A structured questionnaire was designed and administered to 670 medical, optometry and nursing students of the University of Cape Coast, Ghana after a pilot study was conducted. Results: The students strongly agreed that the role of the pharmacist is dispensing drugs, collaborating with physicians to prescribe medications. The students also appreciated the contribution of pharmacists in helping to reduce adverse reactions to medications. The students, however, showed little appreciation of pharmacists carrying out research or physical examinations and helping to reduce cost to patients. There was no effect of sex on the perception of students, although the frequency of interaction with pharmacists influenced their perceptions

Conclusions: The results of this study indicate that non-pharmacy health students appreciate certain roles and contributions of pharmacists to health-care.

Open Access Original Research Article

Muscle Relaxation Strategies on Dysmenorrhea: An Interventional Study

Pushpamala Ramaiah, Afnan A. Albokhary

Journal of Pharmaceutical Research International, Page 79-85
DOI: 10.9734/jpri/2021/v33i25A31454

Background: The chief complaints of menstruating females can impact their life with several physical and psycho-social wellbeing. Menstrual pain could be due to primary or secondary dysmenorrhea. There has been a lack of ongoing studies to demonstrate the association of crucial variables with day-to-day activities during the cycle.

Aim: Study adopted to explore the effectiveness of pelvic rocking exercises and home workouts among adolescents.

Methods: A case-control randomized design was adopted among the adolescents' community where the pre-post test was carried out, and the selected variables have been statistically analyzed.

Results: In total, 180 adolescents participated in our study. Overweight has been well documented as one of the variables to experience pain, and the intensity of the pain minimized after performing a couple of interventions.

Moreover, few findings appeared that exercises and home workouts reduce the pain level (scores) (p<0.05) and documented fewer dysmenorrhea symptoms in the following cycle.

Conclusion: The study reports muscle relaxation strategies to help in the relief of menstrual pain. The authors recommend performing ongoing research with a larger sample size to interpret the findings with cautions to associate cause-effect relationships.