Open Access Systematic Review Article

Neuroimaging and Neuropsychological Performance in Parkinson's Disease Patients with Mild Cognitive Impairment: A Systematic Review

Nourah Alandas, Abeer Alanazi, Hamad Alzahrani

Journal of Pharmaceutical Research International, Page 57-68
DOI: 10.9734/jpri/2022/v34i31A36087

Introduction: One of the most common non motor symptoms of Parkinson's disease (PD) is cognitive decline. Scientific evidence has demonstrated that patients with PD experience rapid cognitive decline in multiple cognitive domains, specifically executive functions, attention, visuospatial, language and memory. However, the extent of cognitive decline with its correlation to brain regions on neuroimaging have not been reviewed extensively in the literature.

Objective: The objective of this review is to summarize the existing literature that explores cognitive performance in patients with PD with mild cognitive impairment (MCI) using different neuroimaging techniques.

Methods: A comprehensive search was conducted on PubMed and Web of Science databases. This review is focused on articles that explored neuroimaging and neuropsychological performance in patients with Parkinson’s disease. We screened articles and excluded those that did not fit the criteria of this study, and a total of 13 articles have met the criteria.

Results: Overall, PD-MCI patients experienced more cognitive decline than PD patients without MCI. Global cognitive ability was associated with frontal lobe, basal ganglia, para-hippocampal gyrus, occipital lobe, and the cerebellum. In addition, some specific cognitive domains were associated with specific brain regions. Attention and executive functions were associated with insula network and the parietal and frontal regions. Learning and memory were associated with grey matter atrophy and right cingulate gyrus and the limbic lobe. Language was associated with frontal cortex, precuneus, and anterior cingulate gyrus. Visuospatial ability was associated with Salience network (SN) and White Matter Hyperintensity (WMH).

Conclusion: This review of the literature showed that PD-MCI patients display different cognitive impairment as well as different neuroanatomical changes when compared to PD-Normal Cognition (NC).  These findings may suggest that cognitive impairment in PD-MCI patients require different clinical treatment and care. This review also can have diagnostic and treatment implications for this group of patients.

Open Access Original Research Article

Assessment of the Relation of Anti-TPO and TSH, T3 and T4 Levels between Some Subclinical Diabetes Patients in Iran

Ebrahim Alinia-Ahandani, Marwa Mohamed Adel Salama Matwalli, Saheb Hosseinnejad, Milad Sheydaei, Hadi Darzi-Ramandi, Zahra Alizadeh-Tarpoei, Seyed Sara Heidary-Bazardehy

Journal of Pharmaceutical Research International, Page 16-25
DOI: 10.9734/jpri/2022/v34i31A36081

Background: As we know, around 28% of ills who had benign fibrocystic mastopathy mostly have shown antibodies of anti-TPO as well as around 80% of them that have shown the thyroid hypertrophy issue. The Assessment of thyroid peroxidase (TPO) as the main antigen agent of the thyroid microsomal fraction has enabled the progress of a sensitive and specific assay for the detection of the corresponding autoantibodies and other digestive fractions.

Aim: Effect of gender, climate, and age on the ATPO, TSH, T3 and T4 rates were assessed as a goal.

Materials and Methods: We evaluated the diagnostic validity of the anti-TPO, TSH, T3, and T4 assays and their relationships in 500 laboratory cases from Isfahan province with various types of thyroid and diabetes diseases and in controls. Age factor in the various levels of T3, T4, ATPO and TSH items is studied in the following research, which demonstrates a reduced rate in T4 factor of the 1st decade.

Results: In the present study, patients with high TSH levels had high TPO tests. Patients with high levels of ATPO usually had high TSH, and in patients with low thyroid status, high TSH and high ATPO, TSH levels were normalized with levothyroxine tablets. Those with a high ATP content and normal TSH levels may have hypothyroidism in the future.

Conclusion: We concluded that you should check the thyroid test every 6 months. This could be concluded from the following research that gender, age, race, and area all demonstrate some remarkable impacts on the levels of T4, T3, TSH, and ATPO.

Open Access Original Research Article

Prevalence of Non-motor Clinical Features of Parkinson Disease in Pakistan

Jaiperkash Moolchandani, Geeta Moolchandani, Shaima Sultana Memon, Humera Khalid, Faisal Ali Baloch, Faizah Mughal

Journal of Pharmaceutical Research International, Page 26-30
DOI: 10.9734/jpri/2022/v34i31A36083

Aim: To highlight the frequency of non-motor clinical features in patients of Parkinson’s disease in Pakistan.

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Study was conducted at the neurology ward of Jinnah postgraduate medical center, Karachi during August 2019 to February 2020.

Methodology:  The study participants were having age >50 years but <70 years and were diagnosed case of Parkinson's disease. Demographic data including; age, gender, residence, and duration of symptoms were collected on the preformed proforma. Depression was diagnosed by using ICD-10 while anxiety and sleep disturbance were diagnosed by using BAI and DSM-IV respectively. Data was entered into SPSS version 20.

Results: The mean ± SD of age of patients was 59.26 ± 5.95 years. The mean ± SD duration of symptoms among these patients was 2.67 ± 2.04 months while mean ± SD of MMSE (mini mental status examination) score was 24.29 ± 1.59. About two thirds (62.86%) of patients were of age 50-60 years. Male to female ratio was 1.69: 1. The main outcome variable of this study was frequency of non-motor clinical features of Parkinsonism, it was noted that depression was more prevalent with frequency of 54.3%, anxiety was 41.4% and insomnia was present in 32.9% patients of Parkinson’s disease.

Conclusion: There is a high frequency of non-motor clinical symptoms particularly depression, anxiety and insomnia among patients of Parkinson’s disease with frequency of 54.3%, 41.4% and 32.9% respectively.

Open Access Original Research Article

Prevalence of Precipitating Factors in Rehospitalisation among Acute Decompensated Heart Failure Patients at Tertiary Care Hospital

Sabir Hussain, Wajid Hussain, Araj Jamil, Laraib Shaikh, Bilal Ahmed, Vengus Manzoor

Journal of Pharmaceutical Research International, Page 31-38
DOI: 10.9734/jpri/2022/v34i31A36084

Aims: The purpose of this research was to assess the frequency of precipitating variables that resulted in hospitalisation among ADHF patients who were admitted to the hospital.

Sample: The sample size was calculated using WHO sample size calculator version 2.0 considering 13.22%7 uncontrolled hypertension among the patients with acute decompensated HF (ADHF), with 95% confidence interval, and 5% of margin of error, the sample size of n = 177 patients was calculated.

Study Design: Cross-sectional study.

Place and Duration of Study: National Institute of Cardiovascular Diseases (NICVD) Karachi from 26th October 2018 to 26 April 2019.

Methodology: Both male and female patients aged 20 to 80 years with documented HF with EF <40% on echocardiogram presenting with acute decompensated HF (ADHF) in NYHA class II, III or IV were included in this study.

Results: A total of 177 hospitalized patients with acute decompensated HF were included. 107 (60.5%) were males & 70 (39.5%) were females with the mean age of 52.039+14.83887 years. The PF were acute coronary syndrome (ACS) in 64 (36.2%), medication Non compliance in 36(20.3%), atrial fibrillation in 44(24.9%), and uncontrolled hypertension in 47(26.6%).

Conclusion: HF hospitalizations are associated with a significant number of preventable PF. The most prevalent precipitating event in our analysis was acute coronary syndrome (ACS), which occurred in 36.2 percent of participants. Patient HF patients may benefit from the identification of possible triggering factors, which may aid in the optimization of therapy and the provision of counseling.

Open Access Original Research Article

Cardio Protective Role of Novel Gemmo Therapeutically Treated Glycyrrhizaglabra against Isoproterenol Induced Myocardial Injury

Amees Akhter, Munazzah Meraj, Mubeena Laghari, Rao Irfan, . Fouzia, Gulam Zahara Jahngir

Journal of Pharmaceutical Research International, Page 48-56
DOI: 10.9734/jpri/2022/v34i31A36086

Aim: To explore cardio protective potential of Glycyrrhiza glabraas against chemically induced myocardial injury in experimental animals by using their blood (serum) for subsequent determination of enzyme levels.

Methodology: Glycyrrhizaglabra with known cardio protective potential was used against chemically induced myocardial injury in experimental animals. These animals were divided into seven groups having ten animals each. Seventy rabbits of both sexes, 1-1.5 kg weight was included while pregnant rabbits weight >1.5 kg were excluded. Glycyrrhiza glabraleaves after gemmo-therapeutic treatment were subjected for phytochemical screening. The blood was drawn from the neck region; serum was separated for biochemical analysis. Pretreatment with native and gemmo-extract resisted to rise (P≤0.05) cardiac enzymes (CK-MB, SGOT, sGPT, LDH).

Results: Phytochemical screening for alkaloids 7% & 7.5%, flavonoids 21% & 24%, glycosides 16% and 20%, tannic acid10% & 15.5%, and saponins 8% & 15% in gemmo and native extract respectively.

Conclusion: It was studied that in isoproterenol injured rabbits, gemmo-extract was significantly better (P≤0.05) than native-extract in curative as well as in preventive treatment to normalizing serum cardiac enzymes.

Open Access Original Research Article

Development and Characterization of Transdermal Patch of Modified form of Brexpiperazol

Dhaval P. Patel, Disha D. Suthar, Hetal K. Patel, Punit B. Parejiya

Journal of Pharmaceutical Research International, Page 69-77
DOI: 10.9734/jpri/2022/v34i31A36088

Aim: Brexpiprazole (BPZ) is a typical antipsychotic drug used for the treatment of schizophrenia and depression. It is classified under BCS class-II with low aqueous solubility and high intestinal permeability. In the present investigation, a solid dispersion of BPZ was prepared to improve the solubility. A transdermal patch was optimized using the central composite design to control the delivery of BPZ.

Place and Duration of Study: The formulation was prepared and characterized at K. B. Institute of Pharmaceutical Education and Research, Gandhinagar, Gujarat, India during January 2021 to September 2021.

Methodology: A solid dispersion of BPZ was prepared using PEG 6000.A transdermal patch of BPZ was prepared and optimized using central composite design. Independent variables were fixed as ratio of RLPO: RSPO=2:1 (X1) and conc. of plasticizer (Triacetin) %W/W of polymer (X2). Dependent variables were fixed as folding endurance% (Y1) and cumulative % drug release at 24, 48, 72 and 96 hrs respectively (Y2-Y5) for the optimization of transdermal patch of SD of BPZ. Optimized formulation was characterized fully for its safety and efficacy using ex- vivo permeation study, skin irritation study and stability study.

Result: The tensile strength of optimized patch was 2.1±0.045 Kg/cm2. The thickness and hardness of patch was 0.0478±0.025 and 80.54±2.64gm/mm. The moisture content and moisture uptake values were 5.2%±0.36 and 6.21±0.24% respectively. Drug content was found to be 99.41±2.64%. The flux value obtained from BRX-SD-TP was 0.06 µg/cm2h. The flux was very proximal to the desired flux value. Prepared formulation was non-irritant and stable.

Conclusion: From the findings it can be concluded that BRX-SD-TP was successfully developed for treatment of Schizophrenia.

Open Access Review Article

Properdin: An Immune System Regulator That Can Be a Therapeutic Target of the Complement System

Mutaib M. Mashraqi, Saeed A. Asiri

Journal of Pharmaceutical Research International, Page 1-15
DOI: 10.9734/jpri/2022/v34i31A36080

Properdin, a serum glycoprotein, is involved in the immune system regulation, particularly in alternative pathways beginning the complement system. Properdin is made up of cyclic oligomers of monomeric subunits and is generated by various leukocyte subsets. Properdin promotes complement activation, which results in changes withinside the cell milieu that makes contributions to innate and adaptive immunological responses, such as the generation of pro-inflammatory cytokines, immune cell recruitment, and the development of immune cells involved in antigen presentation. Despite the presence of potential inhibitors (properdin) in serum and the formation of non-physiological aggregates in pure properdin preparations, properdin has emerged as a critical component in a variety of inflammatory illness models. Using the properdin-deficient murine model has aided in the knowledge of how properdin participates in diseases pathophysiology promotion or prevention. Pharmaceutical therapy for complement-dependent damage such as properdin is possible for a variety of acute and chronic problems, fluctuating from entrenched medicines for rare conditions to prospective future therapies for large patient groups such as the pandemic coronavirus-virus disease 2019. The basics of properdin biology are discussed, with a focus on the main hurdles that devour hampered the analysis of outcomes as of properdin-targeted studies.

Open Access Review Article

A Review on Transdermal Drug Delivery Patches

R. Sanjai Kumar, D. Akila Devi, N. Gokul Raj, M. Deepa

Journal of Pharmaceutical Research International, Page 39-47
DOI: 10.9734/jpri/2022/v34i31A36085

Human civilizations have used substances to the skin as cosmetic and therapeutic agents for thousands of years. The skin, on the other hand, was not exploited as a drug delivery method until the twentieth century. The term “transdermal” was first used in 1944 by Merriam Webster, indicating that it is a relatively new notion in medicinal and pharmacological practice. Transdermal medicines are doses that are self-contained and distinct. To produce a systemic effect, drugs are delivered through the skin. Without causing any changes in the drug’s plasma concentration Topical application of medicinal medicines has a number of advantages. There are numerous advantages to this technique of drug delivery over traditional oral and invasive approaches. Also, ensure that the fluid is released in a regulated manner. A medication for a long amount of time. As a result, a variety of chemical and physical approaches to transdermal patch development are being investigated.