Open Access Original Research Article

Drug Therapy Problems Associated with Antibiotics Prescriptions in University of Uyo Health Centre, Uyo, Nigeria

Olugbenga Matthew Ajulo, Emmanuel Oluwatoyin Olorunsola, Unwanna Akpan Osom

Journal of Pharmaceutical Research International, Page 1-14
DOI: 10.9734/jpri/2022/v34i33B36130

Introduction: Antibiotic resistance has contributed as one of the greatest public health threats at present. This study aimed at identifying drug therapy problems (DTPs) associated with prescriptions of antibiotics to patients attending the University of Uyo Health Centre and presented a seminar as an intervention.

Method: A prospective observational study was carried out. One hundred (100) patient folders with 147 antibiotics prescriptions were used for the survey for the first-month collation of antibiotics prescriptions while one hundred and sixty (160) patient folders with 160 antibiotics prescriptions were used at the second -month of the survey. The seminar presentation on drug therapy problems associated with antibiotics prescriptions was held after the first -month of the survey. Data obtained were analyzed by using descriptive statistical tools such as frequency, mean, standard deviation and bar chart. The statistical analytical tool such as student T- test was used and significance was considered at p ≤ 0.05.

Result: The first survey involved 147 prescriptions of antibiotics. Prescriptions with DTPs were 77 (52.4%) while the most frequently occurring DTPs was drug interactions (37.1%), followed by inappropriate dosage frequency (23.7%) and unnecessary medication (22.7%). The follow up survey included 160 prescriptions of antibiotics, out of which 112 (70%) prescriptions of antibiotics contained 209 DTPs. The most frequent DTPs was drug interactions (49.3%), followed by inappropriate dosage duration (19.1%) and inappropriate dosage frequency (11.5%). The results also showed that antibiotics prescriptions with DTPs were significantly increased in the follow-up survey (p=0.00) of the study. Drug interaction (p=0.00), overdosing (p=0.00), underdosing (p=0.00) and Inappropriate dosage duration (p=0.00) were significantly increased in the follow-up survey.

Conclusion: This study had indicated prevalence of DTPs associated with antibiotic prescriptions. Drug interaction, inappropriate dosage frequency and unnecessary medication were very common among antibiotic prescriptions.

Open Access Original Research Article

Prevalence of Training-related Knee Injuries among Jazan University Students with Determining Possible Related Risk Factors

Ramiz J. Moafa, Hassan Mashbari, Ezzuddin A. Okmi, Marwan Osaili, Abdulrahem Shubair, Mohammed Arishi, Anas Alnami, Ahmad Shugairi, Ayman Altherwi, Abdulaziz Kaal, Amirah J. Moafa, Abdulrahman Kailani, Khaled Khormi, Alhassan Alhazemi, Abdulaziz Alhazmi

Journal of Pharmaceutical Research International, Page 15-21
DOI: 10.9734/jpri/2022/v34i33B36131

Background: The articulating surface of the knee is the most commonly injured joint in athletes. However, there is a lack of proper prevalence and determinant estimations for knee injury among Jazan University students.

Materials and Methods: This cross-sectional study aimed to determine the prevalence of knee injury among students at Jazan University, Saudi Arabia and to identify the associated risk factors. An online self-administered modified Arabic version of the Knee Injury and Osteoarthritis Outcome Score questionnaire was distributed to collect data from the students. 884 participants were included and met our inclusion criteria.

Results: The overall prevalence of knee injuries was 18% (n = 156). Ninety-two injuries were due to sports activity. Men were 2.7 more likely to have a knee injury than women. Performing 2–3 hours of training every week increased the likelihood of knee injury by 1.7 times more than being inactive or performing only 1 hour of activity per week. An increase in the body mass index was associated with knee injury.

Conclusion: Our study highlights the high prevalence of knee injury among male students with a high body mass index, especially those studying in medical colleges. Further large-scale research is needed to address the limitations of this study and generalize the results to a larger population.

Open Access Original Research Article

Molecular Characterization of Salmonella Typhimurium and E. coli O157:H7 Isolated from Ready-to-eat Chicken Meat

Oluwatoyin Hephzibah Ajulo, Olusola Victoria Adetunji, Olugbenga Matthew Ajulo

Journal of Pharmaceutical Research International, Page 22-42
DOI: 10.9734/jpri/2022/v34i33B36132

Background: Virulence genes are important in the pathogenesis of bacteria and in the mechanism of bacterial pathogenicity.

Objective: The study aimed at molecular detection of virulence genes such as sdiA, fimH, InvA and fliC and determination of similarity and links among the isolates.

Method: A total of 67 isolates including 4 controls were tested by Polymerase Chain Reaction (PCR) with 4 primer pairs including invA, fliC, sdiA and fimH to avoid bias. Full sequences of the 16S-Sequencing gene of both strains were carried out with 29 Salmonella and 30 E. coli isolates that were positive for amplification at 1500bp.ward hierarchical clustering model and agglomeration procedure was used. Clustered grouping and relational affinity test were conducted and depicted by the dendrogram. Molecular identification and interpretation were done using BLASTn Protocol.

Result: None of the isolates were positive to the invA or fliC gene fragments. One isolate from each of Salmonella Typhimurium and E. coli O157:H7 was positive to sdiA and fimH respectively. Three E. coli isolates were positive with an amplification of 500bp which is specific for fimH genes. One of the isolates E459 showed amplification of fimH gene with multidrug resistance to 5 drugs namely Ceftazidime, Cefuroxime, Augmentin, Nitrofurantoin and Ampicillin. Four Salmonella isolates had an amplification of 274bp specific for sdiA gene. Two variants of E. coli O157:H7 (unit g1 and unit g2) were identified. A mutant strain Salmonella Typhimurium LTS (STMD1) causing human gastroenteritis was identified also, Salmonella Typhimurium DT104 isolated exhibited multiple resistant genes (ACSSuT, SGI1) against several antibiotics. These are of public health significance.

Conclusion: This study has indicated presence of sdiA and fimH genes in Salmonella typhimurium and E. coli 0157:H7 respectively isolated from ready-to-eat chicken meats from public eateries. It also indicated association of sdiA and fimH genes with multi-drugs resistance.

Open Access Original Research Article

Different Techniques used for Stump Closure in Laparoscopic Appendectomy

. Shafaqat, Syed Ashraf Hassan, Haris Rashid, Mir Arsalan Ali, Fatima Zehra Khan, Santosh Kumar Sidhwani

Journal of Pharmaceutical Research International, Page 43-50
DOI: 10.9734/jpri/2022/v34i33B36134

Background: The most prevalent surgical emergency for which patients present to the emergency room is acute appendicitis. Appendectomy is the surgical therapy for the problem, and it is one of the most common surgeries performed worldwide, with almost a quarter of all people (equally males and females) requiring one at some point in their lives. Methods that are used to close the stump in laparoscopic appendectomy include staplers, endo-loop, titanium clips, non-absorbable polymer clips (Hem-o-lock clips), hand-made loops, extracorporeal sliding knot, intra-corporeal ligation, ligature use or division with bipolar cautery.

Objective: To compare various methods of stumps closure in laparoscopic appendectomy.

Methods: This Double Blind – Randomized Quasi Experimental Trial was conducted upon a sample of 80 patients (selected using non-probability, consecutive sampling) in four  groups (G1: Endoloop, G2: Intracorporeal Knotting with Vicryl Size 2/0, G3: Extracorporeal Knotting with Chromic Catalent no Zero, G4: Vicryl Intracorporeal Trans fixation of Stump with 2/0 vicryl) of 20 each. Data was recorded onto a structured questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, disease history, operative notes and post-operative follow-up. The data obtained was analyzed using SPSS 21.0 and MS. Excel.

Results:  The mean age of the sample stood at 43.96 (SD ± 16.9) years, with the age ranging from 17 to 80 years. Study more females were presented in all four groups. They have shown insignificant statistical association with p-value of 0.983. Post-operative complication in every group was recorded as post-operative hemorrhage, knot slippage, abscess and surgical site infection. Overall in 9 (11.3%) of patients experienced different post-operative complications showed insignificant statistical association with the p-value of 0.945.

Conclusion: In current study we concluded that endoloop is the most efficient and less time consuming procedure used for the stump closure in the patient undergo laparoscopic appendectomy. Intra operative time taken is also less compared to other groups. Less number of intra-operative and post-operative complication were noted in the endoloop group. Hospital stay is also observed to be less in the endoloop group.

Open Access Original Research Article

Examine the Vitamin-D Status of HCV-Infected Patients and Control in Lahore, Pakistan

Muhammad Abbas, Hafiz Usman Ghani, Huda Rauf, Saba Zulfiqar, Muhammad Usman, Abdul Rehman

Journal of Pharmaceutical Research International, Page 56-61
DOI: 10.9734/jpri/2022/v34i33B36136

Introduction: Hepatitis C virus is a serious health issue that can remain fatal owing to their dire repercussions. HCV causes approximately 710,500 deaths each year, has over 190 million individuals affected

Objective: Serum Vitamin-D has an important part in inflammatory and infections illnesses, particularly liver diseases. The purpose of this experiment was to examine the Vitamin-D status of HCV-diseased cases and control in Lahore, Pakistan.

Methods: From the 25th of August, 2019 to the 25th of February, 2020, we conducted randomized cross-sectional research on 78 people at Services Hospital in Lahore. Fifty-one individuals tested positive for hepatitis C RNA-PCR (25 salaried cirrhotic and 25 decompensated cirrhotic cases). In addition, 24 healthy controls were selected who did not have liver problems. ARTUS ® HCV QS-RGQ V1 was used to perform HCV RNA–PCR. Chemiluminescence was used to determine vitamin D levels. For descriptive statistics, SPSS version 20 was employed.

Results: When compared to untreated (32.43 ng/mL), average level of Vitamin-D in Treated patients remained considerably inferior in supplied and fluid resuscitation hepatocellular carcinoma (28.88 ng/mL & 21.67 ng/mL, respectively). In this research, 78.6 percent of HCV patients had suboptimal Vitamin-D levels. Vitamin-D deficiency (22-28 ng/mL) was seen in both healthy people (46.9 percent) and HCV sufferers (38.3 percent) (P 0.002). Furthermore, Vitamin-D levels were shown to have an inverse association with more multi - organ failure, having 56.3 percent of respiratory failure cirrhosis people undergoing from Vitamin-D insufficiency, relative to 14.7 percent in the recovered cirrhotic groups (P 0.0002).

Conclusion: Suboptimal levels of Vitamin-D (inadequacy before lack) remain more common in hepatitis C comparison to well controls. Vitamin-D insufficiency were found to be directly related to somatic symptoms.

Open Access Original Research Article

Comparative Evaluation of Anaesthetic Efficacy of Ropivacaine and Articaine with Epinephrine for Buccal Infiltration Anaesthesia in Maxilla Central Incisor and their Effect on Cardiovascular Parameters – A Randomized Control Trial

Vishwesh Prashant Joshi, Manjusha Rawtiya, Kailash Attur, Nikunj Patel, Pawan Gurjar, Bhargav Chitroda

Journal of Pharmaceutical Research International, Page 62-69
DOI: 10.9734/jpri/2022/v34i33B36137

Aim: To compare the effectiveness, latency time and onset of pulpal anaesthesia with 0.5% plain ropivacaine and 4% articaine with epinephrine 1:100 000 and to determine their probable effect on cardiovascular parameters.

Place and Duration of Study: Department of Conservative Dentistry and Endodontics, NPDCH, Visnagar, Gujarat between January 1st 2022 and January 31st 2022.

Methodology: 20 patients (10 male, 10 females) age range of 18-36 years were inserted 1.8 mL of the anaesthetic solution for buccal infiltration anaesthesia of maxillary central incisors deprived of caries, restorations or signs of pulpitis. The latency time, onset of pulpal anaesthesia and duration of pulp anaesthesia were assessed with an electric pulp tester. Heart rate and blood pressure were measured before, Immediate and after the onset of pulpal anaesthesia of the solutions. Data was sent for statistical analysis.

Results: The efficacy of anaesthesia of central incisors was 100% for both anaesthetics. The comparison of latency time and onset of pulpal anaesthesia were statistically significant for ropivacaine and articaine. Mean duration was less in Articaine group (206.50 ± 9.34) than Ropivacaine group (318.30 ± 43.21). Ropivacaine caused significant increases in blood pressure and heart rate.

Conclusion: Ropivacaine (0.5%) achieved effective and long duration of pulp anaesthesia. Ropivacaine could be beneficial for long lasting operative procedures without the need for a vasoconstrictor.

Open Access Original Research Article

Clinical Presentation of Patients of Carcinoma of Rectum and Different Modalites of Treatment

Ahsan Ali Laghari, Tufail Ahmed Baloch, Ishrat Rahim Katyar, Shiraz Shaikh, Zameer Husain Laghari, Qumber Ali Laghari, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 70-75
DOI: 10.9734/jpri/2022/v34i33B36138

Objectives: To determine the clinical presentation of patients of Carcinoma of Rectum and Different modalities of treatment.

Methodology: This was a Prospective observational study conducted in from May 2019 to April 2021 at Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro, Sindh, Pakistan. The study comprises 50 patients. All were admitted from Outpatient Department (OPD).  All patients were evaluated fully after history & Clinical examinations Digital Rectal Examination (DRE) with Proctoscope and specific investigations of, Stool DR, Fecal occult blood, ultra sound of abdomen and pelvis, Sigmoidoscopy, Colonoscopy with biopsy, Barium enema, C T Scan of Abdomen, chest & pelvis, MRI Abdomen &Pelvis, PECT Scan, Anorectal or Endoluminal Ultra sound, Tumor Marker CEA, Monoclonal Antibodies, LDH level, LFT for liver. and X-  Ray chest PA view. Complete blood picture (CBC) Blood urea, sugar, serum electrolyte, HBSAG, HCV, & HIV, COVID -19, LFT, PT, APTT, INR and ECG for fitness purpose and general assessment.

Results: In this study 50 patients of carcinoma of Rectum were reported. The maximum number of patients were in age group between 12 to 80 years. Out of 50 patient, 15  patients were presented with Altered Bowel habit (Constipation and Diarrhea)  & Spurious Morning Diarrhea , 13  patients  were presented with Altered Bowel habit (Constipation & Diarrhea)  Spurious Morning Diarrhea ,With Bleeding per rectum. Out of 50 patients   15 patients were diagnosed stage 1 ,13 patients were diagnosed stage 11, 9 patients were diagnosed stage 111, 13 patients were diagnosed stage 1V.  Out of 50 patients 28 patients were treated with anterior resection, 15 patients initially treated with New adjuvant therapy followed by patients were treated APR with TME, immunotherapy, gene therapy.  4 patients were treated initially diversion colostomy, then Neo adjuvant therapy, 3 patients were treated laparotomy, colostomy, hart men procedure, Chemo radio therapy, Immunotherapy, Gene therapy.

Conclusion: Carcinoma of Rectum is a common problem all over the world. Patients of carcinoma rectum can present diarrhea, constipation, bleeding per rectum, spurious morning diarrhea if not diagnose, and treat the patient in early stage, patients live style will be complicated.

Open Access Original Research Article

Analysis of Relationship among Bmi and Activity of Daily Living in Homecare Individuals

Huda Rauf, Sidra Rasheed, Ali Raza, Saba Zulfiqar, Muhammad Anas Waheed Jami, Inzamamul Haq

Journal of Pharmaceutical Research International, Page 51-55
DOI: 10.9734/jpri/2022/v34i33B36141

Objective: Obesity has been linked to a variety of chronic diseases. Numerous researchers have discovered that having a high BMI is connected with substantial morbidity and mortality in the aged. As a result, obesity or being overweight may have a negative effect on everyday life. The main aim of our current research remained to look at association among BMI and Action of Everyday Living in Homecare Individuals.

Methods: The data for 2019 from Allied Hospital Faisalabad's homecare unit. During this time, 1125 students come to this clinic. Subjects who were unconscious or bedridden (hemiplegia, hemiparesis, and tetra paresis), as well as those with insufficient information, were eliminated from the research. As a result, the study was finished with 260 files including all of information required for our research. Age, ethnicity, BMI, and Barthel Index values have been entered into the statistical analysis software; p0.06 was deemed statistically substantial.

Results: One hundred fifty-one (61.5%) comprised females, while 97 (38.7%) were males. Age and sex, weight, and Disease activity index scores had no strong correlations. Weight and Barthel index scores had a strong positive connection, as did BMI and Barthel index scores (r = 0.196; p = 0.004). The cases remained separated into two sets: Unit I (low weight for height and normal weight) in addition Class Ii (obese and obese) (overweight and obese). Group II had significantly greater capacity to execute Activities of Daily Living than Group I (p = 0.003).

Conclusion: Many researches claim that overweightness protects in contradiction of activities of everyday living, whereas others claim reverse. Quality and outcomes of BMI and Activity of Daily Living abilities were found in our study, indicating protective benefits. The association among BMI and physical impairment has yet to be shown as linear.