Open Access Systematic Review Article

Meta-analysis on the Effectiveness and Safety of Propolis Preparation in the Treatment of Aphthous Ulcers

Yang Jinlong, Luo Wenhua

Journal of Pharmaceutical Research International, Page 48-57
DOI: 10.9734/jpri/2022/v34i43B36326

Objective: To systematically evaluate the effectiveness and safety of propolis preparation in the treatment of aphthous ulcers in order to provide evidence-based references for its clinical treatment.

Methods: Databases, such as CNKI, VIP, Wanfang, CBM, PubMed, EMbase, Cochrane Library, and so on, were searched to collect the randomized controlled trials (RCT) on the propolis preparation (the treatment group) with the conventional treatments (the control group) in the treatment of aphthous ulcers. After the data of clinical studies that met the inclusion criteria were extracted by two researchers, the Cochrane risk-of-bias tool was used to evaluate the methodology quality, and RevMan 5.4 was used for Meta-analysis.

Results: A total of 23 studies were included, involving 2467 participants with 1356 in the treatment group and 1111 in the control group. The overall quality of the RCTs was relatively low. Meta-analysis showed that propolis preparation for aphthous ulcers, compared with conventional Western medicines could improve the total efficacy rate (RR= 1.40, 95%CI[1.33, 1.46], P<0.00001), no incidence of adverse reactions .

Conclusion: Propolis preparation  has  demonstrated  promising therapeutic efficiency and safety in treatment of aphthous ulcers. However, this study has certain limitations since the overall quality of included RCTs is relatively low, affecting the reliability of the results, and further high-quality studies are required for verification.

Open Access Original Research Article

Clinical Efficacy and Safety of Oral Apremilast: Treatment Analysis for Chronic Plaque Psoriasis

Meet Barbhaya, Afiya Modasiya, Anu Patel, Nirav Bapat, Krina Patel

Journal of Pharmaceutical Research International, Page 1-11
DOI: 10.9734/jpri/2022/v34i43B36316

Background: Apremilast is an oral, selective phosphodiesterase-4 (PDE-4) enzyme inhibitor, approved by the US-FDA for management of moderate to severe plaque psoriasis. Apremilast belongs to class of drug that function by modulating pro-inflammatory cytokines and have a low molecular weight (<1 kD), identified as small molecules. Due to its convenience in administration via oral or topical route, adequate efficacy, great safety profile and low cost they are emerging as treatment choices in inflammatory dermatosis and other systemic inflammatory disorders.                                                                                                 

Material and Methods: A hospital based, prospective, interventional, cohort study was conducted on 78 patients with Chronic plaque psoriasis. Efficacy of Apremilast was studied in 38 patients receiving oral Apremilast with topical steroids in comparison to 36 patients who were given only topical steroids for 16 weeks.  Patients were evaluated pre-treatment and then every 4 weeks for a period of 16 weeks and followed up to the 28th week for any adverse effects associated with apremilast therapy. Outcome was assessed on the basis of PASI score and clinical photographs. Side effects in both groups were recorded.

Results: Primary endpoint (PASI75 and above) was achieved in 68.42% patients in group A. Among this patient's PASI 90 was achieved in 13.16% (n=5) and PASI 100 was obtained in 13.16% (n=5). In Group B, none of the patients achieved PASI 75. Most common side effects observed in group A were GI disturbances.  No significant adverse effect was noted in group B.

Conclusion: Apremilast has good efficacy and safety in patients with chronic plaque psoriasis. and is generally well tolerated which makes it possible to keep other immunosuppressants to be kept in reserve for more severe stages of disease. Our study supports the favorable benefit:risk profile of oral apremilast. 

Open Access Original Research Article

Waist to Height Ratio is a Better Predictor of Non-Alcoholic Fatty Liver Disease in the South Asian Population

Sandeep Kumar, Farina M. Hanif, Rajesh Mandhwani, Zain Majid, Asha Devi, Rani Tulsi, Nasir Luck

Journal of Pharmaceutical Research International, Page 12-18
DOI: 10.9734/jpri/2022/v34i43B36318

Introduction: Numerous obesity indices have been developed that predict non-alcoholic fatty liver disease (NAFLD). We in our study aimed at evaluating a few of these tools including waist to height ratio (WHtR), waist circumferences (WC), body mass index (BMI) and fatty liver index (FLI) and used them to determine their ability in diagnosing NAFLD.

Methods: This cross sectional study was conducted at the outpatients’ department of our hospital. NAFLD was diagnosed on the basis of ultrasound abdomen. Anthropometric parameters like Height (in), weight(cm), WC (cm), BMI, WHtR were calculated and later the FLI (comprising of BMI,WC, triglyceride and gamma glutamyl transferase) was calculated. The Receiver operating characteristic analysis (ROC) was then conducted to determine the discriminatory ability and related cut-off points and a P value of ≤0.05 was taken as statiscally significant.

Results: A total of 300 participants were included and the prevalence of NAFLD was 44.8% in men and 54.8% in women. Univariate analysis reported statistical significant association of NAFLD with all of the applied indices (P = 0.00). The WHtR (AUC = 0.87, 95% CI:0.77-0.97) showed slight superior ability as compared to FLI (AUC = 0.86, 95% CI:0.76-0.97) in diagnosing NAFLD. Regression analysis revealed a stronger association of WHtR (OR = 9.3, P = 0.00) with NAFLD compared to FLI (OR = 6.0, P = 0.02).

The performance of WHtR was similar regardless of gender (AUC = 0.89) while different in FLI with a AUC of 0.88 in men and AUC of 0.85 in female.

Conclusion: This study showed a strong association of WHtR in prediction of NAFLD and a similar discriminatory ability regardless of gender. WHtR is simple and easily performable modality for NAFLD prediction.

Open Access Original Research Article

Impact of Coronavirus Disease Pandemic on Antenatal Care Utilization among Primigravida Women in Asir Region, Saudi Arabia

Hanoof Alqhatani, Mohammed S. Aldalham Alqahtani, Faris A. Alasmre, Khaled Abdulwahab Amer, Abdulrahman Ali Aldosari, Basel Mohammed Saleh Althubait, Abdulrahman Abdullah Mofreh Al Mudawi, Mushary Saeed A. Alqahtani

Journal of Pharmaceutical Research International, Page 19-26
DOI: 10.9734/jpri/2022/v34i43B36319

Background: By the end of 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, Hubei province, China. In Saudi Arabia, the government applied prompt preventive measures against coronavirus disease 19 (COVID-19). COVID-19 associated restrictions have been affected the antenatal care (ANC) services that made careful surveillance of the pregnant women health requirement to protect them from COVID-19 infection. The current study was conducted to assess the COVID-19 pandemic effect on ante-natal care utilization among primigravida women in Asir region, Saudi Arabia.

Methods: A descriptive cross-sectional study was conducted targeting all females with their 1st pregnancy during COVID-19 pandemic. The questionnaire covered pregnant females’ demographic data, medical history, COVID-19 infection history, ante-natal care visits. Final questionnaire was distributed among woman attending antenatal care clinics at primary health care centres (PHCCs) and Abha Maternity and Children Hospital clinics in Asir region during the period from December 2020 to December 2021

Results: A total of 555 women attend to antenatal care clinics participated in the study. Primigravida women, who got pregnant during the COVID-19 pandemic were included. Exact of 114 primigravida women meet the inclusion criteria. Participants’ ages ranged from 21 to more than 40 years with mean age of 24.6 ± 9.4 years old. Ante-natal care visits of 1st pregnancy women during a period of quarantine in Asir regions. Exact of 90 (78.9%) pregnant females were compliant to ANC visits during COVID-19 pandemic. A total of 63 (70%) of these visits were in the private sector while 21 (23.3%) were at the governmental hospitals and 18 (6.7%) at the PHCCs.

Conclusion: The current study revealed that pregnant primigravida females were adequately adherent for the ANC visits during COVID-19 pandemic especially those with multiple pregnancies. The most settings provided ANC visits were the private sector with reported good pregnancy outcome.

Open Access Original Research Article

Knowledge towards Biochemical Parameters of COVID–19 amongst First Professional Year Medicine Students: A Cross-sectional Study

Prafulkumar Ramteke, Madhur M. Gupta, Deepali M. Wanjari

Journal of Pharmaceutical Research International, Page 27-31
DOI: 10.9734/jpri/2022/v34i43B36320

The latest pandemic coronavirus disease (COVID-19) has been linked with mounting morbidity and mortality and this has shocked the existence of the world-wide population. Human activities and acquaintance of the biochemical parameters in medical students during the crisis is important so that they can transmit the correct information to the society. A cross-sectional questionnaire study was conducted in students of first professional year of medicine. An online validated questionnaire was posted. This was followed by a lecture on the same topic and then a post test to assess the gain in knowledge was conducted on the students.100 students participated in this learning endeavour. Most respondents had good acquaintance about the corona virus infection and its associated sign and symptoms. They were conscious of particulars like the contributory factors of COVID-19 disease (91%), the causative factors (92.7%) ,and the precautionary measures to be taken like washing of hands and wearing the face mask. The knowledge regarding the changes in biochemical parameters CRP , LDH , ferritin, procalcitonin, D-dimer in COVID-19 was better in the post test Such interventions should be a part of the learning process in the initial phases of medical education since it will act to generate a human resource in health care during the pandemic.

Open Access Original Research Article

The Evaluation of Prevalence and Hematological Parameters for Assessment of Severity of Coronavirus Infection

Umair Ali Soomro, Majid Ali Hingoro, Nazir Ahmed Pathan, Allah Wadhayo Kalo, Rasheed Ahmed Soomro, Qandeel Abbas Soomro

Journal of Pharmaceutical Research International, Page 32-37
DOI: 10.9734/jpri/2022/v34i43B36323

Objectives: We determined the prevalence of coronavirus (COVID-19 virus) infection on the basis of age, sex, clinical presentation and risk of ABO Blood Groups antigens with COVID-19 virus. We also highlight the Hematological Parameters such as neutrophils to lymphocytes ratio and thrombocytopenia to assess severity of COVID-19 viral infection.   

Methodology: A descriptive study was conducted from May 2020 to May 2021 at rural and urban areas of District Shaheed Benazir Abad in the homes of patients diagnosed with Covid-19 viral infection where they were present in quarantine. A total of 351 patients with their ages ranging between 12 and 68 including 329 males and 21 females present in isolation within their homes with diagnosis of coronavirus infection were included in this study. The clinical features of the patients were noted, and 5 ml of blood was collected in an EDTA bottle from each patient for determination of blood group and complete blood account at the diagnostic and research pathology laboratory of PUMHS, Nawab Shah.

Results: The mean age of these patients was 40 ± 28 years while male to female ratio was 15.6:1. Out of the 351 patients, 169 (45.3%) were blood group A, 117 (33.8%) were blood group B, 50 (11.3%) were blood group AB and 26 (8.6%) were blood group O. The mean value of neutrophil to lymphocyte ratio was found to be 4.7 ±1.7 while the mean value of platelets count was 210000 ± 95000/ mm3 in these patients.

Conclusion: We concluded that the ratio of coronavirus infection among the patients with Blood Group A was higher than the B, AB and O. However, the study revealed a significantly higher proportion of AB+ male patients as compared to females who were infected with COVID-19.

Open Access Original Research Article

Antioxidant Activities of Aqueous Leaf Extract of Anacardium occidentale (Cashew) on Lead Acetate-Induced Cerebellar Toxicity in Wistar Rats

Ezinne C. Oviosun, G. E. Anyanwu, E. A. Esom, S. O. Nweze

Journal of Pharmaceutical Research International, Page 38-47
DOI: 10.9734/jpri/2022/v34i43B36324

Aim: The aim of the present study was to investigate the antioxidant effect of aqueous leaves extract of Anacardium occidentale (A.O) on lead-induced toxicity in the cerebellum of wistar rats.

Methods: Thirty wistar rats were randomly divided into six groups of five rats each. Group A: Normal control received 0.5ml normal saline; group B received 50mg/kg body weight (bwt) lead acetate (Pb) only (28 days); groups C and D: 150mg/kg bwt and 300mg/kg bwt of A.O respectively for 14 days and 50mg/kg bwt of Pb next 14 days; group E: 150 mg/kg bwtA.O and 50 mg/kg bwt Pb (28 days); group F: 300mg/kg bwt A.O and 50 mg/kg bwt Pb (28 days). At the end of the experiment, animals were sacrificed by cervical dislocation. One hemisphere of the cerebellum was homogenized for estimation of tissue Superoxide Dismutase (SOD), Glutathione peroxidase (GPx) and Malondialdehyde (MDA) levels, and the second hemisphere was processed for histological studies.

Results: Histological examination of lead only treated groups, showed alterations in cerebellar architecture. Biochemical estimations showed significant decrease in SOD, GPx levels (P=.03 and .04 respectively) and significant increase in MDA levels (P=.04), indicative of oxidative stress. Pretreatment and co-treatment with A.O showed dose dependent preservation of cerebellar architecture, significant increase of antioxidant parameters (SOD and GPx) (P=.03) and significant (P=.02) decrease in MDA.

Conclusion: This study suggests that Anacardium occidentale especially at a higher dose (300mg/kg) exhibits antioxidant activities against lead-induced oxidative stress in the cerebellum of rats.

Open Access Original Research Article

The Antioxidant Modulating Properties of Justicia carnea Extract on Sheep Red Blood Cells Immunized Mice

Benedict Bolakponumigha Iwetan, Atuboyedia Wolfe Obianime, Lawrence Oberhiri Ewhre, Godfrey Rume Kweki

Journal of Pharmaceutical Research International, Page 58-74
DOI: 10.9734/jpri/2022/v34i43B36327

Aims: Inflammatory cytokines as well as exogenously invading antigens among others are keenly involved in the generation of oxidative stress such as reactive oxygen species, reactive nitrogen species capable of causing related diseases. hence this study aimed at evaluating the In-vivo antioxidant modulatory properties of Justicia carnea aqueous leave extract on sheep red blood cells immunized mice.

Study Design:  The animals were grouped into six with five animals per group (Vehicle; distilled water 10 mL/Kg, Sheep Red Blood Cells 0.2 mL/Kg, Justicia carnea  125 mg/Kg, 250 mg/Kg and 500 mg/Kg, and Levamisole 7.5 mg/Kg )

Place and Duration of Study: The animals used for this study were breed, feed and housed at ambient temperature and well-ventilated animal house of the Basic Medical Sciences in Delta State University, Abraka and Emma-maria laboratory Abraka. The study lasted for two (2) weeks.

Methodology: All groups were immunized at day zero and day 5 with SRBC inducing immune response except for the VEH group that was not immunized. Treatment of the various groups with respective treatment agents commenced on day 3 to day 9. On day 10 the antioxidant enzymes (Determination of Superoxide Dismutase, Catalase, Myeloperoxidase, Malondialdehyde, Glutathione Peroxidase, Nitric oxide and Xanthine Oxidase) of the brain, liver, kidney and Spleen were carried out.

Results: The findings in this study reveal the antioxidant enhancement by the plant Justicia carnea being significant when compared to the Vehicle and Sheep Red Blood Cells. Levamisole a standard immunostimulants drug also has significant antioxidant potentials.

Conclusion: The study was able to showcase the antioxidants activities of the plant Justicia carnea. Pharmacological antioxidants may be developed from the plant, which might be helpful in immune related diseases.