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   2019| July-September  | Volume 11 | Issue 3  
    Online since July 9, 2019

 
 
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ORIGINAL ARTICLES
Formulation of antioxidant gel from black mulberry fruit extract (Morus nigra L.)
Arif Budiman, Arni Praditasari, Driyanti Rahayu, Diah Lia Aulifa
July-September 2019, 11(3):216-222
DOI:10.4103/jpbs.JPBS_57_18  
Background: Ultraviolet (UV) radiation from the sun that is composed of UVA and UVB can cause premature aging when exposed to the skin. Black mulberry fruit (Morus nigra L.) contains anthocyanins as antioxidants that can be protective against UV exposure. The aim of this research was to produce gel formulation from the extract of black mulberry as an antioxidant and sunscreen. Materials and Methods: This research started with the maceration process using 96% ethanol solvent. Later, antioxidant activity of the extract was determined using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) method and compared with vitamin C. Furthermore, the extracts were formulated into gel with variations of hydroxypropyl methylcellulose, sodium carboxymethyl cellulose, Carbopol 934, and extract concentrations. The products were then physically evaluated, including organoleptic evaluation, homogeneity, pH, viscosity, and dispersion, as well as the hedonic test, irritation test, and antioxidant activity test. Results: The results showed that black mulberry extract had antioxidant activity with the half maximal inhibitory concentration (IC50) value of 146.73ppm and its antioxidant strength was 39.6 times lower than that of vitamin C. The formulation with best physical evaluation results was given by formula 4 (Carbopol 934, 1.5%) with extract concentration 0.61%. This formula showed antioxidant activity with an IC50 value of 104.659ppm. Furthermore, on the basis of hedonic test and irritation test, this formula was the most popular and was categorized as a safe topical gel. Conclusion: The gel of black mulberry extract had antioxidant activity and was categorized as a safe topical gel.
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Evaluation of blood pressure control and associated factors among patients with hypertension in Iraq: a prospective cross-sectional study
Ola Ali Nassr, Paul Forsyth
July-September 2019, 11(3):232-239
DOI:10.4103/jpbs.JPBS_82_19  
Background: Uncontrolled blood pressure (BP) is a major contributor to cardiovascular disease–related morbidity and mortality. However, evidence regarding the rate and factors associated with uncontrolled BP in Iraq is scarce. The objectives of this study were a) to assess the magnitude of and factors associated with patient BP control and b) to investigate the patient-level prescribing patterns of antihypertensive medications, in a large Iraqi hospital. Materials and Methods: A prospective, cross-sectional study was conducted in the primary care centers of Al-Yarmouk Hospital in Baghdad, Iraq, between April 2018 and August 2018. Eligible patients answered standard survey questions and had their BP measured. Controlled BP was defined as <130/80mm Hg for patients with diabetes and/or chronic kidney disease and <140/90mm Hg for other populations. Results: During the study period, 300 patients were included; of which, 67.3% were female. The average age was 57.6 (9.2) years (range, 25–79 years). Among the 300 patients included, only 38.7% had controlled BP. In univariate analysis, poorly controlled BP was not associated with education, employment, smoking, comorbid conditions excluding diabetes, and therapeutic regimen used. In contrast, the strongest predictors of uncontrolled BP were age <60 years, male sex, and diabetes mellitus. The majority were prescribed monotherapy (53.0%), followed by dual therapy (38.7%), and triple therapy (8.3%). Angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors were the most commonly prescribed medications at 74.7%, followed by beta-blockers at 29.3%, calcium channel blockers at 28.0%, and diuretics at 23.0%. Conclusion: BP control was suboptimal. Effective feasible strategies should be implemented to increase BP control in Iraq to reduce hypertension-related complications.
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Homology modeling and docking study of Shewanella-like protein phosphatase involved in the development of ookinetes in Plasmodium
Sandhini Singh, Ruchi Yadav
July-September 2019, 11(3):223-231
DOI:10.4103/jpbs.JPBS_205_18  
Objective: Parasites of the genus Plasmodium cause a great deal of morbidity and mortality worldwide, largely in regions with limited access and indication to the tools necessary to control mosquito populations and to treat human infections of malaria. Five species of this class of eukaryotic pathogens cause different human diseases, with Plasmodium falciparum alone infecting approximately 500 million people per year and resulting in approximately one million deaths. Materials and Methods: The two genes encoding the Shewanella-like protein phosphatases of P. falciparum, SHLP1 and SHLP2, are conserved among members of Plasmodiidae family. SHLP is frequently found in asexual blood stages and expressed at all stages of the life cycle of parasite. SHLP deletion results in a reduction in microneme formation, ookinetes (zygote) development, and complete ablation of oocyst formation, thereby blocking transmission of parasite. Structure modeling of SHLP protein can be helpful in understanding the active site and binding site information and hence can be used for drug designing and for therapeutics against malaria. Study of SHLP and its variants was carried out using UniProtKB database. Homology modeling was performed using Schrödinger software, and the modeled structure was verified using Ramachandran plot. Ten antioxidants were searched in PubChem database for docking and comparative analysis. Docking was carried out against SHLP-modeled protein, and the ligand–protein interaction map was analyzed. Effective role of resveratrol was studied against SHLP protein using docking method to identify protein–ligand interaction scheme and bond formation. Results: SHLP protein was modeled and docking was carried out to identify the binding sites and interaction with the SHLP protein. Docking study suggested that resveratrol has a strong interaction with SHLP protein and can be used as a potential ligand for drug designing. Conclusion: SHLP plays a crucial role in ookinetes and microneme development in Plasmodium; hence ligand, which can interact and inhibit SHLP protein, can be a potential drug against malarial parasite development. We studied the binding of antioxidant, such as resveratrol, with this protein-using docking method and it was found that resveratrol as an antioxidant can bind with the target SHLP protein.
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Cytotoxic effects of juglone and Pterocarya fraxinifolia on prostate cancer cells
Morteza Mahdavi, Mohammad Azadbakht, Akbar Vahdati, Mohammad Shokrzadeh, Ayub Farhadi
July-September 2019, 11(3):195-204
DOI:10.4103/jpbs.JPBS_203_18  
Aim: Juglone with naphthoquinone structure has medicinal properties and its anticarcinogenic and antioxidant effects have been proven. In this research, the cytotoxic and apoptosis effects of juglone and Pterocarya fraxinifolia (PF) methanolic extract on human prostate cancer cells were studied. Materials and Methods: The PC3 and DU145 human cancer cells and normal cells of primary prostate epithelial cells (ATCC PCS-440-010) were treated with juglone and PF extract at the concentrations of 10, 50, 100, 500, and 1000 μg/mL for 24, 48, 72, and 96h. The morphological changes were examined by reversed microscope. The survival percentage of cell lines was evaluated by MTT (3,4,5-dimethylthiazole-2-yl-2,5-diphenyltetrazolium bromide) test. The rate of apoptosis and expression of AR and CLU genes were examined by flow cytometry and real-time polymerase chain reaction. Results: All concentrations after 24h caused morphological changes in PC3 and DU145 cells, and these changes were intensified after 48, 72, and 96h. Also, concentrations of 100 and 500 μg/mL caused morphological changes in normal cells. The results of MTT test showed a significant decrease in PC3 and DU145 cell survival rate at 50, 100, and 500 μg/mL concentrations (P < 0.05). Juglone at 10 μg/mL concentration induced apoptosis in cancer cell lines. Conclusion: Juglone and PF could decrease the growth of cancer cell lines through the mitochondrial pathway. So PF could be considered as a potential candidate for therapeutic herbal medicine in treating cancers.
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Exogenous supplementation of N-acetylcysteine can reduce hepatotoxicity induced by ascites fluid (cell-free) adsorbed over Protein-A-containing Staphylococcus aureus Cowan-I without compromising its antitumor effect
Ashish S Verma, Priyadarshini Mallick, Premendra D Dwivedi, Anchal Singh
July-September 2019, 11(3):205-215
DOI:10.4103/jpbs.JPBS_216_18  
Introduction: Hepatotoxicity along with enhanced mortality has remained a major concern during the development of antitumor therapy with the use of cell-free ascites fluid adsorbed (ad-AF) over Protein-A-containing Staphylococcus aureus Cowan I (SAC). Major issue with ad-AF inoculation is the significant depletion of hepatic glutathione (GSH). Exogenous supplementation of –SH contents to the host has offered an encouraging hope to explore the possibilities to use ad-AF as a therapeutic material due to its antitumor effects. GSH and l-cysteine have shown a promise with the recovery of –SH contents as well as the recovery of phase I and phase II biotransformation enzymes. Aforementioned observations prompted us to try other –SH donors. Materials and Methods: Therefore, in this study, N-acetylcysteine (NAC) was used as an exogenous source to provide –SH contents to reduce hepatotoxicity and mortality induced by ad-AF treatment. Results: Exogenous supplementation of NAC along with ad-AF treatment to ascites tumor bearers has shown a significant protection against hepatotoxicity and mortality caused by ad-AF. NAC substitution along with ad-AF has significantly enhanced the mean survival time (MST), without altering the antitumor effect of ad-AF as evident from tumor cell counts and viability. Discussion: NAC supplementation has been successful to recover hepatic –SH contents along with the significant recovery of phase I and phase II biotransformation enzymes. Marker enzymes for liver injury have also given clear-cut indications for the recovery of tumor bearers from hepatotoxicity induced by ad-AF. Conclusion: This study has shown that exogenous supplementation of NAC protects the host from the enhanced mortality and hepatotoxicity induced by ad-AF. These observations offer a hope to develop ad-AF as one of the probable treatment strategies for ascites tumors at least at experimental levels.
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Public perception toward e-commerce of medicines and comparative pharmaceutical quality assessment study of two different products of furosemide tablets from community and illicit online pharmacies
Akram Ashames, Richie Bhandare, Sham Zain AlAbdin, Tasnim Alhalabi, Farah Jassem
July-September 2019, 11(3):284-291
DOI:10.4103/jpbs.JPBS_66_19  
Background: E-commerce of medicines has been extensively spread worldwide. Many reasons influence consumers to purchase their medical needs through the Internet, including low cost, availability, accessibility, and time saving. However, most of these medicines are substandard and counterfeit. Aim: To assess the perception of people in the UAE about purchasing medicines from online sources and to evaluate the quality of furosemide tablets from two different sources including illegal online source. Materials and Methods: A cross-sectional study was conducted on 528 participants in the UAE. The questionnaire included three parts to assess the public perception and experience toward purchasing medicines from online sources. Furosemide tablets, purchased from the UAE market and an illegal online source, were physically and chemically studied to assess their quality according to the British Pharmacopoeia (2018). Results: The survey results revealed that less than 10% of participants have purchased their medicines from online sources and mostly they were nonprescription products (78%). Most common motives for online purchasing were either unavailability in the local pharmacies (43%) or lower cost compared to that in local market (43%). The opinion of participants toward purchasing of online medicines was negative. On the other hand, the experimental analysis showed that online furosemide had failed to pass the chemical assay test (91.0% ± 0.8), which makes it a substandard product. Conclusion: This study showed that few consumers had considered purchasing pharmaceutical products from online sources as a feasible way to save money and time. However, most of them were in doubt about their quality, which encourages health-care providers to guide patients to government-supported websites if required. The study also showed that the quality of online medicines is questionable, indicating that these products are not equally effective as the medicines purchased from a local pharmacy.
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Determination of ethinyl estradiol and levonorgestrel in human plasma with prednisone as internal standard using ultra-performance liquid chromatography–tandem mass spectrometry
Yahdiana Harahap, Devina Devina, Harmita Harmita
July-September 2019, 11(3):254-261
DOI:10.4103/jpbs.JPBS_68_19  
Objective: Ethinyl estradiol and levonorgestrel as a combination of oral contraceptive drugs have very low dosage levels; hence, a highly sensitive and selective method of using ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) is needed. Materials and Methods: This method was developed using prednisone as an internal standard, thus the purpose of this research was to get the optimum condition. The analytical method had been fully validated according to the European Medicines Agency guidelines, 2011. A reverse-phase chromatography separation was performed on ACQUITY UPLC ethylene bridged hybrid C18 column (1.7 μm, 2.1 × 50mm), eluted at a 0.3 mL/min flow rate under a gradient of mobile phase of 0.1% formic acid in water and acetonitrile within 5 min. Sample preparation used protein precipitation followed by liquid–liquid extraction. Quantification analysis was performed by a triple quadrupole mass spectrometry with electrospray ionization in positive-ion mode. The multiple reaction monitoring was set at m/z: 530.16 → 171.08 for ethinyl estradiol derivatized by dansyl chloride; m/z: 313.16 → 245.10 for levonorgestrel; and m/z: 359.10 → 147.04 for prednisone. Results: The validated method was accurate, precise, and sensitive with a lower limit of quantification at 5 and 100 pg/mL for ethinyl estradiol and levonorgestrel, respectively.
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Effect of Litsea lancifolia leaf extract on glucose transporter 4 translocation and glucose uptake in 3T3L1 cell line
Murad Alsawalha, Abeer Mohammed Al-Subaie, Reem Yousuf Al-Jindan, Srinivasa Rao Bolla, Janardhana Papayya Balakrishna, Padma Kanchi Ravi, Shiva Shankar Reddy Gollapalli, Vishnu Priya Veeraraghavan, Aruthra Arumugam Pillai, Joel Palpath Joseph, Surapaneni Krishna Mohan
July-September 2019, 11(3):240-247
DOI:10.4103/jpbs.JPBS_53_19  
Background: Numerous synthetic drugs have been recommended as a remedy for diabetes, but their role in hypoglycemic effects are diverse. The side effects associated with these drugs due to their extended use led scientists to find unconventional medicines with no or little side effects. Aim: This study was aimed at assessment of in vitro antidiabetic activities of methanolic extract of Litsea lancifolia leaves by using 3T3L1 cell line. Materials and Methods: The cytotoxic effect of the leaf extract was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The glucose uptake–inducing capabilities and its correlation with glucose transporter 4 (GLUT4) translocation were measured by flow cytometry in 3T3L1 cells. In addition, the inhibitory effect of L. lancifolia leaf extract on α-amylase activity and α-glucosidase activity was determined by colorimetric methods. Results: Different concentrations of L. lancifolia leaf extract did not show any toxicity on 3T3L1 cells, after the treatment for 24h. On stimulation with leaf extract, 60.22% and 86.26% of 3T3L1 cells showed glucose uptake and GLUT4 expression, respectively. The colorimetric assays showed that the methanolic leaf extract of L. lancifolia has a significant inhibitory effect on the activity of α-amylase enzyme and α-glucosidase enzyme with inhibitory concentration (IC50) value of 248.65 µg/mL and 229.61 µg/mL, respectively. Conclusion: On the basis of the results of this study, it is evident that L. lancifolia leaf extract showed promising anti-diabetic effect when compared to the standard drugs metformin and acarbose and was nontoxic to 3T3L1 cells. Thus, it can be further investigated to recommend as a possible alternative treatment in antidiabetic applications.
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Association of serum calcium level with waist circumference and other biochemical health-care predictors among patients with type 2 diabetes
Moyad J Shahwan, Mohammed H Khattab, Ammar A Jairoun
July-September 2019, 11(3):292-298
DOI:10.4103/jpbs.JPBS_137_19  
Introduction: This study aimed to find the association of serum calcium level with abdominal obesity according to the waist circumference (WC) and the associated factors. Materials and Methods: A cross-sectional study was carried out at private health-care center. A total of 291 patients, aged 18 years and above, with type 2 diabetes mellitus who attended the clinic from May 2017 through March 2018 were included. Sociodemographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for the Social Sciences software (SPSS, version 23). Abdominal obesity was defined by WC ≥ 80cm in women and ≥94cm in men. Results: A total number of 291 participants participated in the study. Among these participants, 42.6% (n = 124) were male and 57.4% (n = 167) were female. The average age of respondents was 55.99 ± 9.81 years. Among the male participants, 90 (72.6%) (95% confidence interval [CI]: 64.6%–80.5%) were abdominally obese as were 154 participants (92.2%) (95% CI: 88.1%–96.3%) among females. Overall, 244 participants (83.8%) (95% CI: 79.6%–88.1%) were abdominally obese. The results of statistical modeling showed that gender, smoking status, physical activity, and serum calcium are strong determinants of abdominal obesity. Conclusion: This study revealed a significant association of abdominal obesity and serum calcium level among patients with diabetes.
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A questionnaire-based study for weight loss by using herbal drugs in Dammam (Eastern Region), Kingdom of Saudi Arabia
Wasim Ahmad, Ayaz Ahmad, Mohammad D Ali, Yousif Amin, Sukainah A Sheikh, Anjum Usmani, Rawan A Otaibi, Sarah A Rashidi, Noura A Salih, Omnia A Mostafa
July-September 2019, 11(3):248-253
DOI:10.4103/jpbs.JPBS_102_19  
Background: Obesity is a common health problem and it is increasing around the world. Herbal drugs are the most commonly used alternative treatment for weight reduction. The aim of this study was to identify the most commonly used plants for the treatment of obesity or to reduce the weight of patients with obesity and to determine the usage rate of herbal drugs in Dammam, Kingdom of Saudi Arabia. Materials and Methods: This cross-sectional study was performed on people who were overweight and obese in Dammam (Eastern Region), Kingdom of Saudi Arabia, by using pretested questionnaire. Participants were randomly selected for this questionnaire study. P value was calculated by using chi-square test. Results: A total of 500 participants were selected, of which 355 participants completed the questionnaire-based study and the remaining 145 were excluded from the study. The majority (n = 190, 53.52%, P > 0.05) used herbal drugs to reduce weight. The most commonly used herbal drugs included green tea (53.52%, P > 0.05), ginger (31.54%, P < 0.01), and flax seed (17.46%, P < 0.01). However, nearly 35% of participants stated that they had unwanted effects; therefore, majority of the participants stated they would use herbal drugs in future to reduce weight. Conclusion: This investigation showed that the treatment to reduce weight of those who were overweight or obese by herbal drugs and the usage rate of herbal drugs/fruits/vegetables were high in Dammam. Further investigations are required to prove the efficacy of herbal drugs and their side effects for the treatment of obesity. A community awareness program is essential to explain the positive and adverse effects of herbal drugs.
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Study of gliclazide solid dispersion systems using PVP K-30 and PEG 6000 by solvent method
Febriyenti Febriyenti, Suraiya Rahmi, Auzal Halim
July-September 2019, 11(3):262-267
DOI:10.4103/jpbs.JPBS_87_18  
Gliclazide is a second-generation hypoglycemic sulfonylurea, which is useful in the treatment of non-insulin-dependent diabetes mellitus. It has low bioavailability because of its limited water solubility and slow dissolution rate. In this study, solid dispersions of gliclazide were prepared by solvent method. Drug and carriers weight ratio were 1:9; 2:8; 3:7; 4:6; and 5:5. The weight ratio of carriers (polyvinyl pyrrolidone K-30 and polyethylene glycol 6000) was 1:1. The properties of solid dispersions were evaluated using scanning electron microscopy (SEM), Fourier-transform infra red (FTIR) spectroscopy, differential scanning calorimetry (DSC), X-ray diffraction (XRD), and solubility and dissolution studies. SEM result showed that gliclazide was highly dispersed and was present as amorphous state in the solid dispersions. The FTIR spectroscopy showed no chemical interaction between gliclazide and carriers. DSC studies indicated melting point of gliclazide was decreased. The XRD studies indicated that crystallinity degree of gliclazide was decreased. Rate of dissolution and solubility of solid dispersions was increased than pure gliclazide (F < 0.05).
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Smoking patterns and willingness to quit: A cross-sectional study in Al Ain City, UAE
Moawia M Al-Tabakha, Muaed J Alomar, Mariam N G Awad, Khairi M S Fahelelbom
July-September 2019, 11(3):276-283
DOI:10.4103/jpbs.JPBS_30_19  
Background: Tobacco use is the major cause of preventable morbidity and mortality. The main objectives of this study were to identify smokers willing to participate in quit smoking campaigns using social media and to identify smoking habits of everyday smokers in Al Ain City, United Arab Emirates (UAE). Research Design and Methods: Everyday smokers from Al Ain city of the UAE were surveyed in different locations of the city including malls and specialized tobacco-selling shops. They were interviewed using a semi-structured survey and the information was recorded by one assessor. The information gathered included type and frequency of tobacco use, smoking history and habits, quitting history, desire to quit, and the preferred communication platform. Result: A total of 412 regular adult smokers were interviewed in which the majority (95%) reported first smoking at or before the age of 28 years. Participants were mainly UAE nationals (33.7%), Egyptians (14.1%), Syrians (12.9%), and Jordanians (10.9%). Manufactured cigarettes were the main form of tobacco consumption (59.5%), and smoking was mainly solitary (56.3%) and at home (26.3%) and coffee shops (24.9%). The majority of interviewed subjects (76.7%; 95% confidence interval [CI]: 72.4%–80.5%) expressed their interest to quit smoking in the future and 55.3% (95% CI: 50.5%–60.2%) were ready to get involved immediately in a smoking cessation program. Of those, 80.3% (95% CI: 74.6%–84.9%) preferred WhatsApp for receiving smoking cessation motivational education. Conclusion: The majority of smokers started at younger ages, which warrant the age of smoking restriction to be raised to 29 years instead of 18 years by the health authority. Everyday smokers were aware of the potentially hazardous effects of tobacco smoking and many were willing to accept help to quit smoking that involves the use of WhatsApp.
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Falcaria vulgaris extract attenuates ethanol-induced renal damage by reducing oxidative stress and lipid peroxidation in rats
Cyrus Jalili, Shiva Roshankhah, Mohammad Reza Salahshoor
July-September 2019, 11(3):268-275
DOI:10.4103/jpbs.JPBS_134_19  
Background: Alcohol consumption is capable of producing free radicals and inducing disturbance in body antioxidant. Falcaria vulgaris (F. vulgaris) is a vegetable and it has beneficial antioxidant effects. Materials and Methods: Forty-eight Wistar rats were divided randomly into eight groups (n = 6): control normal (saline) and ethanol (5g EtOH/kg body weight/24h) control groups, F. vulgaris groups (50, 100, and 150mg/kg), and F. vulgaris + ethanol treated groups (50, 100, and 150mg/kg). Treatments were administered intraperitoneally and through gavage daily for 12 weeks. Parameters related to the function and the histology of the kidneys were evaluated and statistically analyzed from kidney and blood serum samples with respect to the groups. Results: Ethanol administration increased significantly Bowman’s space, qualitative histopathology indices, kidney malondialdehyde (MDA) level, blood urea nitrogen (BUN), creatinine, and nitrite oxide levels and decreased significantly total antioxidant capacity (TAC) level and diameter and number of renal corpuscles compared to that in the control normal group (P < 0.001). The F. vulgaris and F. vulgaris + ethanol treatments in a dose-dependent manner reduced significantly Bowman’s space, qualitative histopathology indices, kidney MDA level, BUN, creatinine, and nitrite oxide levels and increased significantly TAC level and diameter and number of renal corpuscles compared to that in the ethanol normal group (P < 0.001). Conclusion: It seems that F. vulgaris administration in a dose-dependent manner improved kidney injury induced by ethanol in rats.
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