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   Table of Contents - Current issue
January-March 2021
Volume 13 | Issue 1
Page Nos. 1-148

Online since Thursday, February 18, 2021

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Need of vibrant vaccine pharmacovigilance during current global COVID-19 pandemic: More than ever p. 1
Bikash Ranjan Meher
COVID-19 pandemic has brought the vibrant and vivacious human life to a grinding halt. Only a safe and effective vaccine will bring this dicey situation back to normalcy. Researchers across the globe are at present working hard to find an effective vaccine for COVID-19. However, in search of an effective vaccine at the earliest possible time to combat the epidemic, we cannot afford to compromise on the safety of it. Therefore, monitoring the safety of vaccines is a top priority to safeguard the health of vaccine recipients and only a robust vaccine pharmacovigilance can ably do that in this crisis.
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Hydroxychloroquine and chloroquine in prophylaxis and treatment of COVID-19: What is known? Highly accessed article p. 4
Pathiyil Ravi Shankar, Subish Palaian, Shabaz Mohiuddin Gulam
The corona virus disease-19 (COVID-19) pandemic has affected the entire world causing huge economic losses and considerable morbidity and mortality. Considering the explosive growth of the pandemic repurposing existing medicines may be cost-effective and may be approved for use in COVID-19 faster. Researchers and medical practitioners worldwide have explored the use of chloroquine and hydroxychloroquine, in few occasions combined with the macrolide antibiotic azithromycin, for COVID-19 treatment. These two drugs are economic and easily available, and hence gained attention as a potential option for COVID-19 management. As per the available evidence, the outcomes of treatments with these medications are conflicting from both the efficacy and safety (predominantly cardiac related) perspectives. Currently, multiple studies are underway to test the safety and efficacy of these medications and more results are expected in the near future. The retina, the endocrine system (with risk of hypoglycemia), the musculoskeletal system, the hematological system, and the neurological system may also be affected. The use of these drugs is contraindicated in patients with arrhythmias, known hypersensitivity, and in patients on amiodarone. In addition to the published literature, personal communication with doctors treating COVID-19 patients seems to suggest the drugs may be effective in reducing symptoms and hastening clinical recovery. The literature evidence is still equivocal and further results are awaited. There has been recent controversy including retraction of articles published in prestigious journals about these medicines. Their low cost, long history of use, and easy availability are positive factors with regard to use of these drugs in COVID-19.
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An overview of phytochemical and biological activities: Ficus deltoidea Jack and other Ficus spp p. 11
Kamran Ashraf, Mohd Rafiul Haque, Mohd Amir, Niyaz Ahmad, Wasim Ahmad, Sadia Sultan, Syed Adnan Ali Shah, Ahmed Mahmoud Alafeefy, Mohd Mujeeb, Muhammad Fikriey Bin Shafie
Ficus deltoidea Jack (Moraceae) is a well-known medicinal plant used in customary medication among the Malay people to reduce and mend sicknesses such as ulcers, psoriasis, cytotoxicity, cardioprotective, inflammation, jaundice, vitiligo, hemorrhage, diabetes, convulsion, hepatitis, dysentery injuries, wounds, and stiffness. Ficus deltoidea contains a wide variety of bioactive compounds from different phytochemical groups such as alkaloids, phenols, flavonoids, saponins, sterols, terpenes, carbohydrates, and proteins. The genus Ficus has several hundreds of species, which shows excellent therapeutic effects and a wide variety of helpful properties for human welfare. Searching information was collected by using electronic databases including Web of Science, Science Direct, Springer, SciFinder, PubMed, Scopus, Medline, Embase, and Google Scholar. This review is, therefore, an effort to give a detailed survey of the literature on its pharmacognosy, phytochemistry, phytochemical, and pharmacological properties of Ficus and its important species. This summary could be beneficial for future research aiming to exploit the therapeutic potential of Ficus and its useful medicinal species.
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Provision of standardized all-in-one parenteral nutrition (AIO-PN) for very preterm neonates: Evaluation at room and cold temperatures p. 26
Suci Hanifah, Yuli Maulidani, Bambang Hernawan Nugroho, Chynthia Pradiftha Sari
Introduction: All-in-one parenteral nutrition (AIO-PN) is essential for patients with limited venous access, e.g. premature infants. So far, there are still some conflicting data related to the stability of AIO-PN. The aim of this study is to examine the physical stability and sterility of AIO-PN as it was being stored at room and cold temperature. Materials and Methods: AIO-PN contains dextrose, amino acid, lipid, sodium chloride, magnesium sulfate, potassium chloride, calcium gluconate, and vitamin. Formulation of AIO-PN was prepared based on the guidance of nutrition for 3-day-old preterm baby weighing 1000 g. The formulation of AIO-PN then was stored at room temperature (25.43ºC ± 0.54) and cold temperature (6.2ºC ± 2.04). Results and Discussion: Based on the experiments, all formulas confidently fulfilled the sterile criteria, in which there is no microbial growth in the formula within 7 days. During those days, the droplet size of all formulas was under the range (<500 nm) with a good range of pH. However, during the process of storing under the room temperature, AIO-PN showed the reversible creaming starting on day 2 and the discoloration starting on day 4. Meanwhile, we found that there are no such physical changes in the formula within 7 days under the cold temperature. Conclusion: This research confirmed that AIO-PN that is being stored at room temperature cannot be used starting on day 4, but the formulation storage under the cold temperature is still accepted within 7 days.
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Health-related quality of life among healthcare providers in Pakistan p. 31
Muhammad Shahid Iqbal
Evaluation of health-related quality of life (HRQOL) in healthcare professionals (HP) is a crucial measure for improving their healthcare interventions and pharmaceutical care planning which they provide to their patients for prevention and better treatment of diseases. Studies have shown that poor health status among HPs is a greater risk factor in achieving desired outcomes in their patients. This study assessed the current level of HRQoL among HPs and evaluated various factors influencing their HRQoL. A cross-sectional study was conducted among HPs using the self-administered research tool “WHOQOL-BREF”. Descriptive, comparative, and inferential statistics were performed using SPSS ver. 24. The study results reported a total of 336 participants, with more males than females (n=268, 79.8%, and n=68, 20.2% respectively). The mean scores for the physical, psychological, social relationships and environmental domains were 65.18±13.01, 68.92±15.53, 70.30±15.90, and 65.10±15.17, respectively. This study confirmed that HPs in Pakistan were more satisfied with their HRQoL in social domain and relatively less satisfied in physical and environment domains of HRQoL.
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Formulation of edible bird’s nest (Aerodramus fuciphagus) from Central Kalimantan as skin whitening and moisturizing cream p. 39
Dita Ayulia Dwi Sandi, Eka Fitri Susiani
Context: Indonesia is the largest producer of edible bird’s nest (EBN) in the world. Previous research proved that epidermal growth factor (EGF) was detected from edible bird’s nest extract. EGF will increase the metabolism of skin cells and can lighten the skin EGF will increase the metabolism of skin cells and can lighten the skin. Aims: This research aimed to formulate and prove the lightening and the moisturizing effect of EBN cream on white mice. Materials and Methods: The 28 mice were divided into four group treatment. EBN 40% were formulated into cream with two formula types: water in oil (W/O) and oil in water (O/W). Before the treatment, white mice were exposed to UVA radiation until skin color level was 4. For 14 days, white mice were treated and observed skin color level and moisture content by skin analyzer. Results: The skin color level was 1 on day 8 (O/W), on day 9 (W/O), on day 8 (positive control), and showed skin color level was 4 on day 14 (negative control). The average water content on day 14 was 53.70 ± 1.21 (O/W), 50.13 ± 1.39 (W/O), 53.88 ± 0.88 (positive control), and 21.48 ± 2.90 (negative control). Conclusion: No significant difference was observed in lightening effect (Sig. 0.495) and moisturizing effect (Sig. 0.564) between O/W cream and W/O creams. W/O cream has good adhesion and O/W cream has good dispersion.
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In pursuit of preventive audiology in South Africa: Scoping the context for ototoxicity assessment and management p. 46
Katijah Khoza-Shangase, Nothando Masondo
Aim: The study explored the South African healthcare context for ototoxicity assessment and management from the audiologists’ perspectives. Materials and Methods: This was done through a survey research methodology that adopted a cross-sectional research design. South African audiologists were recruited from professional associations databases using specific inclusion criteria; and 31 audiologists from across the country participated. The study used an 18-item web-based survey guided by the Health Professions Council of South Africa (HPCSA) (2018) guidelines. Data were analyzed through both descriptive and inferential statistics. Results: Findings revealed serious contextual challenges influencing the implementation of assessment and management programs within the South African context. Over two-thirds of the participants engage with ototoxicity monitoring and management, but the practices adopted are not aligned to international standards nor the national HPCSA guidelines on assessment and management of patients on ototoxic medications. Findings speak to the frequency of practice; the referral pathways audiologists use; prevention and promotion methods used; availability of resources for the implementation of ototoxicity assessment and management; barriers to ototoxicity assessment and management; the influence of language and culture in ototoxicity assessment and management; as well as information management practices within this context. No relationship could be established between knowledge regarding ototoxicity, communication, caseload, and ototoxicity assessment and management on the chi-square. Conclusion: Implications for strategic planning, budget allocation, collaborative multidisciplinary within the same institution approaches; training; policy formulation; and translation of policies and guidelines into practice are raised by these findings.
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Translation, pilot psychometric validation, and comparative performance of the arabic version of the Anti-Clot Treatment Scale (ACTS) p. 61
Sireen Abdul Rahim Shilbayeh, Sahar Abd El Rahman Ismail
Background: Anticoagulation management is a complex process that is managed through careful monitoring, and patient satisfaction has a significant impact. Given the lack of a valid and reliable tool in Arabic to examine patient satisfaction, the present study aimed to translate and examine some of the psychometric properties of the Anti-Clot Treatment Scale (ACTS) among Saudi patients. Materials and Methods: This was a cross-sectional, methodological study conducted among patients receiving warfarin. The questionnaire was subjected to translation by using a multistep method. The final Arabic translated version of the ACTS underwent face and content validity assessments by independent experts to ensure its conceptual equivalence to the original English version. Subsequently, pilot testing of convergent, discriminant, and criterion validities were examined. Results: Overall, 136 patients participated in the study. All patients were asked to complete the generic Treatment Satisfaction Questionnaire for Medication (TSQM) alongside the ACTS tool. Convergent validity analyses revealed statistically significant positive correlations (p < 0.01) between the ACTS subscales and the four TSQM subdomains, as reflected by the Spearman correlation coefficient (r). Interestingly, the strongest correlations were observed between ACTS Burdens and the TSQM convenience domain (r = 0.61) and between ACTS Benefits and the TSQM effectiveness satisfaction score (r = 0.58). Similarly, discriminant validity was evidenced by moderate to high significant loading of all 12 items on each of their corresponding ACTS subscales. Conclusion: These findings of adequate validity support the use of the ACTS in Saudi patients receiving anticoagulant medications to measure their specific satisfaction levels with this type of therapy. However, future research addressing the clinical impact of ACTS scores in the Saudi population is needed.
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A novel ultra performance liquid chromatography-PDA method development and validation for darunavir in bulk and its application to marketed dosage form p. 69
Sabyasachi Biswal, Sumanta Mondal, Prasenjit Mondal
Aims and Objective: The aim of this study was to develop and validate a novel ultra-performance liquid chromatographic method for estimation of darunavir in a bulk and tablet dosage form. Materials and Methods: The chromatographic separation was achieved using DIKMA Endoversil (2.1 mm x 50 mm, 1.7 µm) column. A mixture of 40% buffer (0.1% octa sulfonic acid) and 60% acetonitrile was used as a mobile phase with the isocratic elution mode and eluent was monitored at 281nm using UV detector. The method was continued and validated in accordance with International Conference on Harmonization Guidelines. Validation study revealed the specificity and reliability of the method. Results: In this method, darunavir was eluted with retention time of 0.516 min. Calibration curve plots were found linear over the concentration ranges 10–50 μg/mL for darunavir. Limit of detection was 0.02 μg/mL and limit of quantification was found 0.07 μg/mL. The present method was also found stable in force degradation study. Conclusion: The empirical evidences of all the study results revealed the suitability of the estimation of darunavir in bulk and tablet dosage form without any interference from the excipients.
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Effect of Metformin on Lipid Profiles of Type 2 Diabetes Mellitus: A Metaanalysis of Randomized Controlled Trials p. 76
Syed Wasif Gillani, Nahal Ghayedi, Pardis Roosta, Parvin Seddigh, Omaimah Nasiri
Objective: The study aimed to perform a meta-analysis on randomised controlled trials to investigate the effect of metformin on lipid profiles among type 2 diabetes mellitus patients. Material and Methods: All published, randomised controlled trials with double blind assessment of outcome were included in the review. Clinical trials were identified by searching: PubMed, SCOPUS, TRIP, Clinical Trial registry and Cochrane. We included all RCT with no language restriction, published from January 2010 to January 2020. Two primary authors of this study were served as independent reviewers to assess the quality and bias risk assessment of each study by using Cochrane instrument. Pooled analysis was performed to determine the efficacy of metformin versus placebo on the body weight, total cholesterol, low-density lipoproteins, high-density lipoproteins and triglycerides. Results: Overall 6 were used for Meta-analysis. All of the studies reported that groups were similar at baseline, patients were blinded to the study, the study dropout rate was described and acceptable, and studies had reports free of suggestions. The pool analysis showed significant effect of metformin on the reduction of mean bodyweight over time compared to placebo -1.66 (95%CI -1.88 to -1.44) p<0.000. No heterogeneity and effect of publication bias found with outcome variable. The data was extracted from all the six studies to analyze the overall effect. The overall effect is z = 5.40, with no heterogeneity and reported publication bias effect on outcome variable. The pooled effect showed significant reduction of mean triglyceride among patients with metformin as compared to placebo -0.24 (95%CI -0.33, -0.15) p<0.0001). Conclusion: This meta-analysis concluded that Metformin has significant reduction effect on body weight, Total Cholesterol, LDL and triglycerides in patients with type 2 diabetes mellitus.
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Naturalistic evaluation of prescription pattern in glaucoma clinic of a tertiary care hospital: A developing country’s perspective p. 83
Niraj Niraj, Nusrat Shafiq, Sushmita Kaushik, Chakrant Mothsara, Gaurav Garg, Samir Malhotra
Background: Glaucoma is a chronic, gradual and progressive eye disorder characterized by visual loss and involving the typical changes in optic nerves and associated structures. Currently, the mainstay treatment lies in the reduction of intraocular pressure (IOP) involving the usage of two or three medications concurrently. However, prescription pattern of antiglaucoma drugs remains largely unstudied so far. Therefore, there is a dire need of drug utilization studies to ensure rational prescribing for better treatment outcomes. Aim: This study was conducted to assess the prescription pattern in glaucoma patients to encourage rational use of drugs. Materials and Methods: The pertinent data of confirmed glaucoma patients were entered in a predesigned case record form (CRF) including patient demographic details, type of glaucoma, number of drug prescribed, drug dosage and dosage formulation with prior patient consent, and finally, the data were analyzed using Microsoft Excel. Results: A total of 247 glaucoma patients were recorded in the study. The mean SD number of drugs per prescription was 2.18 (1.68). Monotherapy was prescribed to 72 (29.15%) patients, and the most common monotherapy prescribed was timolol, whereas in fixed-dose combinations (FDCs), brimonidine and timolol FDCs were most commonly encountered. Furthermore, prescriptions consisting of generic drugs only and prescribed as per the National List of Essential Medicines (NLEM) were 48 (19.43%) and 41 (16.59%), respectively. Conclusion: This study showed the judicious use of medications in tune with principles of rational drug use in our center, and the rationale practices can be extended to the peripheral centers of the country for better drug utilization.
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Retrospective study on the pattern of off-label use of misoprostol in Tabuk, Saudi Arabia p. 88
Nouf M Alharthi, Mohannad Sahaw Alsaeed, Mohammed Omar Alsharif, Mohammed Ghabbash Almalki, Wael Saeed Alshehri, Kousalya Prabahar
Introduction: Off-label drug use (OLDU) refers to the prescription of a currently available and marketed medication for a use that has never been approved by the Food and Drug Administration (FDA). Misoprostol is one of the drugs which is used off-label. This drug, authorized for the treatment or prevention of peptic ulcers and other stomach disorders, is commonly used off-label for inducing labor or intrauterine device insertion. This research focuses on identifying the percentage of morbidity and mortality by off-label use of misoprostol; classifying the most common off-label misoprostol use in Tabuk hospitals; and determining the availability of policy and procedures behind prescribing the off-label misoprostol. Materials and Methods: Retrospective observational study was carried out. Data were collected from patients’ files for those admitted to the maternity wards in Tabuk Hospitals from March 2019 until September 2019. Results: Approximately 53% of cases were diagnosed with missed abortion. The mean time for abortion after administering misoprostol was 20.7 ± 28.2h. About 76% of women had an indication of bleeding. Guidelines were not followed with respect to dosage regimen. The mean of hospital stay was 3 days. There were no significant complications associated with the administration of misoprostol. Conclusion: There is no policy and procedure available in the hospital regarding off-label use of misoprostol. Moreover, physicians have low adherence to the guideline in terms of dosage, interval, and route of administration for each indication in obstetrics and gynecology.
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Pattern of disease and therapy for diabetes along with impact of generic prescribing on cost of treatment among outpatients at a tertiary care facility p. 93
Shubham Atal, Rajnish Joshi, Sadasivam Balakrishnan, Pooja Singh, Zeenat Fatima, Nidhi Jain
Background: India has become the diabetes capital of the world. Analyzing trends in drug prescribing helps in judging rationality of prescriptions in different settings. This study aimed to assess disease and prescribing trends with a special emphasis on evaluating use of metformin, insulin, fixed dose combinations (FDCs), concomitant medications, pill burden, and costs of drug therapy in diabetes. Materials and Methods: This was a cross-sectional study in which patients of either sex who attended the diabetes clinic at a tertiary care center over 9 months were included consecutively. Basic demographic profile, clinical, and treatment details on the day of visit were collected from the prescription charts. Drug costs for prescriptions were calculated using generic and median brand prices of formulations using a recognized commercial drug directory and generic price list of the government, respectively. Data were analyzed by using Microsoft Excel and Open Epi online software to compare results with published studies. Results: Average age of diabetics was 53.9 ± 11.8 years and disease duration was 8.13 ± 7.78 years in 336 prescriptions analyzed. Dual drug regimens were seen in 32.7% prescriptions, most commonly metformin and sulfonylureas, followed by triple drug regimens (25%) with inhibition of dipeptidyl peptidase IV (DPP IV) inhibitor. Metformin was prescribed in 95% prescriptions (mean dose 1511 ± 559.87 mg) and insulin in 22.6% prescriptions. Angiotensin receptor blocker (ARBs) and statins were the most commonly prescribed concomitant drugs. One FDC per prescription (median) each for diabetes and comorbidities were prescribed. Daily pill burden was 4.59 ± 2.65 pills. The median monthly cost of drug therapy with branded prescribing was INR 870.43 and INR 393.72 with the use of generics. Inferences drawn by comparison with published data showed variable results for different parameters analyzed. Conclusion: Disease pattern was as expected for the region and trends of therapy showed concurrence with rational prescribing. Pill burden and cost of therapy remain high with a significant contribution of comorbidities.
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Use of traditional Chinese medicine in Malaysia: A knowledge and practice study among general population toward complementary and alternative medicine in relation to health and quality of life in Malaysia p. 102
Syed Ghouse Mohiuddin, Sohail Aziz, Rizwan Ahmed, Siti Maisharah Shaikh Ghadzi, Muhammad Zahid Iqbal, Muhammad Shahid Iqbal
Purpose: There is a wide range of use of complementary and alternative medicine (CAM), which has increased drastically and affected treatments overall. The knowledge and practice of Chinese herbal medicine among the general population is considered as positive. Literature shows that the effectiveness and acceptance of alternative therapies is still debatable among the general population. Materials and Methods: Study design was cross-sectional, in which sociodemographic data of respondents were collected through a validated questionnaire; results were analyzed by using validated data collection tool. The results were concluded on the basis of good, moderate, and poor response, which was evaluated through data analysis by the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A P < 0.05 was considered as statistically significant. Results: Respondents were 182 (44.4%) males and 228 (55.6%) females; better knowledge was recognized among the females (P < 0.001) with mean knowledge of 15.55 ± 2.7. Chinese population had good knowledge with statistically strong correlation with mean knowledge of 15.63 (P = 0.006). Likewise, Buddhism was reported to have good knowledge among all the religions. Rural population was underlined with lesser family income and they showed good practice and understanding (P = 0.006). Comparatively positive attitude was noticed among the females (P < 0.001) with mean attitude of 15.55 ± 2.7. The highest level of education in this study was postgraduate, which showed 77.1% good attitude. Postgraduate participants were having varied results with standard deviation of ±6.23. Statistically highly significant association was seen between the religion and attitude of respondents with the P < 0.001. Chinese medicine is widely used, but religious difference was found among the races. Similar difference was found in knowledge and practice among the population of rural side and low family income compared to urban population with higher income and access to allopathic medicine. Conclusions: Despite having better practice among the Malaysian population, still the knowledge needs to be disseminated among the population for the overall use of traditional Chinese medicine with safety to improve health and quality of life in Malaysia.
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Impact of pharmacist-led educational intervention on predictors of diabetic foot at two different hospitals of Malaysia p. 108
Amer Hayat Khan, Muhammad Zahid Iqbal, Syed Azhar Syed Sulaiman, Aznita Ibrahim, Nor Shaffinaz Binti Yusoff Azmi, Muhammad Shahid Iqbal, Ahmed A Albassam
Objective: Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia. Materials and Methods: In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0. Results: With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05). Conclusion: A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.
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In vitro cytotoxicity and anti-inflammatory cytokinine activity study of three isolated novel compounds of Prismatomeris glabra p. 116
Khaled A A Alkadi, Kamran Ashraf, Aishah Adam, Syed Adnan Ali Shah, Muhammad Taha, Mizaton Hazizul Hasan, Cinimathew John, Razali Mohamed Salleh, Wasim Ahmad
Objectives: The aim of the present study was to isolate and evaluate cytotoxicity and anti-inflammatory activities of new novel compounds isolated from Prismatomeris glabra. Materials and Methods: Dried root of P. glabra was extracted under reflux with methyl alcohol, fractionated through the vacuum liquid chromatography technique, and evaporated and then purified the compounds using column chromatography and preparative thin-layer chromatography. THP-1 cells were treated with amentoflavone, 5,7,4′-hydroxyflavonoid, and stigmasterol with various concentrations (0–30 µg/mL) and then incubated with MTS reagent for 2h. Treatment was done for 24, 48, and 72h. Then, effects of these compounds were also tested on PGE2, TNF-α, and IL-6 expression in human THP-1-derived macrophage cells for 24h. Results: Three new compounds such as amentoflavone, 5,7,4′-hydroxyflavonoid, and stigmasterol were isolated. After 24h of incubation, a significant decrease in cell viability was reported with IC50 values of amentoflavone, 5,7,4′- hydroxyflavonoid, and stigmasterol (21 µg/mL ≡ 38 M), (18 µg/mL ≡ 66 M) and (20 µg/mL ≡ 48.5 M), respectively. Whereas for 48 and 72h treatment showed a less decreased cell viability compared with 24h treatment. These compounds also showed a significant reduction in the production of TNF-α, IL-6, and PGE2 in a dose-dependent manner. Conclusions: The isolated new compounds showed significant cytotoxicity and anti-inflammatory effects.
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Knowledge, attitude, and practice of oral hygiene among students of a private university p. 123
Muhammad Z Iqbal, Rahul Rathi, Sunil K Prajapati, Khaleda Omar, Mohd B Bahari, Sawri Rajan, Fahad I Al-Saikhan, Muhammad S Iqbal
Objective: The objective of the study was to evaluate the knowledge, attitude, and practice among pre-final and final year students of pharmacy, medicine, biotechnology, and business faculties about oral hygiene. Materials and Methods: A cross-sectional observational study was conducted to evaluate the knowledge, attitude, and practice of students towards oral hygiene at a private university in Malaysia. Validated questionnaires were distributed to a convenient stratified sample of 324 students studying in the different selected faculties, namely pharmacy, medicine, biotechnology, and business, respectively. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. Results: With regard to knowledge, upon evaluation, it was seen that the students of the Faculty of Pharmacy had the highest percentage of adequate knowledge, which was statistically significant with a P-value of 0.001 and the effect size of 0.246. On the evaluation of attitudes, it was seen that the Faculty of Biotechnology had the highest positive attitudes. According to race, Malay students had the highest positive attitude among all the races that participated in the study, which showed a P-value of 0.037 with the effect size of 0.034. Regarding practice, the Faculty of Pharmacy had the lowest practice compared with the other faculties. This variable had a P-value of 0.001 and showed to have significance against the practice with an effect size of 0.193. Conclusion: Overall, a good attitude was seen amongst the students on their oral hygiene. It was also observed that the attitude, knowledge, and practice of the students in a private university increased with an increasing level of education.
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Ameliorative role of diallyl disulfide against glycerol-induced nephrotoxicity in rats p. 129
Ashwani Kumar Sharma, Anmoldeep Kaur, Japneet Kaur, Gurpreet Kaur, Apporva Chawla, Mannan Khanna, Harmanpreet Kaur, Harnoor Kaur, Tajpreet Kaur, Amrit Pal Singh
Introduction: This study investigated the role of diallyl disulfide (DADS) against glycerol-induced nephrotoxicity in rats. Moreover, the role of peroxisome proliferator activated receptor-γ (PPAR-γ) in DADS-mediated renoprotection has been explored. Materials and Methods: Male Wistar albino rats were challenged with glycerol (50% w/v, 8 mL/kg intramuscular) to induce nephrotoxicity. Kidney injury was quantified by measuring serum creatinine, creatinine clearance, urea, potassium, fractional excretion of sodium, and microproteinuria in rats. Renal oxidative stress was measured in terms of thiobarbituric acid reactive substances, superoxide anion generation, and reduced glutathione levels. Hematoxylin–eosin (H&E) and periodic acid Schiff staining of renal samples was done to show histological changes. Glycerol-induced muscle damage was quantified by assaying creatine kinase (CK) levels in rat serum. Results: Administration of glycerol resulted in muscle damage as reflected by significant rise in CK levels in rats. Glycerol intoxication led kidney damage was reflected by significant change in renal biochemical parameters, renal oxidative stress and histological changes in rat kidneys. Administration of DADS attenuated glycerol-induced renal damage. Notably, pretreatment with bisphenol A diglycidyl ether, a PPAR-γ antagonist, abolished DADS renoprotection in rats. Conclusion: We conclude that DADS affords protection against glycerol-induced renal damage in rats. Moreover, PPAR-γ plays a key role in DADS-mediated renoprotective effect.
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Knowledge, attitude, and practice about mental health challenges among healthcare students of a private university p. 136
Muhammad Zahid Iqbal, Rahul Rathi, Sunil K Prajapati, Mavis S Zi Qing, Teh S Pheng, Heng Wei Kee, Mohd B Bahari, Sawri Rajan, Fahad I Al-Saikhan, Muhammad S Iqbal
Objective: The objective of this study was to evaluate the knowledge, attitude, and practice of healthcare students (Medicine, Pharmacy, and Dentistry) in a private university about mental health challenges (MHC). Materials and Methods: A research cross-sectional observational was conducted to evaluate the knowledge, attitude, and practice of students towards MHC at a private university in Malaysia. A validated questionnaire was distributed to 284 students studying in three different selected faculties, namely the Faculty of Medicine, Pharmacy, and Dentistry. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. Results: Upon evaluation of knowledge, male students were having less-adequate knowledge than females (P = 0.006). Malay students were having adequate knowledge than other races about MHC. Faculty of Medicine was having adequate knowledge than other faculties (P ≤ 0.001). Regarding attitude, the Faculty of Pharmacy students had the highest positive attitudes (P = 0.001). Final year students were having a more positive attitude than pre-final year students. For the evaluation of practice, the Faculty of Dentistry students had the lowest practice compared with other faculties. Conclusion: In conclusion, overall, good knowledge was seen among the students of the private medical university about MHC. The medical students had adequate knowledge when compared with other faculties in the university.
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Public knowledge, attitude, and perception toward conventional and novel ocular treatment in Malaysia p. 143
Siti Nabilah Abdullah, Awis Sukarni Mohmad Sabere
One of the major concerns in any pharmacological treatment is the patients’ adherence to medication. However, different types of ocular dosage forms might result in different response and compliance from the patients. This study investigated and compared public willingness on different types of dosage forms available for ocular treatment. The study also evaluated their willingness on new approach for the treatment based on their knowledge, attitude, and perception. This study was conducted between October and December 2017 through a set of questionnaires applied to 90 respondents between the age of 18 and 60 years who lived in Muar and Kuantan, Malaysia. The results were analyzed using SPSS software version 22.0 including inferential and descriptive statistics. There was no significant difference in the knowledge level between all age groups towards different types of dosage forms available; eye drops (P = 0.09), eye ointment (P = 0.252), medicated contact lens (P = 0.05), ocular mini-tablets (P = 0.06), and ocular inserts (P = 0.075). There is a variation of results among the public towards different types of dosage forms with their willingness to try conventional and novel approach. Eye drops show the highest willingness followed by eye ointment (less willingness). However, most of them showed no willingness towards medicated contact lens, ocular mini-tablets, and ocular insert. This research hopes to provide an overview on the development process of new formulation and dosage forms based on the patients’ willingness level in an attempt to increase patient compliance.
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Tamarindus indica fruit: Pharmacognostical standardization, detection of contaminant, and In Vitro antioxidant activity p. 148

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