International Journal of

Pharmaceutical and Clinical Research

e-ISSN: 0975 1556

p-ISSN 2820-2643

Peer Review Journal

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1. Study of Myeloperoxidase (MPO) as an Early Indicator of Metabolic Risks in Obese Children
Radwa G Helal, Hanaa H Ahmed, Ali Abdelaziz Ali, Amr S Megawer, Iman Kamel, Enas Raafat AbdelHamid
Abstract
Childhood obesity is associated with a state of chronic low-grade inflammation. It is a major risk factor for chronic diseases and metabolic syndrome risks. Myeloperoxidase (MPO) plays an important role in the initiation and progression of acute and chronic inflammatory diseases, suggesting a positive correlation between activation of MPO and metabolic disorders in obese children. The current study goaled to estimate serum MPO levels in obese children and to assess whether MPO is an early indicator for insulin resistance and consequently a predictor for metabolic syndrome in these children. Case-control study included 32 obese children aged 7–15 years compared to 32 normal weight matched age and sex children as control. Clinical examination for all children was done. Anthropometric as well as dietary intake were evaluated for all children. In addition, MPO, glucose, insulin, metabolic lipid parameters, Hb and C-reactive protein (CRP) were determined. MPO was significantly elevated in obese children and positively associated with obesity indices (BMI z-score) and metabolic lipid parameters. Also, MPO showed postitive correlation with such proinflammatory and cardiovascular risk biomarkers as CRP. Morover, higher MPO levels were associated with higher SBP and DBP in obese children. In conclusion, myeloperoxidase (MPO) is an early biomarker and indicator for inflammation associated with cardiovascular and metabolic risks in obese children.

Abstract Online: 10- August, 2016

2. Monitoring of Iodine Deficiency Disorders for South Sinai Children (IDD Monitoring in South Sinai)
Yamamah G A, Salah M M, E l Hussieny M S, Ibrahim M H
Abstract
The aim of this work was to monitor IDD in South Sinai through standard indicators. Background: Iodine deficiency disorders are major public health problems worldwide. Goiter prevalence in S. Sinai children accounted 13.6%. WHO described two main groups of indicators to monitor IDD control programs. The first is to monitor salt iodization process. The second group was through assessing median urinary iodine, goiter assessment and measurement of levels of thyroglobulin in school-age children. Methods: Through cross sectional study, we examined 1046 school children living at Ras Sidre district in S.Sinai. They were selected randomly to represent all population differences. All children were subjected for clinical thyroid volume assessment. Sub samples were selected for ultrasound thyroid examination, thyroid function status assessment, urinary iodine excretion evaluation and edible salt analysis for iodine content at household level. Results: The mean value of salt iodine was 29.88±6.16 ppm at household level. All samples’ levels were within accepted values. Goiter rate detected clinically was high. Goiter rate by U/S was 16.32%. UI deficiency was detected in 57.93% with different grades. More vulnerable groups were those of Urban origin, females and those aging ≥ 10 yrs (p<0.05). Thyroid function showed that serum T4 was below normal values for age in 32.43%, while serum Tg levels were higher than normal in 12.4% of examined subjects. Conclusions: We concluded that IDD are manifesting in spite of adequate salt iodations. IDD monitoring is essential for elimination of ID. Nutritional and pollutant evaluation for goitrogenic factors is essential.

Abstract Online: 10- August, 2016

3. In Silico Binding Affinity Study of Lisinopril and Captopril to I/D Intron 16 Variant of Angiotensin Converting Enzyme Protein
Wisnasari S, Rohman M S,  Lukitasari M
Abstract
ACE gene polymorphism is thought responsible to the difference of response to ACE inhibitor therapy in hypertensive patients. The inhibitory potency of ACE inhibitors are mainly determined by differences in the binding affinity. This study was conducted to investigate the inhibitory potency of lisinopril and captopril by analyzing the binding affinity of ACE protein to lisinopril and captopril in silico. Binding affinity was obtained from molecular docking using AutodockVina. Docking calculation showed lisinopril has the higher binding affinity to the C-domain than N-domain ACE, means that lisinopril was found to be more effective to inhibit D variant of ACE protein activity. In case of captopril, captopril showed the same binding affinity of captopril in both N- and C-domain (-6.1 kcal/mol). This result implied that captopril could bind to I and D variant of ACE protein with the same affinity. In conclusion, lisinopril and captopril apparently showed a difference inhibitory potency between I and D variant of ACE, as proven by calculated binding affinity.

Abstract Online: 10- August, 2016

4. Comparative Botanical Study and DNA Finger Printing of Certain Eugenia Species Growing in Egypt
Seham S El-Hawary, Kamilia F Taha, Shahira M Ezzat, Amira Y Eissa
Abstract
Objective: to discriminate between six Eugenia species growing in Egypt based on their micro-morphological and genetic characterization. Methods: For establishment of different botanical and genetic criteria, this study presents a comparative investigation of the botanical features of the leaves and stems through microscopically investigation of the prepared entire, transverse sections and isolated elements of these organs. Furthermore, the DNA of the six Eugenia species was extracted from leaf samples and Inter Simple Sequence Repeat (ISSR) analysis using six primers of arbitrary sequences. Results: Comparative botanical characters of the different organs were identified. On the other hand, the total number of amplified product was 68 fragments, which were generated by the six primers; the primer HB-09 recorded 55.5% as the highest percentage of polymorphism. As well as, the primer HB-44 recorded 54.5% polymorphism. The primer HB-15 recorded the lowest percentage of polymorphism (10%) and the highest degree of similarity (90%). Conclusion: For the present study, microscopical characters, as well as, DNA fingerprinting can be considered as the identifying parameters to authenticate and differentiate between the six Eugenia species under study.

Abstract Online: 10- August, 2016

5. Hypnotherapy Increasing Standard the Rapy Responses in Psychogenic Asthma Patient
Yusup Subagio Sutanto, Handono Kalim, Kusworini Handono, Aris Sudiyanto
Abstract
Asthma has negative effects in patient’s Quality of Life. Usually, asthma treatment is only depending on pharmacotherapy, but it is not easy to achieve controlled asthma stage. This study aims to evaluate the effectivity of hypnotherapy to increasing asthma control level with asthma standard therapy in both of uncontrolled or partial controlled psychogenic asthma patient. We observe 60 psychogenic asthma that divided into group A and group B. First, we evaluate asthma control levels for both of groups, then for group A, we give standard therapy and six sessions of hypnotherapy (for 6 weeks) continuing with reevaluation of asthma control level. Moreover, after 6 weeks we reevaluate asthma control level again. For group B, 6 weeks after the first evaluation, we reevaluate asthma control levels and continue to give standard therapy and six sessions of hypnotherapy (for 6 weeks) then evaluate asthma control level again. To evaluate variation of asthma control level variables, we use Friedman statistic test, then continue to Marginal Homogeneity statistic test. We found the higher asthma control level for both of groups after hypnotherapy that statistically significance. Group A (A1 vs A2; p= 0,001) and group B (B2 vs B3; p= 0,004). We found that age (p = 0,006), smoking history (p = 0,02), BMI (p = 0,026), allergen triggers (p = 0,027) is statistically significance influence asthma control level in this study where all of them have p value < 0,05. Hypnotherapy statistically significance to increasing asthma standard therapy response in psychogenic asthma patient.

Abstract Online: 10- August, 2016

6. Formulation, Evaluation and Antibacterial Properties of Novel Polyherbal Toothpaste for Oral Care
Mahendran Sekar, Noor Jasmin Shamsul Ariffin
Abstract
The demand for herbal based product such as toothpaste is high these days. Consumers believed by using herbal based toothpaste are safe, effective and less toxicity because less and only safe chemical used as compared to the synthetically produced toothpaste. Therefore, this study was aimed to formulate and evaluate new polyherbal toothpaste which containing herbal extracts that available in Malaysia to treat periodontal problem. The polyherbal toothpaste was formulated using three herbal extracts namely banana peel (Musa acuminate), guava leaves (Psidium guajava) and orange peel (Citrus arranticum) and tested against Staphylococcus aureus, Bacillus cereus, Escherichia coli and Pseudomonas aeruginosa with different concentrations varying from 100 mg/mL, 250 mg/mL and 500 mg/mL. The significant inhibition has seen against Staphylococcus aureus (12-18 mm) followed by Bacillus cereus (11-15 mm) and there is no inhibition for both Escherichia coli and Pseudomonas aeruginosa. The formulated toothpaste was also evaluated with the standard physiochemical parameters along with the antimicrobial activity. The formulated toothpaste showed potent inhibition against gram positive bacteria but not against gram negative bacteria.  Thereby, it opens a window for future study to enhance the ability of the toothpaste and to prove the efficacy and safety of the formulated toothpaste.

Abstract Online: 10- August, 2016

7. Recent Diagnostic Aids in Endodontics- A Review
Nivesh Krishna R, Pradeep S
Abstract
In the modern world, there are so many recent advances in diagnosis in Endodontics. It is enhanced by newer technologies. The style of this improvement is targeted towards increasing the objectivity sensitivity and reproducibility of the pulp tests while decreasing the patient’s discomfort. Methods like Pulse Oximetry, Laser Doppler Flowmetry, Ultrasound Doppler, Dual Wavelength Spectroscopy, Photoplethysmography are being developed and evolved to get adapted to the current clinical setting which may be of great use to the modern endodontist. These new methods fulfill the necessity of choosing the best tools for a good diagnosis. The aim of this review therefore was to assess the utility of some devices and techniques utilized in endodontic therapy to make the correct diagnosis.

Abstract Online: 10- August, 2016

8. Simvastatin: A Hopeful Promise for Treatment of Retinopathy and Neuropathy in Diabetic Patients
Azadi A, Mozafari N
Abstract
Diabetes, a metabolic disorder diagnosed by hyperglycemia, is as a result of defects in insulin secretion, insulin action, or both. The most common complication of diabetes is neuropathy, which happened for more than 50% of diabetic patients. Diabetic peripheral neuropathy (DPN) is a disorder diagnosed by demyelination, axonal atrophy, blunted regenerative potential, and loss of peripheral nerve fibers. The exact mechanism of this disorder is still unknown. Diabetic retinopathy (DR) is another major complication of diabetes which eventually causes blindness. The exact mechanism of this disorder has not been understood yet. According to past studies, activation of ERK in MAPK signaling pathway increases in DPN. As well as it was shown that increased expression of JNK leads to DR. Simvastatin as a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor has showed a beneficial effect on both DPN and DR. In this hypothesis, we propose that mechanism of simvastatin in DPN is decreasing phosphorylated ERK (pERK) via different ways and in DR is decreasing JNK via WNT signaling pathway.

Abstract Online: 10- August, 2016

9. Chemical Constituents of Garcinia mangostana Pulp and Seeds
Consolacion Y Ragasa, Theresa Joyce Tabin, Jo Madeleine Ann Reyes, Maria Carmen S. Tan, Chien-Chang Shen
Abstract
Chemical investigation of the dichloromethane extracts of the freeze-dried Garcinia mangostana Linn. led to the isolation of δ-tocotrienol (1), α-mangostin (2), 3-isomangostin (3), stigmasterol (4), triacylglycerols (5), a mixture of β-sitosteryl-3β-glucopyranoside-6¢-O-fatty acid esters (6a) and stigmasteryl-3β-glucopyranoside-6¢-O-fatty acid esters (6b) in about 3:2 ratio, from the pulp; and 4, 5, and linoleic acid (7) from the seeds.  The structure of 1 was elucidated by extensive 1D and 2D NMR spectroscopy.  The structures of 27 were identified by comparison of their NMR data with literature data.

Abstract Online: 10- August, 2016

10. Formulation, Evaluation and Antibacterial Properties of Herbal Ointment Containing Methanolic Extract of Clinacanthus nutans Leaves
Mahendran Sekar, Nurashikin Abdul Rashid
Abstract
Background: Clinacanthus nutans is known as Sabah Snake grass belongs to the family of Acanthaceae. The plant was traditionally used for the treatment of skin rashes, insects and snake bites, lesions caused by herpes simplex virus, gout and diabetes in Malaysia, Thailand, Indonesia and China. Staphylococcus aureus and Escherichia coli are the main pathogens that cause skin infections.  Clinacanthus nutans was also well known for antibacterial properties. Objective: The main objective of the present study was to apply this antibacterial potential in the preparation of ointment. Methods: The leaves of Clinacanthus nutans was extracted with 70% methanol by using soxhlet method. The methanolic extract of Clinacanthus nutans was investigated for qualitative phytochemical analysis and the ointment was formulated and evaluated using standard parameters. The antibacterial activity of the extract and ointment in different concentration were investigated by using two gram-positive bacteria (Staphylococcus aureus and Bacillus cereus) and two gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa) through disc diffusion method. Results: The qualitative analysis showed the presence of carbohydrates, steroids, glycoside, flavonoids, tannins, proteins and amino acids. The antibacterial potential of the formulated ointment was studied with three different concentrations (100, 250, 500 mg/mL. The ointment also showed significant antibacterial activity against all the tested organisms with zone of inhibition ranges from 8.00±2.00 to 18.67±2.09 mm. This activity was maintained when the extract was incorporated into the ointment base. The ointment was stable after two months. Conclusion: In future, the extract can be used for the commercial production of Clinacanthus nutans ointment. Similarly, this ointment can be tested for skin related bacterial infections.

Abstract Online: 10- August, 2016

11. Antidiabetic Activity of First Grade Orthodox Black Tea in Alloxan Induced Male Albino Mice
Dadan Rohdiana, DythaAndri Deswati, Ati Suharti, Hilman Maulana, Mimin Kusmiyati
Abstract
The present study was carried out to evaluate antiabetic activity of first grade orthodox black tea in alloxan induced white male mice. Generally, administered of first grade orthodox black tea infusion expected of PF, showed a better reduction toward blood glucose level as compared with normal control, distilled water.  On treatment with infusion of first grade orthodox black tea, the fasting mean blood glucose level on day 1 (after being diabetic) i.e. 92.00 ± 5.79 mg/dl reduce to 67.40 ± 17.11 mg/dl, 81.20 ± 20.77 mg/dl to 68.00 ± 18.40 mg/dl, 110.00 ± 8.34 mg/dl to 63.00 ± 15.66 mg/dl, 92.40 ± 5.50 mg/dl to 83.60 ± 3.65 mg/dl for BOP, BOPF, Dust and BP respectively. The reduction account for 26.74%, 16.26%, 42.73% and 9.62% respectively.

Abstract Online: 10- August, 2016

12. Chemical and Functional Characterization of Tunisian Artemisia absinthium Volatiles and Non-volatile Extracts Obtained by Supercritical Fluid Procedure
Faycel Sidaoui, Soued Belghith Igueld, Maha Yemmen, Faouk Mraihi, Danielle Barth, Malika Trabelsi-Ayadi, Jamila Kalthoum Cherif
Abstract
The main objective of the present work was to study the chemical composition of antioxidants (polyphenol, flavonoids), antimicrobial and antioxidant activities of Artemisia absinthium L. essential oil obtained by maceration and by supercritical carbon dioxide (SC-CO2). The SC-CO2 was explored at various pressure (10, 12, 18 and 20 MPa), and various size particle (0.25, 0.31, 0.56 and 1 mm) and at temperature of 40°C. The antioxidant activity of extracts was evaluated using 2, 2-diphenyl-l-picrylhydrazyl (DPPH), 2, 2’-azinobis- (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS). The tested plants were extracted with maceration in methanol and with supercritical CO2. Biologically, very sensitive effects of A. absinthium essential oil are found against Gram-positive bacteria (Listeria monocytogenes, Bacillus subtilis and Staphylococcus aureus), three Gram-negative bacteria (Campylobacter coli, campylobacter jejuni and campylobacter fetus). In all SFE assay, the highest yield (2.5%) was reached at 40°C, 18 MPa and 0.25 mm particle size. A total of 25 chemical compounds were successfully identified by GC-MS with β-thujone (8.307%) and α-Farnesene (7.537%) are the most abundant compounds. the major subclasses are monoterpenes oxygenated (19.02%) and hydrocarbures (33.755%) respectively. The results show that the leaves extracts obtained by maceration contain the highest antioxidant capacity with radical DPPH (5.26 µg/ml of Trolox). On the basis of the obtained results of antioxidant activity (IC50), Artemisia has a potential use as natural antioxidants due to their significant antioxidant activity. Their antiradical scavenging activity revealed a good relationship with the total phenolics content (r2 = 0.884) and with flavonoids content (r2 =0.999). The essential oils extracts of plants exhibited good activity against all microorganisms tested.

Abstract Online: 10- August, 2016

13. Oxidative and Chlorinative Stress in Children with Dengue Hemorrhagic Fever
Edi Hartoyo, Iskandar Thalib, Eko Suhartono, Ari Yunanto
Abstract
In this present study, we try to investigate the oxidative and chlorinative stress in children with Dengue Hemorrhagic Fever (DHF). The level of hydrogen peroxide (H2O2) and malondyaldehyde (MDA), myeloperoxidase (MPO) activity, and chlorinative index (CI), were measured in 61 confirmed dengue hemorrhagic (DHF) patients. Subjects were classified into 3 grades of DHF according to the Wold Health Organization (WHO) 1997  guidelines: grade I (DHF-1, n-22); grade II (DHF-2, n= 36); and grade III (DHF-3, n= 3). H2O2 and MDA level, and MPO activity were measured spectrophotometrically. CI was calculated by dividing the level of H2O2 and MPO activity.  The results shows that the levels of H2O2 and MDA, MPO activity, and CI significantly different between group. The all parameters that investigated in this present study seems more higher with the higher grade of DHF, except for MPO activity. From this result, it can be concluded that both oxidative and chlorinative stress pathways might be involved in the pathomechanism of DHF.

Abstract Online: 10- August, 2016

14. Analysis of Bioactive Compounds of Tribolium Castaneum and Evaluation of Anti-Bacterial Activity
Jenan mohammed ubaid, Haider Mashkoor Hussein, Imad Hadi Hameed
Abstract
The aims of this research were analysis of methanolic extract of bioactive compounds of Tribolium castaneum and evaluation of anti-bacterial activity against Streptococcus pneumonia, Pseudomonas eurogenosa, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis, Streptococcus pyogenes, Staphylococcus aureus, Streptococcus faecalis and Klebsiella pneumonia. GC-MS analysis of Tribolium castaneum revealed the existence of the Oxirane, [(hexadecyloxy)methyl], 5-Methyl-6-phenyltetrahydro-1,3-oxazine-2-thione, Cis,cis,cis-7,10,13-hexadecatrienal, Methyl N-cyclohexyl-3-phenylpropanimidate, Ethyl(1-adamantylamino)carbothioylcarbamate, (-)-Norephedine, 1-Dimethyl(pentafluorophenyl)silyloxycyclopentane, 2-Cyclopropyl-2-nitro-1-phenyl-ethanol, 3-Chloropropionic acid ,nonyl ester, Decane, 1-chloro, 2,5-Dimethylhexane-2,5-dihydroperoxide, Ethanamine, 2-(2,6-dimethylphenoxy)-N-methyl, D-(+)-Ribonic acidγ-lactone, Methanone, 1,3-dithian-2-ylphenyl, Cyclopentaneacetaldehyde, 2-formyl-3-methyl-α-methylene, Phenylethyl alcohol, 2,5-dihydroxy-α-methyl, 1-Hexadecanol, 3,6-Diazahomoadamantan-9-one Hydrazone, 3-Pyridinecarboxylic acid, 1,6-dihydro-4-hydroxy-2-methyl-6-α, Spiro[5.5]undecane-1,7-dione, 4-Cyclopropylcarbonyloxytridecane, Eicosanoic acid, phenylmethyl ester, 3,6-Dinitro-4-cyclohexene-1,2-dicarboxylic acid, 1-Propyl-3,6-diazahomoadamantan-9-ol, 2(1H)-Benzocyclooctenone , decahydro-4a-methyl-,trans, Heptanoic acid, 4,5-dimethoxy-2-nitrobenzyl ester, Phthalic acid, butyl undecyl ester, Pterin-6-carboxylic acid, 2(3H)-Naphthalenone ,4,4a,5,6,7,8-hexahydro-1-methoxy, Cis-9-hexadecenoic acid, 9,12-Octadecadienoic acid (Z,Z), Octadec-9-enoic acid, Methyl 18-fluoro-octadec-9-enoate, Dasycarpidan-1-methanol, acetate(ester), 3′,8,8′-Trimethoxy-3-piperidyl-2,2′-binaphthalene-1,1′,4,4’tetra. The results of anti-bacterial activity produced by Tribolium castaneum showed that the volatile compounds were highly effective to suppress the growth of Escherichia coli.

Abstract Online: 10- August, 2016

15. Periconceptional Folic Acid Usage Pattern in Malaysian Women
Fazlollah Keshavarzi, Choong Moon Ting, Wan Mun Yi, Noor Haliza Yusoff
Abstract
Aim: This study aims to determine the knowledge, attitude and practice of Malaysian women towards periconceptional folate supplementation in prevention of neural tube defects. Methods: The study group consisted of 400 Malaysian women attending their care at the Department of Obstetrics and Gynecology of Hospital Kuala Lumpur with a convenience sampling method. Data was collected by face to face interview, using a questionnaire, which included demographic details and knowledge, attitude and practice outcomes, to be filled with the assistance of the investigator. The data was analyzed by multiple logistic regression, Pearson’s correlation and percent ratios with the significance level of P < 0.05. Results: 88.3% of the respondents reported to have heard of folate, but only 8% were assessed with good knowledge. Majority (49.3%) were informed about folate by physicians or obstetricians; 42% expressed good perception towards folate use and only 11.8% were assessed to have good consumption practice. Educational level and household income are significantly predictive of good level of knowledge and practice. Higher educational qualification is also predictive of positive attitude towards folic acid use. Conclusion: Educational level and household income are significantly predictive of knowledge, attitude and practice levels as these outcomes are reflective of better pressure in health evaluation and quality of life. Good awareness regarding folate use is not necessarily associated with optimal consumption. Thorough and effective interventions are needed to improve folate consumption, and to prevent neural tube defects.

Abstract Online: 10- August, 2016

16. Analogue and Structure Based Drug Designing of Prenylated Flavonoid Derivatives as PKB/Akt1 Inhibitors
Neelamma M, Anuradha G H, Shravan Kumar Gunda
Abstract
The 3D-QSAR studies on prenylated flavonoid derivatives as PKB/Akt1 inhibitors were endeavored using CoMFA and CoMSIA studies. Internal and external validation techniques were investigated using leave-one-out, no-validation and cross-validation and bootstrapping. The CoMFA model predicted satisfactory correlation coefficient q2 value of 0.880 and conventional correlation coefficient r2 value of 0.973, while CoMSIA model predicted q2 value of 0.906 and r2 value of 0.991, inferring the important role of steric and electrostatic properties of candidate compounds. The models were graphically interpreted by using contour plots, which gave more accuracy into the structural requirements for increasing the biological activity of compounds and proved a strong basis for future rational drug design of more active inhibitors for cancer. The resulting CoMFA and CoMSIA contour map analysis were used to classify the structural features relevant to the biological activity in selected series of prenylated flavonoid derivatives. Molecular docking studies were also carried out for all 56 PKB/Akt1 inhibitors in the binding pocket of “Akt1 with AMP-PNP” (PDB id: 4EKK). The results revealed that these derivatives act as anti-cancer agents.

Abstract Online: 10- August, 2016

17. Prevalence and Severity of Possible Drug-Drug Interactions in the Inpatient Department of Internal Medicine
Ramam Sripada, S V Suresh Kumar, N Devanna, Kandula Ravindra Reddy
Abstract
Background: Drug-drug interactions became a major concern in clinical practice at present. The change in the effect of the object drug as a result of the co administration of the precipitant drug is known as a drug-drug interaction. In order to manage the complex and chronic diseases, multiple drug therapy became more common and thus drug-drug interactions became a major concern for both the patients and health care providers. Even today, research on drug-drug interactions was very limited in India. Hence in this study, we made an attempt to assess the prevalence and severity of possible drug-drug interactions in the inpatient department of internal medicine. Methods: The present study was a retrospective cross-sectional study. Case records of the in-patients of internal medicine from the medical records department were included and the records of the ambulatory patients were excluded from the study. All the collected cases were subjected to check for the drug-drug interactions by using the software MICROMEDEX 2.0. Results: During the study period, a total of 437 cases were screened for drug-drug interactions by using the software. Among them, 227 cases were observed with 675 possible drug-drug interactions and the prevalence was found to be 51.9%. Among the total cases observed with possible drug-drug interactions, 115 (50.7%) were found to be in males and 112 (49.3%) were found to be in females. The prevalence of possible drug-drug interactions in the elderly age group was found to be significantly higher than all the other age groups in our study. Among the 227 prescriptions, which were observed with possible drug-drug interactions, 131 (57.7%) were observed with major polypharmacy, 65 (28.6%) were observed with moderate polypharmacy and 31 (13.7%) were observed with minor polypharmacy. In our study, 6.8% of the interactions were of minor severity, 63.3% were of moderate severity and 29.9% were of major severity. Minor, moderate and major interactions are highly prevalent in the age group 61-70 years. Conclusion: According to our study, elderly patients were more prone to have more number of possible drug- drug interactions than other age groups because of the concurrent disease conditions and poly pharmacy. Based on the poly pharmacy classification, major poly pharmacy is the major factor for the chance of occurring drug-drug interactions. The severity of the majority of the interactions was found to be moderate in this department. By taking all the above aspects into consideration, clinical pharmacist should play a crucial role in the prevention and management of drug-drug interactions.

Abstract Online: 10- August, 2016

18. Identification of Risk Factors for Hypertension and Its Complications Among Hypertensive Adults Attending Medical OPD– A Hospital Based Case Control Study
J Vasantha Priya J, C Kanniammal
Abstract
Hypertension is one of the major public health problems and it is prevalent all over the world. It is a ‘silent killer’ as it is asymptomatic until its effects like Stroke, Myocardial Infarction, Renal dysfunction or visual problems are observed. So, the assessment on the risk factors which contribute more to development of blood pressure and the efforts at an early stage to control them will prevent the health hazards of Hypertension. The aim of the study was to identify the risk factors for Hypertension among patients attending Medicine OPD of Meenakshi Medical College and Hospitals (MMCH & RI) during January 2016. This study also evaluated the complications associated with hypertension. 100 consecutive Known hypertensive patients aged ≥40yrs were taken as cases. Another 100 age and sex matched non-hypertensive patients from the same OPD were taken as controls. Pretested questionnaire was applied to get the socio-demographic details and life style. Height, weight, BP and Hip Circumference were measured. Complications were assessed from the history and medical records. The analysis shows that family history of hypertension (OR=2.614, p-value=0.002) and Obesity (OR=1.833, p-value=0.040) are the major risk factors for hypertension. Among the complications, Coronary artery disease (OR=1.949, p-value=0.048) and Retinopathy (OR=2.111, p-value=0.015) are most commonly associated with hypertension. The positive family history and Obesity are the significant risk factors for hypertension. Coronary Artery Disease and Retinopathy are the most common complications of hypertension. Health education is to be given to the patients on the risk factors for hypertension and its prevention.

Abstract Online: 10- August, 2016

19. The Effect of Honey on Relieving Coughs in Elderly Patients Diagnosed with Chronic Obstructive Pulmonary Disease: A Clinical Trial
Zeynab Zare, Abbas Balouchi, Hosien Shahdadi, Esmat Bandadni
Abstract
Background and Objective: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of death in developing countries. The mortality rate resulting from COPD is rising. This article aims to study the effect of honey on relieving coughs in elderly patients diagnosed with COPD. Method and materials: A clinical study was performed on 38 patients (26 men and 12 women) aged 55-75 diagnosed with COPD referring to professor of pulmonary in Zabol, Iran in 2015. Convenience sampling method was employed in order to select the patients. The basic characteristics of patients were identical concerning age, gender, duration of disease, general health, and cardiopulmonary tests. The sample size was randomly divided into two groups (19 members in each group). The first group received honey and routine treatment three times a day and the third dose of honey was given two hours prior to sleep. The other group received routine treatment. Re-examination was carried out 72 hours after receiving the treatment. The severity of cough was studied during 24 hours a day. Data were analyzed using SPSS-21, Pearson correlation test, and Wilcoxon instability test. Results: The severity of coughs declined by 63.2% in 89.5% of cases in the group receiving honey and routine treatment compared to the group receiving routine treatment (P<0.03). Conclusion: The study showed that honey along with routine treatment relieves the cough in patients diagnosed with COPD.

Abstract Online: 10- August, 2016

20. Study of Phytochemical Screening, Physicochemical Analysis and Antimicrobial Activity of Bacopa monnieri (L) Extracts
Pawar S S, Jadhav M G, Deokar T G
Abstract
Bacopa monnieri (L) popularly known as Brahmi is an important nervine herb in an ayurvedic medicine. It belongs to the family Scrophulariaceae. It has been traditionally used as ethno medicine and is useful to treat anxiety, anger, insomnia, nerve pain, concentration difficulties and learning problems. It has also been used as a cardio tonic, digestive aid and improves respiratory function. It shows antioxidant, antiaging, antidepressant, anticancer and antibacterial activity. The present study was carried out to determine the phytochemical constituents and physicochemical values according to the pharmacopoeial method. The antimicrobial activity of Bacopa monnieri (L) was also investigated by using aqueous and methanolic extracts against two gram positive, two gram negative bacteria and two fungal organisms at 1.25 mg/ml, 2.5 mg/ml, 5 mg/ml and 10 mg/ml concentrations. The methanolic extractive value of Bacopa monnieri (L) (10.1%) was found highest followed by ethanol (8.6%), aqueous (7.6%), chloroform (2%), acetone (1.5%), dichloromethane (0.6%), ethyl acetate (0.5%) and petroleum ether (0.5%) extract. Phytochemical investigation of Bacopa monnieri (L) revealed the presence of various important secondary metabolites such as carbohydrates, proteins, amino acids, steroids, glycosides, flavonoids, alkaloids and tannins in methanolic, ethanolic and aqueous extracts. No activity was observed against bacterial strains like Staphylococus aureus, Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa when subjected to aqueous and methanolic extract of Bacopa monnieri (L). Methanolic extract showed significant antifungal activity against Candida albicans and Aspergillus niger at 2.5mg/ml and 1.25mg/ml concentrations.

Abstract Online: 10- August, 2016

21. Biological Investigations of a New Natural Recipe Expected to Promote Healing of Superficial Burns
Nasef M, Kadry H A, Ashour M A, Nassar S L, Selim N M, El-Raey M A
Abstract
Burns expose the deeper tissues of the skin or body to invasive microbes. Topical preparations for treating burn wounds, to be useful, should ideally have antibiotic power and promote healing by different mechanisms like their anti-inflammatory and antioxidant effects. Silver compounds have been the mainstay of topical burn treatment for decades. However, most chemical substances retard wound healing. Several natural agents such as honey and moist exposed burn ointment (β-sitosterol; MEBO ®) are believed to protect wounds from infection and promote healing of burns without causing any of the adverse effects of purified chemicals. In this study, we investigated the antimicrobial, anti-inflammatory and antioxidant characteristics of a new natural recipe expected to promote healing of superficial burns and also determined the safety of its topical pharmaceutical use. Moreover, we compared the healing properties of the recipe with the commercial drugs; silver sulphadiazine (SSD; Dermazin ®); a long-standing conventional burn dressing, and also with (β-sitosterol; MEBO ®); a herbal preparation of Chinese origin widely used in Asia and the Middle East. Biological investigations and trials had been made and conducted on experimental animals that were obtained from the animal house colony of National Research Centre, Dokki, Cairo, Egypt. All animals were kept on a standard laboratory diet and under the same hygienic and healthy conditions. They were acclimatized for two weeks in the laboratory in equal light and darkness periodicity, with liberal access to food and water. Animals were housed in separate hygienically maintained cages. For induction of superficial burns, one hundred and twenty adult male Murine albino rats weighing 130-150 g. were divided into four groups; each group consisted of 30 animals. They were housed in separate cages and received partial-thickness burn wounds on their dorsal skin in accordance to the Modified Murine model of partial thickness scald burn injury (A Standardized Model of Partial Thickness Scald Burns in Rats). Animals within each group were numbered then treated three times a day (t.i.d) with our new natural recipe, two times a day with (SSD; Dermazin ®), three times a day with (β-sitosterol; MEBO ®) in addition to three times a day treatment with a placebo plain gel (negative control). The burn wounds were visually inspected daily until day 14. It was found that animals in the first three groups were well preserved. No clinical infections occurred. Wound healing was at an advanced stage by the day 14 in all animals except the placebo group. Clinical examination showed that the three agents gave comparable protection and healing possibilities for the experimental animals. It is concluded that our new natural recipe is a suitable and efficacious alternative to conventional silver-based topical therapies and MEBO ® for treating partial-thickness burn wounds.

Abstract Online: 10- August, 2016

22. The Impact of Cadmium Exposure on Several Tooth Mineral Content
Diny Aulia Ratnasari, M. Rizal Surya Permana, Widodo, Yanuar Ichrom N, Nurdiana Dewi, Eko Suhartono
Abstract
The objectives of this study were to determine the impact of  cadmium (Cd) on several tooth mineral content. The tooth mineral content that investigated in this present study are calcium (Ca), Phosphate (P), magnesium (Mg),  and zinc (Zn). Teeth samples were taken from 25 human maxillary premolar-1 free of caries and defects. All the teeth samples were extracted in Dental Faculty, University of Lambung Mangkurat, Banjarmasin, South Kalimantan, Indonesia. Each of tooth sample was put in the water contained Cd in the form of cadmium sulphat (CdSO4) with concentration 1 mg/l for 96 hours. The mineral content of the tooth estimation were made from 0 hours and every 24 hour, so the teeth samples can be divided into 5 groups based on the time of Cd exposure (T1: 0 hours; T2: 24 hours; T3: 48 hours; T4: 72 hours; and T5: 96 hours). The results of this present study show that the administration of Cd led to a significant decrease of Ca, P, Mg, and Zn level in the tooth. The results suggest that Cd exposure can affect several mineral content in the tooth, including Ca, P, Mg, and Zn.

Abstract Online: 10- August, 2016

23. A Review on Published Pharmacoeconomic Studies in Southeast Asian Countries
Dwi Endarti, Susi Ari Kristina
Abstract
Objectives: This study concerned on an exploration regarding pharmacoeconomic studies in Southeast Asian countries from the published articles. Its aim was to describe the situation of pharmacoeconomic studies conducted in Southeast Asian countries from the published articles and explore a brief of the methodology applied in the studies. Methods: A literature search was conducted in September 2012 using the Medline electronic database with the PubMed interface. A combination of MeSH terms of  ‘cost analysis’, ‘healthcare’, and ‘southeast asia’ was employed. Limitation was set for articles published at last 10 years in English language. Results: Out of 306 records, 83 eligible articles were retrieved and reviewed. It was found that the studies had been conducted in eight of eleven countries in the region and one study conducted in the region accros-country. Thailand had the greatest number of publications (34), followed by Singapore (17). the number of articles regarding economic evaluation of healthcare-related in Southeast Asian countries increased over the time. The capacity of local researchers both in number and the role as first/correspondence author were more than researchers from outside. Most of the authors were affiliated with the university and hospital. Most of studies that revealed the funding source got the funding support from international sources. Pharmacoeconomic study methods mostly used were COI and CA (65%), while there was also a consideration number of the use of CEA (13%) and CUA (17%) in the studies. From the studies reviewed, infectious diseases and chronic diseases were the most issues on pharmacoeconomic studies in Southeast Asian countries. Conclusions: A review was conducted on publications focusing on pharmacoeconomic studies in Southeast Asian countries. Pharmacoeconomic study is gaining importance in policy decision making for the particular setting in Southeast Asian countries. A consideration number of pharmacoeconomic studies in Southeast Asian countries gives possibility of using the economic evidence  as well as the methodology to be used in other settings across the country.

Abstract Online: 10- August, 2016

24. Comparison of the Effects of Foot and Hand Reflexology Massages on Stress and Anxiety in Candidate Patients Undergoing Upper Gastrointestinal Endoscopy
Shima Shaermoghadam, Hosien Shahdadi, Ali Khorsandvakilzadeh, Mehdi Afshari, Mahin Badakhsh
Abstract
Background and Objective: gastrointestinal diseases are common disorders and endoscopy is the most important diagnostic method for these disorders. Due to the aggressiveness, endoscopy causes stress and anxiety in patients. Stress and anxiety prior to endoscopy reduced willingness of the patients to undergo endoscopy and increased the time of endoscopy. The present study aimed to compare the effects of hand and foot reflexology massages on stress and anxiety in candidate patients undergoing upper gastrointestinal endoscopy. Materials and Methods: This study was designed as a single-blind randomized controlled clinical trial. Endoscopy was performed on 95 patients. Hand and foot reflexology massages were performed for 20 minutes prior to endoscopy in intervention groups. Stress and anxiety levels prior to intervention and immediately prior to endoscopy were measured in the three groups. Depression Anxiety Stress Scales (DASS‐21) was used to collect the required data. Results: The results showed a statistically significant difference between intervention and control groups in terms of demographic variables prior to intervention (p>0.05). A significant reduction was observed in mean and standard deviation of stress and anxiety in hand and foot reflexology massage groups (n=30) compared to control (n=35) before intervention and immediately prior to endoscopy (p<0.0001). Conclusion: Implementation of reflexology massage in the patients undergoing endoscopy can reduce stress and anxiety prior to this diagnostic method. Thus, either hand reflexology massage or foot reflexology massage (a non-pharmacological, low-cost and unaggressive method) was used to reduce stress and anxiety of the patients before performing aggressive diagnostic procedures by taking into account willingness of the patients according to similar effect of hand and foot reflexology massages.

Abstract Online: 10- August, 2016

25. Oral Administration of Decitabine Nanoparticles Effectively Suppresses Nmu-Induced Leukaemia In Sprague-Dawley Rats And Arrests K562 Cells In S-Phase
Jain P, Tiwari M, Kumar N, Chonkar A, Rao J V, Udupa N
Abstract
Oral delivery of anticancer drugs has been an important topic of research in medicine for a decade. Unfortunately, most of the anticancer drugs, either old or novel, with high therapeutic efficacy, do not realize their full potential in the market. The epigenetic drug, decitabine (DEC), is one such potent hypomethylating agent, but its effect is temporary. The main reason is low oral bioavailability due to the gastrointestinal (GI) drug barrier and other instabilities. Therefore, it is commercially available as i.v. infusion to be used in hospital settings. We aimed to design and fabricate decitabine loaded PLGA nanoparticles (DEC-NPs) for potential oral delivery of DEC. The DEC-NPs were characterized by particle size, zeta potential, differential scanning calorimetry (DSC), X-ray diffraction (XRD), scanning electron microscopy (SEM), and in vitro, ex-vivo and in vivo release studies. The efficacy of DEC-NPs was investigated in vitro in leukaemia cells, K562, and in vivo by NMU induced leukaemia model of male Sprague Dawley rats. The antiproliferative effect of DEC-NPs was significantly enhanced (p < 0.05) over DEC in K562 cells with a significantly prolonged (p < 0.05) cell cycle arrest in the S-phase. Upon oral administration, the WBC count was significantly reduced (p < 0.05) by DEC-NPs in rats compared to plain drug. The studies suggested that DEC-NPs have high potential for effective oral delivery of decitabine.

Abstract Online: 10- August, 2016

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