Research in Pharmacy and Health Sciences

ISSN: 2455 5258
An International Peer Review Journal

Volume 2, Issue 3: July 2016 – September 2016

1. Management of Superficial Mycotic Infections: A Review
Anu Anto, Bincy CM*, Mincy C Das, Babitha M
Superficial mycotic infections of  skin and nails are  the most common diseases seen in our daily practice and the main causative groups are dermatophytes, yeasts and moulds. The degree of immunosuppression and the number of immunosuppressed patients are increasing at an unprecendented pace, hence the management of dermatophytoses will be a challenge to mankind in the years to come.The increasing number of antifungal agents, reformulations of existing agents and novel treatment strategies have all improved the management of fungal infections, but still the infections are associated with high mortality. Currently, topical azoles and allylamines are used for the treatment of Cutaneous mycoses with disadvantages like long duration of therapy, which leads to poor compliance and a high relapse rate. Assessment of efficacy, Quality of life (QOL) and Medication adherence are important issues in all areas of clinical medicine, including dermatology. Here the clinical efficacy was assessed based on signs and symptoms severity score and global clinical response, Dermatology life quality by Finlay and Khan’s 10 question Dermatology Life Quality Index (DLQI) and adherence by medication adherence questionnnaire. Both Terbinafine (250–500 mg/day for 2–6 weeks) and Itraconazole (100–200 mg/day for 2–4 weeks) appear to be effective for limited disease (tinea corporis/cruris/pedis). However, an appropriate dose and duration of administration which can produce mycologic cure and prevent recurrence remains elusive. This review also highlights the huge research gaps in the management of cutaneous dermatophytosis which need to be plugged to provide better and effective care to the patients.

2. Dapagliflozin: A new class of drug in the treatment of Type 2 diabetes    
N. Surendra Reddy*, P. Lakshmi, G. Divya, T. S. Durga Prasad, D. Ranganayakulu
Sodium-glucose co-transporter (SGLT) inhibitors are a new group of oral medications used for treating type 2 diabetes. Dapagliflozin was approved in January 8th, 2014 and is the second selective inhibitor of the sodium-glucose co-transporter 2 (SGLT2) to be marketed in the US. It is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 Diabetes Mellitus (T2DM).It is available 5mg and 10 mg in film coated tablets. It acts by inhibiting SGLT2 decreases plasma glucose by increasing urinary glucose excretion. The common adverse reactions are genital mycotic infection, nasopharyngitis, urinary tract infections, back pain, urination increase, nausea, influenza. It is contraindicated in hypertension, renal impairment, hypoglycemia, genital myotic infections and bladder cancer.

3. A Comparative Study of Thrombolytics Used for The Treatment of STEMI in a South Indian Tertiary Care Hospital
Adhin Antony Xavier*1, Raga Chandana1, Aleem Sarwar1, C K Dhanapal1, S Sudarshan2
Background: ST segment elevated myocardial infarction is the most common cause of mortality and morbidity in worldwide; it occurs when thrombus formation results in complete occlusion of major epicardial vessel, thrombolytics was the first choice of treatment for STEMI along with other supporting therapies. Objective: To compare safety and efficacy of thrombolytics Streptokinase, Tenecteplase and Reteplase for the treatment of STEMI. Methodology: This is a prospective observational study conducted for a period of 6 months (November 2014 to May 2015) in RMMCH, Chidambaram. A total of 90 cases were collected. Study consist of three groups, group-1 (receiving streptokinase), group-2 (receiving Reteplase) and group 3 (receiving tenecteplase). Relevant data was obtained from case sheets before and after lysis and analyzed. Result: The study identified all three fibrinolytic drugs to be efficacious in causing > 50% resolution in ST segment, symptoms relief. Safety parameters were found to be fair in Reteplase group where no side effect was observed. Hypotension and cardiovascular arrest was observed in Streptokinase and Tenecteplase respectively. Efficacy was found to be high in Reteplase group with 93% of STEMI resolution and 93% of symptomatic relief where 83 % and 90% in tenecteplase and 83% and 86% in streptokinase groups. One death was reported in streptokinase and tenecteplase group respectively. Conclusion: Reteplase was found to be most safest and efficacious drug followed by tenecteplase and streptokinase.

4. Basic Phytochemical Study and Evaluation of Antidandruff Potencial of Fruit Juices of Citrus Limon.  L
Deepa Sreekanth1* and Sreekanth Sudhan Kaithavalappil2
This study investigates the scientific proof for phytochemical composition and also the proof of antidandruff activity. Screening of phytoconstituents was carried out on the juice concentrates using established procedures. The anti-dandruff activity was carried out by Agar Well Diffusion Assay method against Malassezia furfur, which is the organism responsible for dandruff. The result of antidandruff activity revealed that juice concentrates of the fruits of citrus lemon (10 mg extract/mL) exhibited highly significant antifungal activity against Malassezia furfur. The results of Minimum inhibitory concentration (MIC) study reveal that the extract possesses anti-dandruff activity above the concentration of 0.1%w/v. The results of MIC study revealed that the extract possesses anti-dandruff activity in a concentration-dependent manner against the test organism and were comparable to the standard drug.

5. Incidence of Intravenous Medication Errors in a South Indian Tertiary Care Hospital  
Vinitha Kandala*, Tejaswini Pisati, Nagasri Bandari, Mehraj Fatima
Background: The use of medications in the hospital is a complex process which is dependent on the successful interaction of the health care professionals. Intravenous medication errors are one such which compromise patient confidence in the health-care system, increase health-care costs and has high incidence but limited evidence. Objective: The study reports the incidence of intravenous errors in preparation and administration. Specifically, the study was done to explore and measure the frequency of IV medication errors by direct observation and identify clues to their causes. Methodology:  The study design is a prospective observational study which enrolls patients given intravenous therapy in the department of general medicine and ICUs in a tertiary care hospital. Error categories were categorized and error rate of drug classes was measured. Results: In a period of 6 months, 161 (N) samples were observed. Five error types (improper aseptic conditions, wrong diluents, improper mixing, wrong dose/volume, and wrong time) accounted for 78.88% of errors. Improper aseptic conditions were the most frequent and accounted for 39.13%. The least type of errors was wrong dose errors-7.45%. The other categories wrong diluents, improper mixing and wrong time accounted for 9.93%.10.55% 13.04% respectively. Conclusion: This study found a high rate of intravenous medication errors of moderate significance. Changes in practice should be considered to make intravenous therapy safer for patients. The findings of this study suggest that it is necessary to engage pharmacists in IV dose preparation and administration.

6. Drug Delivery System in Pakistan: A Review
Shumaila Arshad*, Ali Aun, Muhammad Uzair Yousaf
Drug Delivery systems are the means by which drug molecules are delivered to sites of action within the body.There are several pharmaceutical dosage forms (delivery Systems) available in Pakistan that is being used in different health care centers. Both conventional and advance dosage forms are used now days depending upon the condition of the patient, the disease state and available resources. But unfortunately Pakistan is a way behind in the field of technology among the other developing and developed countries in the world. There are few private setups which are well equipped with high class technology that caters the need of advanced drug delivery system in Pakistan. Mostly advanced drug dosage forms are imported from the other countries, thus it costs Pakistan a lot. In the present study Drug Delivery Systems in Pakistan is thoroughly studied and represented according to the generations of drug delivery system.

7. Specific Poisons in Pakistan: A Mini Review   
Shumaila Arshad*, Farah Abid, Hafiza Amina Aziz, Raffia Anjum, Iram Nadeem
Poisoning either results from intentional or unintentional exposures, recreational drug use, and therapeutic use of drugs or other agents. Although mortality and serious morbidity in poisonings are uncommon, patients requiring hospitalization often require intensive care. The appropriate management of poisoned patients should improve outcome and decrease complications. Some specific poisons in Pakistan are pesticides, hydrocarbons, iron, insecticides, benzodiazepines, organophosphates etc.

8. A review on Madhuca longifolia
Ashish Kumar*
Since the beginning of human civilization, medicinal plants have been used by mankind for its therapeutic value. Madhuca longifolia (Family: Sapotaceae), is an Indian tropical tree found largely in the central and north Indian plains and forests. Its common or trade name is Mahwa or Mahua. Various parts of Madhuca longifolia has been used traditionally for different ethnomedicinal purposes. This review enlists the contributions of various scientists on Madhuca longifolia under different sections like ethnomedicinal activity, pharmacological activity, toxicological activity, phytochemistry, insecticidal & pesticidal activity, antimicrobial activity, ethnobotany, clinical studies, miscellaneous, pharmacognosy, analytical and processing techniques, biochemistry and agronomy. This review will provide a path to the researchers to explore the therapeutic potentials of Madhuca lngifolia.

9. The Unregistered Drugs Coverage in the Media in Malaysia: Content Analysis of the Public Newspapers
Nur Wahida Zulkifli1*, Noorizan Abd. Aziz1, Yahaya Hassan1, Mohamed Azmi Hassali2, Nur Liyana Zainal Bahrin1
Newspaper is the most common media that can be used as a reference to know the current issues that happened in the countries. Also, there are a lot of articles about unregistered drugs published in newspapers in Malaysia. The purpose of this research to explore the content of the unregistered drugs in Malaysia based on the interviewee statements in the articles or news in the selected newspapers. The two most popular newspapers online available chosen (Kosmo and Utusan Malaysia newspaper online). About 56 articles identified for the year 2000 until 2014. The selected data was analysed using content analysis method. The production of unregistered drugs articles are increasing trend since 2000 until 2014. The findings from the content analysis indicate that majority of the articles are finally sub-categorized to certain themes which are, contributing factors, the impact of unregistered drugs and management of the unregistered drugs. The limited of references in this scope made these findings as benchmark findings. This findings used as the problem statement in designing research for the future to combat unregistered drugs in order to achieve authorities’ aims which are to provide the quality, safety and effective pharmaceutical products to the public.

10. National Primary Care Pharmacist Job Satisfaction System at MOH in Saudi Arabia
Yousef Ahmed Alomi
The National Primary Care Pharmacist Job Satisfactions at Ministry of Health founded in Saudi Arabia. It is a part of the pharmaceutical care strategic plan of General Administration of Pharmaceutical Care. There is no literature existed about primary care pharmacist job satisfaction and job satisfaction in the specialized clinical pharmacy at primary care centers. The survey consisted of ten elements of job satisfaction factors, and the primary care pharmacist should fill it annually. The system assesses the implementation of pharmacy strategic plan, improve primary care pharmaceutical care, and stop turnover rate quitting of primary care pharmacist jobs.

11. A Comparative Study of Quality on Conventional Paracetamol Tablets Available in Pakistan
Muhammad Saquib Qureshi*1, Gul Rukh2, Pooja Deepak Kirplani3, Asiya Farheen4, Madhia Hamid5
Background: Paracetamol (Acetaminophen) is used as over the counter (OTC) medicine for relief of pain and fever. Paracetamol is available in different brands in Pakistani pharmaceutical market. Objective: To assure the quality control parameters of different brands of paracetamol in Pakistan. Methodology: The pharmaceutical and chemical equivalence of five brands of paracetamol were assessed. For ethical concerns, the brands were coded as PRC-1, PRC-2, PRC-3, PRC-4 and PRC-5. Study was conducted in quality control laboratory of Adamjee Pharmaceuticals during December 2015 to February2016. Identification, physical characteristics, thickness, diameter, weight variation, hardness, disintegration time, percent label claim (Assay) and dissolution rate were calculated for each brand using monographs of British Pharmacopeia and United States Pharmacopeia. Results: Identification, physical characteristics, thickness, diameter, weight variation, hardness, and disintegration time, percent label claim (Assay), and dissolution ratewere calculated for each brand and the results were within the specifications provided by British Pharmacopeia and United States Pharmacopeia. Conclusion: All the brands selected in the study showed results within the limits assuring quality standards of manufacturing.

12. Health Care System in Pakistan: A review
Shumaila Arshad*, Hira Waris, Maria Ismail, Ayesha Naseer
Health systems are expected to serve the population needs in an effective, efficient and equitable manner. The factors determining the health behaviors may be seen in various contexts physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behavior of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioral health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population. The paper reviews the health care providers, the national policies emphasizing health services as well as health care systems in Pakistan and the role of the pharmacist in health care system of Pakistan, health and economics of Pakistan and current budgeting policies and the importance of non government organizations in health care system of Pakistan.

13. Identification and Characterization of Metabolites of Irinotecan in-vivo and in-vitro matrixes by HPLC/LC-MS
Nidhi Srivastava*1, Vishal Dubey1, Madhumita Sengar1, Rastogi Sameer2
In the present study metabolite identification and characterization has done by using HPLC and LC-MS. During method development various mobile phases have tried for identification of metabolites. The matrixes selected for in- vivo study were urine because nearly all the metabolites of irinotecan were obtained in it. The extraction mixtures have selected to retain maximum amount of analyte with less effort. During experiment four extraction solvents were used in six different concentrations out of which TBME suit our method. In-vitro study done by Human Liver microsomes by using Phosphate buffer (pH 7.4) and NADPH as co-factors for initiation of enzymatic reaction. Irinotecan is a prodrug that is converted in the liver to an active metabolite, SN-38. It is eliminate in Bile and Faeces and thus its dose reduced in Hepatic Failure. Irinotecan act by inhibiting Topoisomerase-1.It is the enzyme which nicks, introduces negative supercoils and reseals the DNA strand.  Conventionally, drug metabolite identification in the past has usually been based on the comparison of ultraviolet (UV) spectral data and high-performance liquid chromatography (HPLC) retention times of isolated ‘unknown’ metabolites with those of synthesised standards. Such a method of detecting and characterising drug metabolites is an uncertain, time-consuming and expensive process, as well as affording very limited structural information. Furthermore, Phase I metabolism of a drug candidate often results in only minor structural modification of the parent compound; these minor changes can make it particularly difficult to determine suitable chromatographic conditions to effect HPLC separation of metabolites. This study describes contemporary approach to identification and characterization of xenobiotic metabolites in complex biological fluids derived from drug metabolism studies.

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