Universal Journal of Pharmaceutical Research
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THE ANTICOAGULATION STRATEGIES FOR MANAGEMENT AND PREVENTION OF STROKE IN NEUROLOGICAL PRACTICE
Get PDFStrokes are categorized as either ischemic or hemorrhagic and the specific interventions will be based on the type of stroke. About 13% of stroke is hemorrhagic and 87% is ischemic. Transient Ischemic Attacks require emergency intervention to decrease the threat of stroke, which is thought to be maximum within the first few days after TIA. Anticoagulants play a major role in the primary and secondary prevention of ischemic strokes.
The optimal timing of anticoagulants initiation or resumption inpreventing and managing ischemic strokes is very important. This article will explore certain controversies surrounding this issue, while also highlighting the benefits of antithrombotic therapy used in prevention of ischemic strokes in antiphospholipid antibody syndrome (APS), atrial fibrillation, prosthetic heart valve, cancer, and vascular disorders. Aggressive local and regional efforts to organize stroke care and greater use of evidence-based recommendations may help improve outcomes.
Peer Review History:
Received 16 May 2024; Reviewed 11 July 2024; Accepted 24 August; Available online 15 September 2024
Academic Editor: Essam Mohamed Eissa, Beni-Suef University, Egypt, [email protected]
Reviewers:
Taha A.I. El Bassossy, Medicinal and Aromatic Plants Department, Desert Research Center, Cairo, Egypt, [email protected]
Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected]
PREVALENCE OF BLATEM, BLASHV, AND BLACTX-M GENES AMONG ESBL-PRODUCING ESCHERICHIA COLI ISOLATED FROM THE BLOOD SAMPLES OF ICUS PATIENTS OF UNIVERSITY HOSPITALS IN SANA'A CITY, YEMEN
Get PDFAim and Objective: With the emergence of organisms such as Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL), which are resistant to multiple medications (multidrug-resistance), concerns about how best to treat infections have significantly increased. The current study examined the molecular features of ESBL in clinical isolates of Escherichia coli that resulted in bloodstream infections as well as the pattern of antibiotic resistance to gather useful data on the infection's epidemiology among Yemeni ICU patients.
Subjects and methods: A cross-sectional study was conducted on sepsis patients admitted in intensive care units at four hospitals in Sana'a, Yemen, between January, 2021 and April, 2022. Blood cultures were used on patients suspected of having sepsis. Standard laboratory procedures were then used to isolate and identify possible bacterial infections, and the disk diffusion method was used to test for microbial susceptibility. All strains were tested for Extended Spectrum Beta-Lactamase (ESBL) production using the Modified Double Disc Synergy Test (MDDST). Following analysis, polymerase chain reaction, β-lactamase genes (blaTEM, blaSHV, and blaCTX-M) were identified.
Results: The results of the conventional PCR experiment revealed that 33.3% of the blaCTX-M genes, 0.0% of blaSHV, and 100% of blaTEM were present in the strains of ESBL-producing E. coli that were collected. It was discovered that the E. coli isolates' patterns of antibiotic resistance to 23 different antibiotics differed greatly. The bulk of the E. coli isolates were found to be multi-drug resistant (MDR). Furthermore, MDR characteristics were observed in 85% of E. coli isolates.
Conclusion: Control and surveillance of antibiotic resistance depend on an understanding of the resistance genes and patterns of antimicrobial resistance of bacterial pathogens within a given geographic area. The current study's findings showed that MDR was very common. According to the current study's findings, TEM was significantly more common than other ESBL gene types.
Peer Review History:
Received: 6 October 2023; Revised: 7 November; Accepted: 28 December; Available online: 15 January 2024
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Dr. Rola Jadallah, Arab American University, Palestine, [email protected]
Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, [email protected]
THERAPEUTIC EVALUATION OF CENTELLA ASIATICA MACERATE ON SURGICAL COMPLICATIONS OF OVARIOHYSTERECTOMY IN THE BITCH
Get PDFBackground and objectives: The management of post-operative complications such as severe inflammatory reactions, suture dehiscence and abdominal hernia in farm animals calls for a variety of practices, including the use of plant resources. The aim of this study is to explore practices for managing surgical complications in bitches and the healing properties of Centella asiatica.
Methods: Discussions were organised with bitch owners about the practice of ovariohysterectomy and its importance for the well-being of the animals. The harvested plant was then prepared and the resulting crushed material was macerated, followed by the addition of drinking water. The subjects were divided into two batches of 6 animals: the control batch (batch 1) and the extract batch (batch 2). Before applying the macerate, the wounds were cleaned with distilled water and then an absorbent paper towel was used to dry them.
Results : Application of C. asiatica macerate to post-operative wounds in female dogs showed good clinical applicability, with anti-inflammatory and wound-healing accelerating activity. The therapeutic potential of the plant is thought to be attributable to its most important bioactive components.
Conclusion : The study argues that C. asiatica could be a better alternative for surgical wound closure, helping breeders to minimize intervention costs.
Peer Review History:
Received: 5 October 2023; Revised: 8 November; Accepted: 25 December; Available online: 15 January 2024
Academic Editor: Dr. Emmanuel O. Olorunsola, Department of Pharmaceutics & Pharmaceutical Technology, University of Uyo, Nigeria, [email protected]
Reviewers:
Dr. Adebayo Gege Grace Iyabo, University of Ibadan, Nigeria, [email protected]
Dr. Alfonso Alexander Aguileral, University of Veracruz, Mexico, [email protected]
ANALYSIS OF HARDWARE REMOVAL IN MAXILLOFACIAL TRAUMA: A RETROSPECTIVE STUDY IN A MILITARY HOSPITAL IN SANA'A, YEMEN
Get PDFBackground and objective: Dental trauma is a significant problem for total dental health in terms of expenses, frequency, and age (young patients). Collaboration between various professionals, including oral surgeons, maxillofacial surgeons, dentists, orthodontists, and periodontists, frequently results in the treatment process. Surgical treatment may entail placing plates for fractures and shattered bones for long or permanent periods, and may require their removal for many reasons. Therefore, this study sought to ascertain the reasons for plate removal in individuals referred to the Department of Oral and Maxillofacial Surgery at Military Hospital in Sana'a, Yemen during a period of 3 years.
Method: The study included 57 Yemeni patients who visited the Department of Oral and Maxillofacial Surgery at the Military Hospital in Sana’a during the period 2021-2023. Cases of hardware removal were extracted from the medical records to include sex, age, medical history, accident history, type of fracture, primary complaint, period from the date of the first operation, approach to the operation, tooth in the fracture line, and extracted tooth.
Results: Gunshot injuries (40.4%) and explosive injuries (31.6%) were the most common causes of maxillofacial fractures. Mandibular fractures (68.4%) were the most frequent, followed by orbital and zygomatic fractures (12.3% each). The main reason for hardware removal was infections (29.8%), followed by patient preference (22.8%) and visible exposed hardware (15.8%). Mini-plates (68.4%) were the most commonly removed hardware, and the extra-oral approach (56.1%) was the most frequently used for removal. There was a significant association between orbital fractures and the incidence of positive discharge, as well as between reconstructive plates and the incidence of positive discharge. Longer plate usage, exceeding 24 months, increased the probability of positive discharge. Tooth involvement and extraction were minimal.
Conclusion: Gunshot and explosive injuries were the main causes of maxillofacial fractures, while infections, patient preferences, visible exposed devices, and pain and discomfort were the main reasons for removal of devices. Mandibular fractures were the most common and orbital fractures carry a higher risk of infection, while small plates have shown lower rates of infection. Prolonged panel use beyond 24 months increased the probability of positive discharge.
Peer Review History:
Received: 5 October 2023; Revised: 11 November; Accepted: 28 December; Available online: 15 January 2024
Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, [email protected]
Reviewers:
Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected]
Dr. Hasniza Zaman Huri, University of Malaya Medical Centre, Kuala Lumpur, [email protected]
IN-VIVO ANTIDIABETIC POTENTIALS AND TOXICOLOGICAL EFFECT OF DENNETTIA TRIPETALA SEEDS ON ALLOXAN-INDUCED DIABETIC MALE ALBINO RATS
Get PDFBackground: Hyperglycemia and dyslipidemia are hallmarks of diabetes mellitus. Diabetes mellitus is a complex metabolic disorder characterized by disturbances in carbohydrates, protein, and lipid metabolism due to insufficient insulin production.
Aim: Present study was aimed to estimate the effects of Dennettia tripetala seed methanol extract (DTSE) on blood sugar and toxicological effect in alloxan-induced diabetes models using male wistar rats.
Methods: A total of thirty (30) male albino rats were divided into six distinct groups. Group A served as normal control group, where rats were neither induced nor treated. Group B acted as the negative control group, where rats were induced but not treated. Group C served as the positive control group, where rats were induced and treated with glibenclamide. Group D consisted of rats that were induced and treated with 100 mg of DTSE. Group E included rats that were induced and treated with 200 mg of DTSE. Lastly, group F comprised rats that were induced and treated with 400 mg of DTSE. Liver and kidney functions were determined using established analytical procedures. Blood samples were collected through ocular puncture for the evaluation of biochemical parameters.
Results: Blood glucose level in all the alloxan-induced diabetic rats treated with DTSE showed a relative significant (p<0.05) reduction when compared with the controls. Histological investigation of diabetic rat’s liver and kidney indicated degradation of normal tissue architecture, however after the treatment with DTSE minor reparative alteration were seen.
Conclusions: The study suggests that DTSE possesses a hypoglycemic effect, hepatoprotective and anti-atherogenic effect but has toxicological effect on the kidney of the rats treated with high dose of DTSE as pathological changes were elicited in the organ of the rats.
Peer Review History:
Received 6 February 2024; Revised 9 March 2024; Accepted 20 April; Available online 15 May 2024
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, [email protected]
Dr. Sangeetha Arullappan, Universiti Tunku Abdul Rahman, Malaysia, [email protected]
Mayada M. El-Azab, Phytochemistry Unit, Department of Medicinal and Aromatic Plants, Desert Research Center, Cairo, Egypt. [email protected]
ANTIOXIDANT, ANTI-INFLAMMATORY, ANTIDIABETIC, ANTHELMINTHIC, AND THROMBOLYTIC ACTIVITY OF THE METHANOL EXTRACT OF CITRULLUS LANATUS PEEL
Get PDFBackground: The present study aimed for in vitro evaluation of Citrullus lanatus Peel (CLP) methanol extract for antioxidative, anti-inflammatory, antidiabetic, anthelmintic, and thrombolytic activity.
Method: CLP was extracted with methanol and tested for in vitro antioxidative (DPPH and H2O2 scavenging method), thrombolytic, anthelmintic, antidiabetic, and anti-inflammatory properties (human red blood cell membrane stabilization method, α-amylase inhibitory effect by using Iodine-Starch method.
Results: The percentage yield was 7% and phytochemical profile showed the presence of steroid, tannins, saponins, flavonoids, glycoside and reducing sugar. In DPPH scavenging assay, 88.7% was at 1000 g/ml, whereas 34% to 48.9% (IC50 27.65 µg/ml) in H2O2 and from 61.8% to 95.2% (IC50 value: 07 µg/ml) in ASCOR. In in vitro anti-inflammatory activity, the maximum protection percentage was observed 58% and 44%. Consecutively, in anti-diabetic activity, IC50 values of 1137.64 μg/ml whereas reference (Acarbose) exhibited IC50 at 671.71 μg/ml. On the other hand, the inhibitory effect of Acarbose showed 57% and 98% respectively at 2000 μg/ml. In earthworms, it considered as very potential for the helminthic infection and helminthiasis. A significant clot lysis activity of 44% was noticed when the clots were treated with 100 µl of CLP extract (10 mg/ml) in in-vitro thrombolytic activity assay.
Conclusions: The findings of this study revealed that the peel possessed the antioxidant, anti-inflammatory, antidiabetic, anthelminthic and thrombolytic activities. These findings will be motivated to do further research on molecular level to finds into more depth which is considered as the limitation of this study.
Peer Review History:
Received 3 February 2024; Revised 12 March 2024; Accepted 20 April; Available online 15 May 2024
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, [email protected]
Dr. Francis Adou Yapo, Felix Houphouet Boigny, University of Abidjan, Ivory Coast, [email protected]
PERIPHERAL BLOOD COUNT RECOVERY TIME COURSE DURING INDUCTION TREATMENT FOR ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILDREN
Get PDFBackground: In recent years, the survival rate of pediatric ALL patients has increased to almost 90%, particularly for individuals with favorable prognoses. This success is mostly attributable to the use of risk-adapted medication, enhanced supportive care, and adjustments to therapy based on each patient's unique pharmacodynamics and pharmacogenomics. This research investigates ALL patients' response to induction chemotherapy, focusing on changes in peripheral blood cell counts and hematological markers, to predict therapeutic outcomes and provide a practical prognostic parameter.
Methods: This study involved 100 under 15-year-old patients with newly diagnosed ALL treated in pediatric leukemia units at Kuwait Hospital, Sana'a. Blood markers were collected and analyzed using Epi Info statistical program version 6. The study followed the French, American, and British classifications of pediatric leukemia. Participants were informed of the study's goals and advantages, and their participation was optional.
Results: The majority of patients were aged 5-9 years, with a mean age of 6.9 years. Hemoglobin levels were measured before and after treatment, with the mean level being 8.8 mg/dL before and 10.8 mg/dL after treatment. Severe anemia was reported in 10% of patients before treatment and decreased to 2% after treatment. PCV levels were also measured before and after treatment, with the mean PCV level being below normal in 66% of patients before induction chemotherapy but improving to 20% after treatment. The mean RBC count before treatment was 2.9 cells × 106/μl, but improved to 3.8 cells × 106/μl after induction chemotherapy. The study found that over 50% of patients had iron deficiency anemia before and after induction chemotherapy, with a mean neutrophil percentage of 18.2%, lymphocyte percentage of 73.7%, monocyte percentage of 3.8%, and eosinophil percentage of 0.85%.
Conclusions: The study reveals that blood cell parameters replenish at different rates during induction chemotherapy, resulting in rapid platelet and slow neutrophil recovery. Changes in blood markers during induction may be prognostic.
Peer Review History:
Received 6 April 2024; Revised 10 May 2024; Accepted 25 June; Available online 15 July 2024
Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, [email protected]
Reviewers:
Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected]
ANTIMICROBIAL RESISTANCE PATTERNS AMONG BACTERIAL PATHOGENS ISOLATED FROM CLINICAL SAMPLES IN SANA'A HOSPITALS
Get PDFBackground and objectives: Yemen is among the developing nations where antimicrobial resistance (AMR) is posing a danger to public health. AMR can lead to increased morbidity and mortality from treatment failures and a lack of effective therapies. Particularly in the research arena, there is a dearth of knowledge about the antimicrobial resistance patterns of frequently isolated, locally occurring diseases. Therefore, the purpose of this study was to evaluate the diseases' microbiological profiles and resistance trends in Sana'a, Yemen.
Methods: In Sana'a, Yemen, a retrospective study was carried out at various governmental and private hospitals between June and September of 2020. Information about antibiotic susceptibilities and cultures was taken from the microbiology department's 2019 files. The data analysis method employed was descriptive statistics.
Results: This study includes 4156 pathogen isolates, with 58.2% of the isolates being Gram negative. Of all the isolates, urine (26.1 %, n = 1086) and pus specimens (24.6 %, n = 1025) demonstrated the greatest detection rates. The most often isolated pathogens were S. aureus (35.6%, n=1479), E. coli (29.2%, n=1215), P. aeroginosa (14.1%, n=586), and Klebsiella species (10.7%, n=443). The highest rates of resistance were found for cephalosporins (cefixime 90%, cefadroxil 87.9%, cefepime 72%, and ceftriaxone 70%) and penicillins (carbincillin 87%, amoxacillin 80%, and amoxacillin/clavulanic acid 77%). Gram positive and Gram negative isolates showed minimal resistance to linezolid and vancomycin, with Enterococcus showing higher resistance. Colistin was most effective against Gram negative, while E. coli, Klebseilla, and Proteus showed high resistance.
Conclusions: The high rate of resistance discovered in the current study in both Gram-positive and Gram-negative organisms is alarming and highlights the necessity of routinely determining the prevalence of resistance in a given area in order to guide empirical therapy and choose the most effective course of antibiotic treatment.
Peer Review History:
Received 27 March 2024; Revised 8 May 2024; Accepted 27 June; Available online 15 July 2024
Academic Editor: Prof. Dr. Gorkem Dulger, Duzce University, Turkey, [email protected]
Reviewers:
Dr. Heba M. Abd El-Azim, Damanhour University, Egypt, [email protected]
Dr. Jennifer Audu-Peter, University of Jos, Nigeria, [email protected]
TREATMENT OUTCOMES IN PCOS (POLYCYSTIC OVARIAN SYNDROME)-RELATED INFERTILITY
Get PDFPolycystic ovarian syndrome (PCOS) is one of the underdiagnosed endocrine disorders found to be prevalent among females in the reproductive age group. PCOS effects on an average 8-13% of reproductive aged women, globally. This condition is responsible for causing distress physiologically and psychologically paving the way for a poor quality of life. One of the devastating complications of PCOS is infertility. At present, there is no treatment for PCOS but could be managed by alternate options such as lifestyle modification to in-vitro fertilization. The primary objective of this review article is to analyze the outcomes of certain pharmacological treatment options such as clomiphene citrate which is a selective estrogen receptor modulator, Letrozole an aromatase inhibitor, and gonadotropins for PCOS-related infertility. Clomiphene citrate binds to estrogen receptors indirectly increasing the gonadotropins. Studies confirm a 35-40% successful outcome. Letrozole similarly increases gonadotropins by indirectly decreasing estrogen. A notable increase in the successful outcome was observed with both clomiphene citrate and letrozole, with almost near similar results. The pregnancy outcome was approximately 40% with clomiphene citrate, while letrozole showed 50%. Notably, more side effects were observed in the administration of clomiphene citrate compared to letrozole. Human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (FSHr), that are gonadotropins, were used as they are directly responsible for the maturation of follicles and ovulation itself. The use of gonadotropins increased the pregnancy rate outcome to 20 -30 %, albeit with the risk of multiple births. Furthermore, we have discussed why letrozole and clomiphene citrate are used as the primary therapy compared to gonadotropins.
Peer Review History:
Received 22 May 2024; Reviewed 14 July 2024; Accepted 23 August; Available online 15 September 2024
Academic Editor: Dr. Rola Jadallah, Arab American University, Palestine, [email protected]
Reviewers:
Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected]
Dr. Ogbonna B. Onyebuchi, Nnamdi Azikiwe University, Awka, Nigeria, [email protected]
DRY POWDER INHALERS TECHNIQUE OF COMMUNITY PHARMACISTS: AN OBSERVATIONAL STUDY FROM LAHORE, PAKISTAN
Get PDFIntroduction: Inaccurate utilization of various inhaler devices may severely influence the drug therapeutic effectiveness. The aim of this study is to evaluate the community pharmacist knowledge, attitudes and practice regarding the use of dry powder inhalers (DPIs).
Method: The present observational study was conducted for the evaluation of pharmacist’s knowledge and patient counseling attitude concerning the use of DPIs. A total of 114 community pharmacists from various community pharmacies of Lahore, Punjab were selected and a validated questionnaire was used to assess the knowledge of community pharmacists. The DPI technique presented by “National Heart, Lung and Blood Institute” was used as criteria for evaluation. The covert simulated patient approach was used to evaluate the DPI technique of pharmacists without any biasness.
Results: Out of 114, only 27.2% pharmacists presented adequate knowledge about the correct use of inhaler device (DPIs). Pharmacists from chain pharmacies presented higher adequacy 66.7% as compared to individual pharmacies i.e., 33.3%. Pharmacists whose working experience was more than 5 years presented better DPIs technique knowledge.
Conclusion: The study demonstrated that majority of the community pharmacist (72.8%) have inadequate dry powder inhaler technique at baseline. Setup type (Chain pharmacies) and work experience were the demographic variables that were positively associated with the adequate technique.
Peer Review History:
Received 15 July 2024; Reviewed 7 September 2024; Accepted 21 October; Available online 15 November 2024
Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, [email protected]
Reviewers:
Antonio José de Jesus Evangelista, Federal University of Ceará, UFC, Brazil, [email protected]
Asmaa Ahmed Mohamed Ahmed Khalifa, Pharos University, Alexandria, Egypt, [email protected]