Universal Journal of Pharmaceutical Research
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THE IMPACT OF DRUG COST ON MEDICATION ADHERENCE IN NIGERIA: A PERCEPTION AMONG PHARMACISTS
Get PDFBackground: Given Nigeria's huge economic instability, medication expenses may significantly impact medication adherence, creating a barrier to the treatment of various ailments. The study aimed to assess pharmacists' perceptions about the impact of drug costs on medication adherence in Nigeria.
Methods: The study was cross-sectional among practicing pharmacists across Nigeria. The 25 items semi-structured questionnaire was administered online using simple random sampling with the snowballing technique to recruit the pharmacists for the study. The collected data was coded into Microsoft Excel 2016 and subsequently analyzed using IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics were utilized to summarize the data, providing an overview of the demographic characteristics and key findings. Inferential statistics, specifically Pearson’s Chi-square test, were employed where applicable to determine the relationships between variables.
Results: Total 161 pharmacists responded to the survey, giving an 80.5% response rate. The respondent rate was mainly young pharmacists (20–30 years old; 82.6%) and predominantly male (51.6%). Almost all the respondents possess only a bachelor of pharmacy degree (91.9%). Total 90% have practiced for 5 years or less, mostly in community settings (60.9%). Generic substitution has been cited as the most important technique to manage drug costs. Non-adherence due to cost was associated with practice settings, whereas adherence counseling was correlated with gender and setting of practice. All differences were not statistically significant at p<0.05.
Conclusions: Most participants believe that the cost of medication is a major barrier to accessing quality healthcare and drives massive non-adherence among those who can barely afford the medicines. Implementing a comprehensive national strategy to enhance the healthcare system, expand the reach of the national health insurance program, and promote cooperation among healthcare practitioners will result in improved clinical outcomes for patients.
Peer Review History:
Received 22 May 2024; Revised 11 July 2024; Accepted 26 August; Available online 15 September 2024
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected]
Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected]
DISTRIBUTION AND ANTIBACTERIAL RESISTANCE OF WOUND PATHOGENIC BACTERIA IN PATIENTS OF SANA’A HOSPITALS, YEMEN
Get PDFBackground and objectives: Cutaneous wounds are a common symptom in human medical practice. Understanding the physiology of the wound healing process and using the right therapeutic intervention are necessary for managing the existing healing in wound patients. Infection can cause wounds to take longer to heal, cosmetic surgery outcomes to be less satisfactory, and medical expenses to rise. Due to the dearth of studies in Yemen and other Arabic-nations that describe the different forms, locations, and current understanding of the bacterial causes of wound infection. So, general care hospitals in Sana'a, Yemen, undertook a study to identify the different types, locations, and prevalence of wound contamination caused by various bacteria, as well as to examine the antibiotic susceptibility pattern of wound-isolated bacteria.
Subjects and methods: This cross-sectional study was carried out among 699 wound patients with clinically diagnosed wound infections at NCPHL during the years 2021-2022. Pus and wound swab samples were processed using standard microbiological procedures at NCPHL. A modified Kirby Bauer disc diffusion technique was used to investigate the susceptibility of bacteria to various antibiotics. From pre-questionnaire and laboratory records of the NCPHL, clinical information about patients was gathered, including the types and locations of wounds.
Results: Out of 699 samples, 580 (82.98%) were positive for bacterial cultures. The most common wound was postoperative (30.8%), followed by diabetic foot ulcer (24.5%), traumatic wound (18.7%) and bullet wound (16.9%), while it was less frequent for caesarean section (5.7%) and sharp cut (2%). The present study revealed that Gram-negative bacteria were less frequent than Gram-positive bacteria (43.3% vs. 56.7%). Also gram-positive bacteria show a very high percentage (92.1%) of multidrug resistant (MDR) in compared to gram-negative bacteria (37.8%).
Conclusion: In the current study's wound bacteriological profile, Staphylococcus aureus was shown to be highly prevalent, followed by Escherichia coli, S. epidermidis (CoNS), Acinobacter spp., and Pseudomonas aeruginosa. Their sensitivity to widely used antibiotics showed a pattern of decline. It is crucial to be informed of the current bacterial profile trend and to adjust the antibiotic schedule in accordance with sensitivity.
Peer Review History:
Received: 2 April 2023; Revised: 11 May; Accepted: 29 June 2023; Available online: 15 July 2023
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Dr. Sheikh Abdul Khaliq, Department of Pharmacy Practice, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan, [email protected]
Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, [email protected]
Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, [email protected]
DEVELOPMENT AND EVALUATION OF MICROEMULSION FORMULATIONS OF BIFONAZOLE
Get PDFAim and objective: The purpose of this study was to develop microemulsion formulations for topical delivery of bifonazole with an objective to increase the solubility of the drug.
Methods: Total 5 microemulsion formulations were developed using water titration method. Capmul Pg-12 (oil), Tween-80: (surfactant) and Propylene glycol (co-surfactant) were used in different ratio based on the solubility and emulsification efficiency. Prepared formulations were evaluated on different parameters like transmittance (%), pH, refractive index, viscosity, drug content, solubility, and in-vitro release study Franz diffusion cell. Ternary phase diagram was prepared using oil (Capmul Pg-12), surfactant (Tween 80), co-surfactant (Propylene glycol) in different ratio
Results: The % transmission was found to be in the range of 98.47±0.09 to 99.2±0.08%, the pH value was found to be in the range of 3.34±0.08 to 4.02±0.09, refractive index in the range of 1.3418±0.016 to 1.3818±0.004, drug content was found to be in the range of 98.47± 0.08 to 99.62±0.02 %, viscosity was found to be in the range of 65.23±2.1 to 71.56±5.77%. It was seen that after 4 hours of diffusion, the drug released from the formulation ME5 faster and more than that of the other ratios i.e., 91.2±0.06%. It was observed that drug release was governed by the diffusion process.
Conclusion: On the basis of different evaluation parameters microemulsion formulations of batch ME5 were found to be the best. Present study concludes successful delivery of Bifonazole by the means of microemulsion formulations
Peer Review History:
Received: 4 April 2023; Revised: 10 May; Accepted: 26 June 2023; Available online: 15 July 2023
Academic Editor: Dr. Marwa A. A. Fayed, University of Sadat City, Egypt, [email protected]
Reviewers:
Rola Jadallah, Arab American University, Palestine, [email protected]
Dr. Taiwo O Elufioye, University of Ibadan, Nigeria, [email protected]
THE EFFECT OF DENTAL IMPLANTS ON AEROBIC BACTERIA COLONIZATION IN THE ORAL CAVITY AND THE ANTIBIOTIC PROFILE OF COMMON ISOLATED AEROBIC BACTERIA
Get PDFBackground and aims: The mouth's microflora may alter as a result of dental implants. The purpose of this study was to examine the composition of aerobic bacteria in patients with dental implants and those who had natural teeth (without implants) as well as the response of those bacteria to antibiotic treatment.
Methods: Bacteriological tests were performed on 72 patients (36 dental implants and 36 natural teeth) who visited dental clinics run by Sana'a University's Faculty of Dentistry and private dental clinics. Antibiotic susceptibility tests and culture trials were carried out at the National Center for Public Health Laboratories (NCPHL) in Sana'a, Yemen. Swabs were taken from the mucous membrane of the palate and the dorsum of the tongue from both groups, and cultured on selective and non-selective solid medium, in addition to culturing the swabs on medium enriched with 5% blood, then all cultured plates were incubated to microaerophilic conditions (5% CO2) and oxygenated in 37oC for 48 hours. Then bacterial growth was identified by standard methods.
Results: In implant patients, the rate of bacterial isolates from the palate and tongue was slightly higher for potentially harmful bacteria such as E. coli (8.3% in tongue implant patients vs. 2.8% in non-implant patients) and Pseudomonas aeruginosa (5.6% versus 0%). While in viridians Streptococcus including S. mutans, there was a higher colonization rate in implants patients (83.3% in the palate verses, 75% in the palate of individuals without implants). A low level of oxacillin resistance (5.1%) in S. mutans isolates but S. mutans had a substantial level of tetracycline resistance (55.93%), 11.9% for co-trimoxazole, 10.2% for erythromycin, and just 1.7% for clindamycin.
Conclusion: The study found that pathogenic bacteria like E. coli and Pseudomonas aeruginosa were isolated from the palate and the back of the tongue swabs at a slightly elevated rate in implant patients; also colonization rates of Streptococcus viridians, including S. mutans, were higher in implant patients compared to those without implants. There was a significant levels of antibiotics resistance in S. aureus, CoNs and S. viridians oral isolates in both groups of tested individuals.
Peer Review History:
Received: 3 June 2023; Revised: 7 July; Accepted: 27 August; Available online: 15 September 2023
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Dr. Rola Jadallah, Arab American University, Palestine, [email protected]
Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, [email protected]
EFFECT OF REMOVABLE DENTURES ON COLONIZATION OF AEROBIC BACTERIA IN THE ORAL CAVITY AND ANTIBIOTIC PATTERN OF THE COMMON ISOLATED BACTERIA
Get PDFBackground and aims: Wearing a removable dental prosthesis causes a change in the micro flora of the mouth. The aim of this research was to verify the composition of aerobic bacterial in the oral cavity of patients with removable dentures and with normal teeth (without dentures), and antibiotics pattern for common isolates.
Methods: Bacteriological investigations were performed in 122 individuals (61 removable dentures: 61 normal teeth) attending dental clinics of Faculty of dentistry, Sana’a University, Yemen and private dental clinics. The culturing and antibiotic sensitivity were conducted in the Microbiology Department of the National Center of Public Health Laboratories (NCPHL) Sana'a, Yemen. Tongue dorsa and palate mucosa swabs were collected from normal teeth and denture groups, and as well swabs from mucosal part of denture surfaces in prosthetic patients. Cultivation in microaerophilic (5% CO2) and oxygenic conditions were performed on solid selective and non-selective media in addition to media enriched with 5% blood.
Results: Regarding the prosthetic patients, the rate of bacterial isolates from the palate, back, tongue and dental plaque smears was higher potential pathogenic bacteria as S. aureus and Enterobacteriaceae spp in denture wearers, as E. coli (6.6% in dentures vs. 1.6% in the absence of dentures), Klebsiella pneumoniae (11.4% in dentures versus 1.6% in the normal teeth) and Pseudomonas aeruginosa (13.1% versus 0.0% ).While in viridians Streptococcus including Strept .mutans, there was a lower colonization rate in denture patients (18% in palate verses, 73.8% in individuals without dentures).
Conclusion: The study demonstrated an elevated rate of bacterial isolates from palate, back, tongue and plaque swabs in denture patients of pathogenic bacteria such as S. aureus, E. coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa; while in Streptococcus viridians including S. mutans, there was a lower colonization rate in denture patients verses a very high rate in individuals without dentures.
Peer Review History:
Received: 4 October 2022; Revised: 13 November; Accepted: 28 December 2022, Available online: 15 January 2023
Academic Editor: Ahmad Najib, Universitas Muslim Indonesia, Indonesia, [email protected]
Reviewers:
Dr. Alfonso Alexander Aguileral, University of Veracruz, Mexico, [email protected]
Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
PREVALENCE OF SALMONELLA AND INTESTINAL PARASITES AMONG FOOD HANDLERS PREDISPOSE CONSUMERS TO SIGNIFICANT HEALTH RISKS
Get PDFBackground and objectives: Food borne diseases are a global public health problem and food handlers play a major role for the transmission of food borne diseases. This study was aimed at exploring the prevalence of intestinal parasites, Salmonella typhi carrier rate and risk factors of infection with typhoid and/or intestinal parasites among food handlers at Ibb city, Yemen.
Subjects and methods: A cross sectional survey was conducted among three hundred and fifteen food handlers, in age ranges from 14 to 65 years. All individuals were working in restaurants, cafeterias or school buffets in Ibb city. For collecting data; a pre-tested structured questionnaire was used. Stool samples were examined for intestinal parasites microscopy and for S. typhi by stool culture media and blood for detection antibodies per the standard laboratory methods were used.
Results: A total of 315 food handlers in Ibb city over a 12-month period were enrolled in this study, ages ranged from 14 to 65 years, with a mean±SD age of 31.2±11.9 years. The highest prevalence of antibodies against S. typhi antigen suspension O was 18.4%, while antibodies against S. typhi H antigen suspension were 7.6%. Also, the positive rate for total S. typhi antibodies ELISA IgG was 9.5% and the positive rate for S. typhi stool cultures was 7.3%. The overall prevalence of intestinal protozoa was 20%, the most intestinal parasitic prevalent was Entamoeba histolytica (15.6%), followed by Ascaris lumbricoides (12.1%), Hymenolepis nana (4.4%), and Schistosoma mansoni (3.2%).
Conclusion: Inexperienced and poor personal hygienic food handlers play a role in the transmission of food-borne infections. Local health authorities should implement food handlers training on food safety, institute periodic focused medical check-up for food handlers and improve human waste disposal.
Peer Review History:
Received: 8 December 2022; Revised: 11 January; Accepted: 27 February 2023; Available online: 15 March 2023
Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected]
Reviewers:
Rola Jadallah, Arab American University, Palestine, [email protected]
Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected]
Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, [email protected]
Dr. Rawaa Souhil Al-Kayali, Aleppo University, Syria, [email protected]
UV SPECTROPHOTOMETRIC STUDY OF AMOXICILLIN–ANTACIDS INTERACTION AND ESTIMATION OF ANTIMICROBIAL ACTIVITY
Get PDFBackground and aims: Interaction between a drug and another element which causes a drug interaction when it prevents the medication from functioning as intended. Usually, an interaction can change how the drug is absorbed, distributed, metabolized and eliminated by the body. The purpose of this study is to assess the type and strength of in-vitro complexation that may be caused by an interaction between Amoxicillin with Antacids and investigation of antimicrobial study of Amoxicillin.
Methodology: This work ensures as a possible interaction between Amoxicillin with Mg(OH)₂ (Antacid-1) and CaCO₃ (Antacid-2) which was determined by Job’s plot approach. Investigating the number of Mg(OH)₂ (Antacid-1) and CaCO₃ (Antacid-2) connected in the complexation with Amoxicillin complexes was demonstrated by exploiting several spectrophotometric methods. Ultraviolet studies of these were carried out and balanced. The microbial sensitivity assessment is important to identify whether Amoxicillin’s efficacy has changed as a result of its interaction with antacids.
Findings: The study supported that there is a probable interaction between Amoxicillin with antacids which is confirmed by job’s plot method. The Amoxicillin absorbance is verily different from absorbance of Amoxicillin –Mg(OH)₂ (Antacid-1) and Amoxicillin- CaCO₃ (Antacid-2). And the intensity of the peak of Amoxicillin changes particularly when Amoxicillin forms strong 1:1 complex with Mg(OH)₂ (Antacid-1) and CaCO₃ (Antacid-2). These curves were able to indicate strong kinetics of complexation of Amoxicillin with antacids. By Antimicrobial investigation against gram positive bacteria, it was certain that the zone of inhibition of Amoxicillin with Mg(OH)₂ (Antacid-1) and CaCO₃ (Antacid-2) reduced from 15 mm, 11 mm and 9 mm respectively against gram positive bacteria and Amoxicillin with Mg(OH)₂ and CaCO₃ did not exhibit any detectable antibacterial action when tested against gram negative bacteria.
Conclusion: It has been demonstrated that the standard absorbance of Amoxicillin differs significantly from the absorbance of drug-antacid and the antimicrobial activity is also reduced due to interaction.
Peer Review History:
Received: 5 December 2022; Revised: 9 January; Accepted: 23 February 2023; Available online: 15 March 2023
Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, [email protected]
Reviewers:
Dr. Nicola Micale, University of Messina, Italy, [email protected]
Dr. Hayriye Eda Şatana Kara, Gazi University, Turkey, [email protected]
ANTIBIOTIC SENSITIVITY AND MULTIDRUG RESISTANCE TO MICROBIAL ISOLATES FROM FOMITES OF HEALTHCARE WORKERS AT HOLLY MEMORIAL HOSPITAL, OCHADAMU, NIGERIA
Get PDFAim and objective: Microbial contamination of some fomites were screened for, in which over 100 samples were collected from table, mobile phone and biro pen from Holley Memorial Hospital Ochadamu, Kogi State, Nigeria.
Methods: Using standard techniques, the samples were collected using a sterile swab stick dipped in normal saline and aseptically swabbing the surface of the fomites. The organisms; Staphylococcus aureus(40%), Escherichia coli (15%), Klebsiella pneumoniae (5%), Pseudomonas aeruginosa (5%), Bacillus cereus (10%), Proteus mirabilis (5%), and Streptococcus pneumoniae(20%) were isolated and identified using both morphological and biochemical techniques. The antibiotic sensitivity test was carried out using disc diffusion method.
Results: this finding revealed that all the organisms were sensitive to tarivid but were resistant to septrin with varied zones of inhibition. However, the highest inhibition zone was recorded for perfloxacin (30.00 mm) on Klebsiella pneumoniae. All the isolates showed varying multidrug resistant pattern to the antibiotics used.
Conclusion: The understudied fomites are cheap source of nosocomial infections and also showed varying degree of multidrug resistant pattern.
Peer Review History:
Received: 6 February 2023; Revised: 11 March; Accepted: 25 April 2023, Available online: 15 May 2023
Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, [email protected]
Reviewers:
Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected]
Dr. Ogbonna B. Onyebuchi, Nnamdi Azikiwe University, Awka, Nigeria, [email protected]
PREVALENCE OF INTESTINAL PROTOZOA, HELMINTHES, AND COCCIDIAN INFECTIONS AMONG PRIMARY SCHOOL CHILDREN IN THALA’A DISTRICT AT AMRAN GOVERNORATE, YEMEN
Get PDFBackground and objectives: The prevalence of intestinal parasite infection, which can range between 18% and 90%, is one of the most frequently reported diseases in Yemen and poses a serious health issue for schoolchildren. In Thala’a District, Amran Governorate, Yemen, the study's main goal was to ascertain the prevalence of intestinal parasite infection among primary school students.
Subjects and methods: A cross-sectional survey was conducted from January to April 2022 among 400 schoolchildren, in the age groups 7-12 years. All the children were residents of the city of Thala’a. A pre-tested structured questionnaire was used to collect data. Stool samples were examined for intestinal parasites according to standard laboratory methods.
Results: The children's ages ranged from 7 to 12 years, with a mean±SD of 9.52 ± 2.9 years. The results showed that 136/400 (34%) of the tested children were positive for intestinal parasite infection with a higher prevalence of specific intestinal worms (50.4%) than protozoa (33.3%) and coccidian infection (16.3%). The rate of infection alone was also higher than that of multiple parasitic infections (19.3% vs. 14.8%). The highest number of intestinal parasites was 50/400 (12.5%) for Ascaris lumbricoides, and 49/400 (12.25%) for Entameba histolytica followed by 9.8% for Giardia lamblia, 11.5% for Entrobius vermicularis, 6.5% for Cryptosporidium species, 6.5% for Hymenolepis nana, 2% for Schistosoma mansoni, and 0.8% for Trichuris trichiura. Considering the associated factors, boys had a higher infection rate than girls (50% vs. 24.2%) with an OR of 2.6, CI =1.7–3.9 (p < 0.001). A higher rate was also recorded in older children (41%) with an odds ratio of 1.6 (p=0.03).
Conclusion: There is a high prevalence of intestinal parasites among school children in Thala’a city, and various control measures are required to control and prevent intestinal parasites among school children.
Peer Review History:
Received: 4 April 2023; Revised: 16 May; Accepted: 28 June 2023; Available online: 15 July 2023
Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, [email protected]
Reviewers:
Rola Jadallah, Arab American University, Palestine, [email protected]
Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected]
Dr. Sheikh Abdul Khaliq, Department of Pharmacy Practice, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan, [email protected]
EFFECT OF COMPUTED TOMOGRAPHY (CT) SCAN EXPOSURE ON HEMATOLOGICAL PARAMETERS
Get PDFBackground and aims: CT scan is more used in diagnosis; however, this examined was delivered a low dose estimated approximately to 50 mGy. In this study, the impact of CT scan exposure on hematological parameters for Congo-Brazzaville patients was analyzed.
Methods: Blood samples have been obtained from 61 patients including 23 young patients (<17 years). Blood sample was obtained before and 24h after CT-scan exposure from three different hospitals Congo-Brazzaville. 30 healthy donors have been included as a control. Hematological parameters have been analyzed using software.
Results: Significant decrease of red blood and hemoglobin were observed after 24 h of CT scan exposure for all patients (p=0.0002 and p=0.0004 respectively). Significant increase of white blood and granulocyte were observed only in adult patients (p=0.0057 and p=0.011 respectively). Significant correlation was observed between the Abdominal-Pleven CT-scan and the variation of white blood and granulocytes. Interestingly, decrease of lymphocytes was observed in adult patients and lymphocyte increase was detected in young patients.
Conclusion: We were demonstrated for the first time the variation of hematological parameters after exposure to be very lower doses such as CT-Scan doses. These variations could be reflected inflammatory reactions. Additional analysis can be performed for the validation of these data using a large cohort.
Peer Review History:
Received: 5 June 2023; Revised: 10 July; Accepted: 26 August; Available online: 15 September 2023
Academic Editor: Prof. Dr. Gorkem Dulger, Duzce University, Turkey, [email protected]
Reviewers:
Dr. Sheikh Abdul Khaliq, Department of Pharmacy Practice, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan, [email protected]
Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected]
Ali Jaber, Laboratory for Research and Development of Medicines and Natural Products, RDMPN, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon, [email protected]