Int J Pharm : Most Popular Articles

S.NO Title & Authors Name
1
THE ASSOCIATION BETWEEN CHRONIC VITAMIN D DEFICIENCY AND INCIDENCE OF TYPE 2 DIABETES MELLITUS IN ADULT POPULATION IN A TERTIARY HOSPITAL
Mubarak Nasser Al Ameri, Emad Makramalla, Umnya Albur, Anil Kumar, Ahmad Atta Sultan and Haytham Salem
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Vitamin D, commonly known as sunshine vitamin, is both indispensable and vital for human beings. The prevalence of vitamin D deficiency (VDD) is on the rise globally including the sunny regions such as in the UAE. The aim of this study was to examine the relation between the degree of chronic vitamin D deficiency as a risk factor of the incidence of type 2 diabetes mellitus among adult populations. This is a single-centre observational retrospective cohort study conducted in a tertiary hospital in the UAE. It was mainly based on reviewing the electronic data-base and medical records of all chronic patients that match the inclusion criteria. The inclusion criteria of this study included all adult patients aged between 18 and 55 years old, tested for vitamin D level, visited the practice at least three times in the past year. The exclusion criteria included renal failure patients, patients who had malabsorption disorders and those with T2DM risk factors. A sample size of 35,000 adult patients who were screened in a period of 12 months for vitamin D level was selected using the lab database. Patients were checked against the inclusion criteria and of them, only 391 patients met the inclusion criteria. Other diabetes risk factors such as obesity, family history, pre-diabetes, presence of co-existing hypertension and dyslipidemia were also reviewed and excluded. The results of this study showed that a total of 56 patients [14% (95% CI 10.56- 17.44)] had normal results compared to 335 patients [86% (95% CI 82.56-89.44)] who had a chronic vitamin D deficiency. In addition, the results showed that 17% (95% CI 13.28- 20.72) of the 391 patients had mild vitamin D deficiency (VDD), 31% (95% CI 26.42- 35.58) moderate VDD and 38% (95% CI 33.2- 42.8) severe VDD. A total of 32% of patients with severe vitamin D deficiency developed diabetes compared to only 16% from patients with normal vitamin D deficiency and statistically showed significant difference from all other VDD groups as to developing T2DM. This indicates that the more the severity of vitamin D deficiency, the more the susceptibility to develop T2DM. Of a note, in the prevalence of severe chronic VDD, female patients showed significantly higher percentage (61%) of VDD compared to their male counterparts (39%). According to the results of this study, there is a clear relation between severe vitamin D deficiency and incidence of type 2 diabetes mellitus, whereas, mild and moderate VDD showed no difference from normal.
2
EFFECTS OF THE PROPERTIES OF CREAMS ON SKIN PENETRATION
Yutaka Inoue, Arisa Shimura, Misa Horage, Rikimaru Maeda, Isamu Murata, Masahiro Sugino, Kazuhiko Juni, Ikuo Kanamoto
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The current study conducted human sensory testing and temperature-dependent measurement of the creams to examine their viscosity and viscoelasticity. A retention on filter paper test and skin penetration test involving Yucatan micropigs (YMPs) were conducted to measure penetration of the skin and transdermal transfer. The relationship between testing results and physical properties of the creams was then examined. When viscosity was measured, NDFX-A and NDFX-B displayed similar behavior as gauged by viscosity and shear stress. NDFX-C produced a large flow curve, with a larger area under the flow curve than NDFX-A or NDFX-B. Measurement of viscoelasticity indicated that the storage modulus G’ and the loss modulus G” for NDFX-A and NDFX -B increased with a change in temperature (60?C to 10?C) while G’ and G’’ decreased for NDFX-C. The loss tangent tan ? was determined for each cream. Prior to and after a rise in temperature to 60?C, NDFX-A had a tan ? of +0.48 at 20?C, NDFX-B had a tan ? of ?0.34, and NDFX-C had a tan ? of ±0. In a retention on filter paper test, NDFX-B had the highest level of drug retention, followed by NDFX-C and then NDFX-A. Water content presumably plays a role in this phenomenon. Results of a skin penetration test indicated that NDFX-B and NDFX-A had approximately the same amount of skin penetration and the same amount of transdermal transfer after 24 hrs while NDFX-C had less skin penetration and less transdermal transfer. This is because crystals were noted in NDFX-C. Microscopy revealed oil droplets in that cream. Thus, these aspects presumably affected its skin penetration and transdermal transfer. Skin penetration amount is directly related to efficacy, so physical properties of creams may be an important aspect to consider.
3
THE CLINICAL PRACTICE OF VANCOMYCIN DOSING AND MONITORING, AND FACTORS AFFECTING LEVELS AMONGST ONCOLOGY AND CARDIOLOGY PATIENTS IN QATAR: A RETROSPECTIVE ANALYSIS
Shereen Elazzazy, Khalid Al Siyab, Amir Nounou, Ahmed Mahfouz, Prem Chandra, Manal Zaidan.
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The paper focuses on the assessment of current vancomycin (VCM) use in National Centre for Cancer Care and Research (NCCCR) and Heart Hospital (HH) (the only tertiary care specialty hospitals in Qatar) which are 2 out of 8 teaching hospitals in Hamad Medical Corporation the main and largest healthcare organization in Qatar. Primary objectives were to assess the current vancomycin use for cancer and cardiology patients among Qatar population admitted to National Centre for Cancer Care and Research (NCCCR) and Heart Hospital (HH), and to explicate the factors that affected VCM serum trough levels, secondary objective was to access the need to develop and establish a guideline, which is essential to assure the standardization of practice and meets the unique needs of our patients’ population. A retrospective cross sectional study was conducted to review patients’ medical record of the clinical practice of VCM use in two hospitals the NCCCR and HH. We reviewed all VCM level determinations performed during the 12-month (from January, to December, 2012) study period that met inclusion criteria. We retrospectively analyzed the trough and peak concentrations (if taken) of vancomycin in 206 hospitalized patients (between 16 to 92 years of age) with VCM treatment episodes. The relationship between dose and concentration of drug, dose and body weight/ CrCl were established by regression analysis. Statistical analyses were done using excel and statistical packages SPSS 19.0. This multicenter study shows that 71% (118/167) of patients received a total daily dose of 2000 mg/ day (1000 mg every 12 hours over 60 minutes); this dose was common among different body weights (40-145 kg) and estimated CrCl (11-139 ml/min) values, dose selections was not considered based on body weight and/ or CrCl, therefore no linear correlation were shown between VCM trough and body weight/ CrCl. Initial loading dose of VCM was not considered for any of the patients included in the study (n=167). Only 16% of trough concentrations presented therapeutic levels, therefore a high percentage of patients was found to have sub-therapeutic or supra-therapeutic concentrations, furthermore 31% of patients had no trough levels. No linear correlation was found between patients body weight and the total daily dose (r=0.037). Only 39% (65/167) had cultures done, out of which7.8% (13/167) showed various gram positive bacteria (MRSA, MRSE, other coagulase-negative staphylococci, or Enterococcus) were isolated. Multiple areas of improvement were identified in dosing and monitoring of VCM in NCCCR and HH, evidence based guidelines are urgently required with the direct involvement of Clinical Pharmacists and Infectious Disease department to apply the optimal VCM initial dose based on creatinine clearance (CrCl) and body weight (BW) to minimize sub-therapeutic or supra-therapeutic trough levels.
4
PREPARING FOR U.S. PHARMACY PRACTICE: REGISTRATION PROCESS FOR FOREIGN PHARMACY GRADUATES
Mousa Abkhezr, Valerie U. Oji
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Practicing abroad in the global health arena is a desired objective by many foreign pharmacy graduates. By definition, a pharmacist whose undergraduate pharmacy degree was conferred by a recognized school of pharmacy outside of the 50 United States and the District of Columbia, and Puerto Rico is considered a foreign pharmacy graduate. These pharmacists in order to be licensed in the USA have to pass four tests including: 1-foreign pharmacy graduate equivalency examination (FPGEE), 2- test of English as a foreign language (TOEFL), 3- North American pharmacist license examination (NAPLEX), and 4-multistate pharmacy jurisprudence examination (MPJE). There is a last requirement to complete 1500 hours internship; this may be required before or after passing NAPLEX and MPJE, depending on the specific state of intended practice. This internship has to be under the supervision of a licensed pharmacist known as preceptor. Studying and practicing abroad may be challenging, but there are opportunities and resources to navigate through the process.
5
ANTITUMOR EFFECT OF THE INFUSION OR PLUMBAGIN METABOLITE OF PLUMBAGO PULCHELLA BOISS WHEN ADMINISTERED TO CD-1 MICE WITH L5178Y LYMPHOMA CANCER CELLS
Georgina Almaguer Vargas; Miguel A Villavicencio Nieto; Blanca Estela Pérez Escandon; Alejandro Chehue Romero; Lauro Figueroa Valverde; Guillermo Manuel González Hernández, Diana Andrea Altamirano Báez, José Ramón Montejano Rodríguez
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Cancer is a group of diseases with a high incidence worldwide. Since existing treatments have extremely strong adverse effects and are often inaccessible to many patients, it is necessary to seek alternatives. The aim of this study was to explore the effectiveness of infusing Plumbago pulchella Boiss and its main metabolite, plumbagin, on L5178Y tumor growth and survival time of the animals. The acute toxicity of Plumbago. pulchella Boiss infusion was also evaluated. The results showed that the antitumor effect both infusion and plumbagin was the same, regardless of the concentration or the route of administration (oral / intraperitoneal), nor which is given as a single exposure or every 48 hours. The tumor size was inhibited between days 8 and 14 of treatment; however there was no increase in survival time of the animals. The Infusion of Plumbago pulchella shows no toxic effects. No macroscopic alterations were noted in the viscera of the treated rats.
6
ASSESSMENT OF THE COMMUNITY PHARMACY PRACTICE IN THE REPUBLIC OF MACEDONIA - BUILDING PLATFORM FOR IMPLEMENTATION OF GOOD PHARMACY PRACTICE
Lidija Petrushevska-Tozi, Kristina Mladenovska, Jasminka Patceva, Th (Dick) Thromb, Kirsten Holme, Nina Sautenkova
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The objective of the study was to evaluate the actual status of the community pharmacy practice and quality of services and to identify the gaps and barriers to implement the best pharmacy practice and care. Cross-sectional descriptive survey was conducted for the pharmacies/pharmacists where pre-coded multiple choice closed questions were used with response format: activity fully applied, partially applied, applicable or not applicable. Set of 155 indicators was developed covering five essential components: pharmacy structure and practice; patient safety; manufacture practice; staff workflow and competences and quality assurance. The actual score was 64 out of 100. Pharmacy services related to manufacture practice and quality assurance were identified as the areas of highest priority for improvement, followed by the services related to patient safety. Priorities for intervention by key stakeholders (national authorities, academia, professional associations and pharmacists) and recommendations for introducing new and improving the existing roles of the pharmacists were defined.
7
SAFE USE OF A DAILY 20-MG DOSE OF OMEPRAZOLE IN ORDER TO AVOID HYPOMAGNESEMIA
Cecilia Maldonado; Nicolás de Mello; Pietro Fagiolino; Marta Vázquez
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The objective of the current study was to examine the safe use of a daily standard dose of omeprazole (20 mg) regarding magnesium levels in blood in hospitalized patients. A total of 51 patients (15 women, 36 men) with different characteristics (pathologies, comedications, age, habits, etc) and taking a standard dose of omeprazole for more than three months were included. 17.6 % of the patients showed mild hypomagnesemia but we concluded that the observed low levels of this electrolyte could be attributed to comedications, age and different pathologies rather than the 20-mg dose of omeprazole. So, hypomagnesemia does not eliminate proton-pump inhibitors as a reasonable option; it just requires clinicians to be aware of this problem and use them safely at conventional doses.
8
COMMUNITY PHARMACISTS’ INTERVENTION: How a 6-episode of one-on-one intervention changed patients’ attitudes towards their medication and disease self-management
Hana Morrissey, Patrick Ball, David Jackson, Louis Pilloto
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Adherence to medication is reported to be <33%. Most people who suffer chronic conditions require pharmacological intervention; they collect prescription repeats every month creating an opportunity for further regular intervention by the community pharmacist. to investigate if pharmacist intervention in Chronic Disease Management in rural Australia could improve patients’ outcomes through better monitoring of disease markers, self-management skills and medication adherence. This project was a pilot before and after, pragmatic study, which was designed as a foundation to support future definitive studies. The data was analysed in ASReml-R™ using linear mixed models or generalised linear mixed models. Using modified Health Education Impact Questionnaires™, there was 29.65% improvement in patients’ total score from pre and post clinical intervention. Patient education and ongoing interaction between patients and pharmacists enforced the importance of monitoring improving patients’ knowledge and self-management commitment. The use of prescription repeat collections as an opportunity to reinforce disease management messages deserves further investigation.

9
COORDINATION OF SOME HEAVY TRANSOTION METALS COMPLEXES WITH 2-AMINO ACETIC ACID-6- METHOXY BENZOTHIAZOLE USING MICROWAVE AND THERMAL METHODS
Mahasin F. Alias, Basha\'ar A. Stephan and Farah S. Jaafer
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The ligand 2-amino acetic acid -6- methoxy benzothiazole (L) was prepared as a chelating ligand, which was treated with the ions Rh(III), Pd(II), Cd(II) and Pt(IV) in alcoholic medium in order to prepare series of new metal complexes. These complexes were prepared by conventional and microwave methods and characterized by the available techniques. FT-IR, UV-Visible, magnetic susceptibility, flame atomic absorption technique as well as elemental analysis and coductivity measurements. From the spectral studies, all complexes have square planer geometry except Cd complex have Td geometry. The nature of complexes in liquid state was studied by using molar ratio method and give results similar approximately to those obtained from isolated solid state; also, stability constant of the prepared complexes were studied and found that they were stable in molar ratio 1:1. A theoretical treatment of these compounds in gas phase was studied by Hyper Chem-8 program using Semi-empirical method.

10
INCORPORATION OF ROSEMARY (ROSMARINUS OFFICINALIS LINN.) EXTRACT IN AN ENDODONTIC SEALER: ANTIMICROBIAL EVALUATION
Marcela Agne Alves Valones, Jalber Almeida Santos, Thiago Maciel Cavalcanti, Michelly Cauás Queiroz Gatis, Arnaldo França Caldas Júnior, Eliziane Pereira Costa, Janete Magali de Araújo Alessandra de Albuquerque Tavares Carvalho
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The aim of this study is to evaluate the microbial activity of an endodontic sealer containing rosemary extract in comparison to Sealer 26. Agar well diffusion assays were used to evaluate the antimicrobial activity of the materials in the presence of the following bacterial strains: S. mutans (ATCC 25175), S. aureus (ATCC 9811) and E. faecalis (ATCC 51299). Bacterial growth inhibition halos were measured. The Mann-Whitney test was used to determine the statistical significance of differences between groups. Mean inhibition halos were 27.1, 26.4 and 38.6 mm for the strains of S. aureus, E. faecalis and S. mutans when the rosemary-based sealer was used and 16.3, 15.8 and 25.5 mm, respectively, when Sealer 26 was used. Significant differences between sealers were found for each bacterial strain (p less than 0.05). The rosemary-based endodontic sealer demonstrated greater antimicrobial efficacy in comparison to Sealer 26.