Pharmacy

Introduction: Inappropriate use of antibiotics has resulted in a dramatic increase of antimicrobial resistance in developing countries. We examined knowledge, attitudes, and practices of antibiotic use in three Asian countries. Methodology: A nationwide cross-sectional study of teachers in large cities of Yemen, Saudi Arabia, and Uzbekistan was conducted. A random sample of 1,200 teachers was selected in each country. Data were collected through a questionnaire-based survey and then analyzed using descriptive and multivariate statistical methods. Results: The prevalence of non-prescription antibiotic use ranged from 48% in Saudi Arabia to 78% in Yemen and Uzbekistan. Pharmacies were the main source of non-prescribed antibiotics. The most common reasons for antibiotic use were cough (40%) and influenza (34%). Forty-nine percent of respondents discontinued antibiotics when they felt better. Although awareness of the dangers of antibiotic use correlated inversely with self-medication, ...

Background: The contribution of B 12 and folate deficiencies to pathophysiology of psychiatric illnesses is well known worldwide, however it was not evaluated in Sudanese psychiatric patients. Aim: To assess the association between the neuropsychiatric syndromes and the levels of both vitamin B 12 and folic acid in Sudanese psychiatric patients. Materials and Methods: The study involved a test group of 100 psychiatric patients and an age/gender matched control group of 100 subjects with no past history of psychiatric illness. Laboratory investigations, including complete blood count (CBC), serum vitamin B 12 and folate concentrations were done to all studied subjects. Significance of the difference in the means of the studied variables and the association between psychiatric illnesses and both B 12 or folic acid deficiencies were assessed using appropriate statistical tests. Results: Most of hematological indices were significantly less in psychiatric patients, although their means were within normal range. The serum concentrations of vitamin B 12 in the psychiatric patients (M±SD = 527.9 ± 305. 8 pg/ml) were significantly lower compared with the control group (M±SD = 590.5± 186.1 pg/ml, P = 0.001). There was significant association between B 12 deficiency and psychiatric illnesses (P = 0.014). Six percent of the psychiatric patients were suffering from B 12 deficiency while none the control group was suffering from the same deficiency. The serum concentrations of folic acid were comparable in both studied groups (M±SD = 7.2 ± 1.7 ng/ml, 7.2 ± 2.6 ng/ml in the control and test groups respectively, P > 0.05). There was no folic acid deficiency in both test and control groups. Conclusion: There was association between vitamin B 12 , but not folic acid, deficiency and psychiatric diseases in studied Sudanese subjects. Most of the hematological indices were significantly less in psychiatric patients, although their means were within normal range. The significantly lower levels of vitamin B 12 deficiency were not associated with megaloblastic changes.

Aim: Present study aimed to estimate knowledge, attitude, and awareness of allopathic physicians regarding herbal medicine in the Northern Border Region of Saudi Arabia. Dispensing, prescribing, and use of herbal medicines have tremendously increased over the past few decades world-over, including Europe and the USA. Herbal drugs are claimed as safe but are reported to have serious adverse effects and drug interactions with allopathic medicines. Material and Methods: This cross-sectional study, using a self-administered questionnaire, was conducted with general practitioners and physicians in major hospitals, and primary healthcare centers in Arar, the main city of Northern Border Region. Data were analyzed using SPSS, version 25. Results: From 117 participants, 65% were female doctors, 32% were males, and 3% did not respond. General practitioners and rest specialists accounted for 40%; 84% of patients and 66% of doctors had used herbal medicine for some ailment. Some patients (43%) liked to discuss with their doctors about herbs, but doctors usually avoided. Many doctors (68%) knew that herbal medicines can produce adverse effects or drug interactions with allopathic medicines (60%). Discussion: Herbal drugs are commonly consumed in the Northern Border Region of Saudi Arabia and allopathic physicians of the region are mostly aware that herbs can cause adverse effects and drug interactions.

Aim: In this study, we aimed to investigate and compare the effect of topical administration of quaternary amines (QA) to tertiary amines (TA) on the pupil size of rabbit eyes. Material and Methods: TA (Pilocarpine and Physostigmine) and QA (Neostigmine and Pyridostigmine) muscarinic agonists were used as pupil constrictors, while TA (Tropicamide and Cyclopentolate) and QA (Hyoscine-N-butylbromide, Ipratropium, Isopropamide, and Hexahydro-adephenine) muscarinic antagonists were used as pupil dilators. Serial dilutions of these drugs (4 concentrations for each) were prepared in distilled water from their preparations available on the market. Their effect on pupil size was measured at 0, 15, 30, 45, 60, 120, and 180 minutes (n=4). Linear plots of the effects of various concentrations were drawn by MS-Excell. The onset and duration of action of QA were compared with the corresponding TA. Results: The onset of action of pupil constriction with TA and QA muscarinic agonists was between 15-30 minutes and the effect lasted for 120-180 minutes. The onset of action of pupil dilatation with TA and QA was also between 15-30 min and effect lasted for > 180 minutes. Discussion: This experimental study demonstrated that the extent of ionization of QA muscarinic agonists or antagonists did not influence their diffusion across ocular tissues cornea and conjunctiva. These drugs can be used topically for pupillary constriction or dilatation.

Introduction: Bacterial resistance to the most commonly used drug ceftriaxone and its adverse effects have increased due to its injudicial use. Drug Utilization Evaluation (DUE) is an ongoing, systematic process designed to promote the appropriate and effective use of drugs. The purpose was to detect potential problems and search out solution. Methods: Data were collected in structured preform specific for DUE and were represented as numbers and percentages. For comparing numerical data, Mann-Whitney U-test was used as the data were non-parametric in distribution for ages and BMI, while Fisher exact test was used for categorical data comparison. Multivariate multi-logistic regression models to study the overlapped effect of the variables in development of Ceftriaxone induced liver functions derangement. Data were processed and analyzed using SPSS16 for statistical analysis. Significance was considered as P < 0.05. Results: Our study showed that ceftriaxone use was more. High dose was used and for more than 10 days were the result of adverse effects and liver insult. Conclusion There is need for awareness among the general practitioners and clinicians to ensure rational use of antibiotics. This will minimize bacterial resistance to drug, adverse effects and save national economy.

Context: Hypertension is one of the most common disorders in the world, and is associated with serious short and long term complications. Awareness of the disease, drugs and patient compliance to the treatment can contribute to prevent these complications. Aim: To assess the knowledge and awareness of hypertensive patients about disease, drug, and compliance, in Arar, Kingdom of Saudi Arabia. Settings and Design: Cross-sectional descriptive study. Methods and Material: Data was collected using intervieweradministered questionnaire; constructed on the basis of Hypertension Knowledge Level Scale (HK-LS). Statistical analysis: Descriptive statistics was done for all variables, and chi-squared test was applied for nominal variables to assess correlations. Results: The respondent were 72 patients, 53% were male, while female shared 47%. In our study the overall participant knowledge and awareness about medical treatment, drug compliance, and the disease was ranging from 60-86%. There was...

The purpose of this study was to evaluate the awareness about management and drugs used for treatment of gout by using questionnaires to collect data from patients who attended the hospitals and health care centers in Khartoum state, Sudan. The results showed that (81.2%) of the patients were males and (18.8%) were females and those of age between 46-60 years represented 46.5%. This study found that (90.1) of the patients were prescribed for allopurinol and (54.5%) of them stopped taking allopurinol when the attack occurred and taking non-steroidal anti-inflammatory drugs (mainly indomethacin 45.45%) to relieve the pain. This study revealed that (86%) of gout patients were advised to avoid certain types of foods such as Red meat, legumes, fatty foods and salt and (31.7%) of them were committed with the advice and (38.6%) sometimes complied with advice while (29.7%) didn't comply. Some medications used to treat concomitant diseases in this study have major drug interactions with allopurinol such as Lisinopril (5%), Aspirin (5%), Amlodipine (10.9%) and Captopril (1.0%).

There's considerable gap in the knowledge of epilepsy among the sufferers of the disease and general population that lead to negative impacts on the lives of people with epilepsy. Both knowledge of all aspects of the disease and positive attitude towards epilepsy help providing better therapeutic outcomes, quality of life and prognosis.

The purpose of this study was to detect the incidence of potential drug-drug interactions (DDI) in renal failure patients in Khartoum state, Sudan. It is important to consider the problem of polypharmacy and drug interactions in patients with renal failure, including drug-drug, drug-herb and drug-food interactions. This was cross sectional study covered selected renal failure centres in Khartoum state, Sudan, during 2012. The total number of hospitals was eight hospitals. DDIs were determined by using an online drug interaction checker. The main concern of this study was drug-drug interaction of prescribed medication, which accounted about 5.6% major, 61.6% moderate and 28.8% minor. While the interaction of nonprescribed with prescribed drugs; accounted about 0.8% major, 11.2% moderate and 2.4% minor. This study showed that 44.0% of patients used herbal and traditional medicines. In conclusion; Interactions between (prescribed and non-prescribed) drugs occurred and varied from major, moderate and minor. This study also included the incidence of the usage of herbs and traditional medicine concomitantly with prescribed and non-prescribed medications, as most patients believe it might treat renal failure. But it might lead to herb drug interactions and nephrotoxicity in healthy kidneys, which is an issue of concern that may need further studies.

The renin system is an important mediator of blood volume, arterial pressure, cardiac and vascular function. Components of this system can be identified in many tissues, but primary site of renin release is the kidney. The renin system can be triggered by sympathetic stimulation, renal artery hypotension, and decreased sodium delivery to distal tubule (1). The system is activated when there is a loss of blood volume or a drop in blood pressure (2). Renin acts on oligopeptide substrate angiotensinogen to produce the decapeptide angiotensin I. In turn, angiotensin I is converted by angiotensin converting enzyme (ACE) to form octapeptide angiotensin II. Angiotensin II acts di resistance vessels to: increase systemic vascular resistance and arterial pressure, stimulate the adrenal cortex to release aldosterone, which lead to increase cardiac and vascular hypertrophy (3) (4). The peptide angiotensin II (ANG II) play an important role in cardiac and vascular disorder

In Kingdom of Saudi Arabia &lt;em&gt;Achillea fragrantissima&lt;/em&gt; is a fragrant, perennial herb has long been used medicinally for its analgesic properties among Rafha residents. The present study concluded that &lt;em&gt;Achillea fragrantissima&lt;/em&gt; (Gaisoom) possess a potent anticonvulsant activity against PTZ induced seizures which may be due to GABAA agonistic activity and /or antioxidant activity. The results of the current study showed that the ethanolic extract of Gaisoom at doses of 300 mg/kg and 600 mg/kg has anticonvulsant activity in pentylenetetrazole and maximum electroshock induced seizures models on mice. The Hexane extract have protected the mice against pentylenetetrazole – induced seizures with 100% protection rate and 100% animal survival similar to the anticonvulsant drug phenobarbital. HPLC–DAD fingerprints of different fractions were also carried out to find the pharmacological active compound. The studies are in progress to isolate the compounds by...

Background: Hair dye is commonly used in the Kingdom of Saudi Arabia (KSA). Poisoning occurs when someone swallows dye or tint used to color hair and is considered one of the most significant causes of intentional self-harm. Commercial hair dye may contain varying amounts of paraphenylenediamine and even undeclared chemical ingredients. Therefore, the aim of this study was to evaluate the organ toxicity of commercial hair dye in rats. Acute toxicity study: The commercial hair dye X was orally administered to the rats at a dose of 50 mg/kg and was observed for 24 h for mortality or behavioral changes. Sub-chronic toxicity: The commercial hair dye X was administered to rats orally for 8 days in doses of 2.5 and 5 mg/kg, then the heart, liver, kidney, and testis were dissected out of the animals and kept in formalin for histopathological examinations using HE stain. Results: In this study, the commercial hair dye X at the dose of 50 mg/kg single dose has not shown any mortality in rats. On the other hand, the commercial hair dye X administered to rats orally for 8 days at doses of 2.5 and 5 mg/kg caused toxicological effects manifested by some histopathological changes in the heart, liver, kidney, and testis in rats compared to the control group. Conclusion: The current study showed that the commercial hair dye X at doses of 2.5 and 5 mg/kg produced toxic effects on the heart, liver, kidney, and testis in rats. Therefore, it is important to raise the public awareness about the potential toxicity of the hair dyes.

The term off-label drug use (OLDU) is utilized broadly in the medical literature. It is a polarizing term since it may be related to incredible advantage or harm to patients. OLDU is defined as drug uses that not included in the indications or dosage regimens listed in the drug labeling. The main issue with off-label use is that there is insufficient information supports the use of the drug so this review aims to give brief information about some common drugs with effective and useful off-label uses based on scientific study and to encourage the researcher to provide sufficient information for the physician and health care providers about off-label uses to decrease the risk of harm to the patients. There are many drugs with various off-label uses that play an important role clinically such as using atorvastatin in chronic heart failure (CHF) due to its pleiotropic action also it can show a significant reduction in the frequency of hospitalization due to CHF exacerbation. However, th...

Introduction Intramuscular paromomycin monotherapy to treat visceral leishmaniasis (VL) has been shown to be effective for Indian patients, while a similar regimen resulted in lower efficacy in Eastern Africa, which could be related to differences in paromomycin pharmacokinetics. Methods Pharmacokinetic data were available from two randomized controlled trials in VL patients from Eastern Africa and India. African patients received intramuscular paromomycin monotherapy (20 mg/kg for 21 days) or combination therapy (15 mg/kg for 17 days) with sodium stibogluconate. Indian patients received paromomycin monotherapy (15 mg/kg for 21 days). A population pharmacokinetic model was developed for paromomycin in Eastern African and Indian VL patients. Results Seventy-four African patients (388 observations) and 528 Indian patients (1321 observations) were included in this pharmacokinetic analysis. A one-compartment model with first-order kinetics of absorption and elimination best described paromomycin in plasma. Bioavailability (relative standard error) was 1.17 (5.18%) times higher in Kenyan and Sudanese patients, and 2.46 (24.5%) times higher in Ethiopian patients, compared with Indian patients. Ethiopian patients had an approximately fourfold slower absorption rate constant of 0.446 h-1 (18.2%). Area under the plasma concentration-time curve for 24 h at steady-state (AUC τ,SS) for 15 mg/kg/day (median [interquartile range]) was higher in Kenya and Sudan (172.7 µg•h/mL [145.9-214.3]) and Ethiopia (230.1 µg•h/mL [146.3-591.2]) compared with India (97.26 µg•h/mL [80.83-123.4]). Conclusion The developed model provides detailed insight into the pharmacokinetic differences among Eastern African countries and India, however the resulting differences in paromomycin exposure do not seem to explain the geographical differences in paromomycin efficacy in the treatment of VL patients.

Male infertility and issues of impaired fecundity have been currently a global problem. Diabetes mellitus can influence male fertility either directly or indirectly due to abnormal spermatogenesis, which results in reduced sperm quality. Most reported cases of diabetes are of type 2 DM cases, frequently treated with oral anti-diabetic drugs. Metformin is considered first-line therapy for the treatment of T2DM. This drug is an oral insulinsensitizing agent that can elevate insulin sensitivity and reduce plasma fasting insulin. The main metabolic action of metformin target the liver. However, it was indicated that metformin acts on many organs of the body which include the male reproductive system. With the increasing numbers of diabetic individuals among younger people, there is an enhancement in the utilizaton of metformin in individuals of this age group. Therefore, it is critical to recognize the role of metformin in male fertility. In this review, we are presented with the most r...

In the present study the methanolic extract of corn silk was evaluated for antidiabetic activity. The antidiabetic activity was studied using the glucose uptake by isolated rat hemi-diaphragm using in-vitro model. Corn silk increased the uptake of glucose by isolated rat hemidiaphragm significantly (P&lt;0.001) and was found to be more effective than insulin. It appears that corn silk has direct peripheral action on glucose uptake. The value of glucose uptake by rat hemi-diaphragm after addition of corn silk extract was 109±1 as compared to control (12± 1) and Insulin (49 ± 8)mg/g/30min .These results strongly suggest that Corn silk will be alternative choice for the treatment of diabetes mellitus.

The synthesis of novel fused pyrimidines and imidazole derivatives from 2-amino-s-triazino[1,2a]benzimidazoles 2a-e and 3a-c was successfully carried out by a ring annelation reaction in a very good yield. Compound 3c was screened for analgesic activity against acetic acid irritation and has shown protection equal to the reference drug (diclofenac sodium). The acute toxicity study revealed that compound 3c is safe up to 300 mg/kg and there is no sign and symptoms of toxicity and mortality for 72 hours.