INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES

1431-1437

Authors: Jasem Mohamadi1 , Mojtaba Darabi2 , Mohamad Reza Havasian3*

Neonatal mortality is defined for death of infants under age of 4 weeks. It is considered as an important indicator for developing in a country. Despite many efforts that were done in the last years, unfortunately there is high rate of mortality in new born infants; the aim of this study investigated the causes of the mortality of infants hospitalized in NICU of Imam-Khomeini and Mustafa-Khomeini hospitals of Ilam from 2012 to 2016. The present research is a cross-sectional study, the statistical population of which includes all deceased infants who were hospitalized in NICU of Imam Khomeini and Mustafa Khomeini hospitals of Ilam from 2012 to 2016. The information related to gender, gestational age, age at birth, birth weight, mode of delivery, Apgar scores in the first and fifth minutes, history of breast disease of the mother, and cause of death were recorded and the collected data was analyzed using SPSS, version 20 and statistical tests of chi-square and T-test. Based on the findings of the analysis, the most common causes of mortality among infants were respiratory distress syndrome (60.3%), asphyxia (9.3%), congenital cardiovascular diseases (7%), sepsis (6.7%), Intracerebral hemorrhage (3.7%), and Disseminated intravascular coagulation (2.7%). There, also, turned out to be a significant relationship between being stillborn, birth weight of the stillborn infant, gestational age, 1st and 5th minutes Agar rate, and the cause of death. Considering the high incidence of infant mortality at gestational age of less than 37 weeks, implementing stricter caregiving in order to prevent Preterm labor, as the most important cause of infant mortality, is of particular importance in reducing infant mortality. Key Words: Neonatal Mortality, NICU, Ilam, Iran.

1449-1457

Authors: Khalil Y. Abujheisha1* , Magdy Mohamed Muharram2,3, Enas E. Elsaid

Background:The intensive care unit [ICU] is considered as infection epicenter because vulnerable population of critically ill patients and use of different invasive devices. Consequently, the ICU population has one of the highest occurrence rates of nosocomial infections leading to an enormous impact on morbidity, hospital costs, and often survival. In addition, the increasing problem of antibiotic resistance loads the burden of nosocomial infection in the ICU. Constant and careful global monitoring for multidrug-resistant bacteria is needed to minimise the possibility of appearance and dissemination of new resistant isolates and to avoid complications in treatment choices. Methods:This study was carried out from March to June 2016 in King Khalid Hospital [Al-Kharj-KSA] to explore the multidrug-resistant bacteria, Extended Spectrum

1464-1470

Authors: Shora Baymani 1 , Nasrin Elahi 2* , Mohammad Adineh 3 , Mohammad Hossin Haghighyzadeh 4

Introduction: performance evaluation is as one of the principal tasks of managers to achieve organizational goals and promote the quality of services. It can have an impact on job satisfaction. This study aimed to determine the impact of performance evaluation by compilation method on nurses’ job satisfaction. Methods: forty eight nurses working in hospitals in Ramhormoz were enrolled with census. In the first phase, their job satisfaction was measured using JDI questionnaire. Then, before the intervention, samples were taught about the new way of compilation performance evaluating was made by researcher during a workshop session, then using the compilation evaluation form, their evaluation was for two months. At the end of the evaluation and feedback to subjects, again their job satisfaction were measured and job satisfaction scores after the intervention than before the intervention were compared and evaluated. Data were analyzed using the software SPSS-22. Results: The results of this study showed that the performance evaluation scores of subjects after intervention [researcher made compilation performance evaluation] compared to pre-intervention three dimensions work, colleagues and supervisors of JDI job satisfaction separately and as a whole increased and there are significant differences meaningful. The results showed that there are significant difference in the scores of size [P <0/001], supervisor [P <0/001], college [P = 0/002] and job satisfaction [P <0/001]. Conclusions: Using new evaluation methods for nurses according to the clinical situation not only will increase the job satisfaction but also will improve the quality of patient care. Its application for Nursing Management Changes in the traditional evaluation systems and using new nurses’ evaluation methods and involving all in the evaluation can increase the level of the quality of care services. The implementation of this new method promotes the sense of confidence and job satisfaction. Keywords: performance evaluation, nurse, job satisfaction.

1476-1480

Authors: Niaz Hussain1* , Muhammad Iqbal 2 , Nasrullah Aamir3

Objective:To analyze recurrent hospital admissions to the hospital due to gout and associated comorbidities Methodology:The retrospective analysis is based upon the hospital records of 200 consecutive patients (non-probabilityconsecutive sampling) presenting again to the study setting (after prior admission and discharge) due to gout and its associated comorbidities from January 2016 to December 2016. The characteristics of all the patients and the recurrent admissions were analyzed as individual variables and analyzed using SPSS v. 19.0 and Microsoft Excel 2016. Results:A total of 200 admissions due of gout were aggravated by their respective comorbidities, meriting re-admission. The comorbidities meriting re-admission included hypertension (40%), renal anomalies (25%) and diabetes mellitus (30%). 5% of the re-admissions were due to gout alone, without any comorbidity. Conclusion:This study is the first of its kind, to analyze the re-admission of gout patients and the spectrum of comorbidities behind the re-admissions a tertiary care hospital in a major city of Hyderabad. The hospital plays host to a wide array of patients hailing from diverse sociodemographic backgrounds. Keywords: Gout, Diabetes mellitus, Hypertension, Renal anomalies and Medical comorbidities.

1487-1496

Authors: Malalai Shakoor,Fazal Ur Rehman* ,Gulmakai Shakoor, Hafsa sunniya

Probiotics,are living cells with various benefiting properties ,which are studied in extensive ways,and in the world commericialy various products have been introduced .In hundred of scientific research ,their useful effects in both human and animal health have been proven. The main groups of probiotics which are lactobacillus and Bifidobacterium .There are also reports on the probiotic potential of Pediococcus ,Lactococcus,Bacillus and Yeasts.In various ways the immunity have been enhanced by consuming the diary and non diary products.Their is brief documentation of different food matrics,which have been used with probiotics.In this review probiotics along the bacteriocins their mode of action ,classes ,their applications in the health and in different areas of food have been presented.

1501-1504

Authors: Zohreh Mahmoodi

Diagnostic curettage, endometrial biopsy, and hysteroscopy are some diagnostic methods for patients who are hospitalized with abnormal uterine bleeding. In fact, curettage is implemented to diagnose uterine complications, treat forgotten abortions, and determine the cause of infertility. The main objective of the present study is investigating the prevalence of abnormal pathologies in evacuative curettage products in Amiralmomenin Hospital in Zabol from 2013 to 2016. The present descriptive study included 339 patients, aged more than 35 years old, who underwent diagnostic curettage because of abnormal bleeding in Amiralmomenin Hospital in Zabol from 2013 to 2016. Required data was collected using a researcher-made questionnaire and analyzed using SPSS, Version 18. Mean age of patients with cancer turned out to be 45.75±1.98, 54.4±1.33 for atrophy patients, 44.31±0.45 for miscellaneous diagnosis, and 43.45±0.95 for healthy subjects. According to the analysis of the results of sample curettage pathologies, 134 cases (39.5%) had Hyperplasia, 7 cases (2.06%) had cancer, 40 cases (11.79%) had atrophy, 107 cases (31.5%) had normal uterus, and 51 cases (15.04%) had miscellaneous complications; in case of abnormal bleeding complaints, 159 cases (46.9%) had Menorrhagia, 57 cases (16.8%) had metrorrhagia, 43 cases (13.2%) had menometrorrhagia, and 80 cases (23.1%) had postmenopausal bleeding. According to the results of the present study, abnormal uterine bleeding is the most important clinical sign of endometrial cancer; therefore, it is quite essential for women above 35 years old with uterine bleeding to undergo clinical examination. It is, also, recommended to conduct further studies on the causes of hyperplasia, endometrial cancer prevention, and the impact of hyperplasia treatment. Key Words: Abnormal Pathologies, Curettage Products, Zabol, Iran.

1511-1519

Authors: Bassam R. Almutairi*1, Mohd. Imran2 , Emad Obaid3 , Monadil H. M. Ali3 , Abdulkhaliq J. Alsalman

The objective of this study was to assess the prevalence of multi-drug resistance isolates of Klebsiella pneumoniae among the patients at Northern Area Armed Forces Hospital (NAAFH) of the Eastern region of Saudi Arabia. This retrospective, chart review observational study was conducted from February 1, 2016 to February 29, 2016 at Northern Area Armed Forces Hospital (NAAFH), a 330-bed community general hospital located in the Eastern region of Saudi Arabia. A total of 870 isolates were identified in 298 patients (3 isolates per patient involving multiple sites). It was observed that the risk of females being infected or colonized with K. pneumoniae was higher than males; the K. pneumoniae was more frequently encountered in hospitalized patient compared to outpatients; a greater number of isolates were obtained from medical service; and the K. pneumoniae was more likely to be isolated from the genitourinary system. Prevalence of multi-drug resistance of K. pneumoniae to antibacterial agents showed that 41% isolates were resistant to third generation cephalosporin primarily due to production of ESBLs, but this was considered statistically insignificant (RR 1.18; 95% CI, 0.96 to 1.47; p = 0.131). The K. pneumoniae producing carbapenemase (KPC) were significantly prominent in this series (RR 0.32; 95%CI, 0.23 to 0.43; p < 0.001). The rapid growth of the K. pneumoniae species that are resistant to carbapenem, a class of drugs considered the last-line of defense, is a matter of concern. Kew Words: Prevalence, multi-drug resistance isolates, Klebsiella pneumoniae, Saudi Arabia.

1527-1539

Authors: T. Usha Kiran Reddy*, S. Rajesh, G. Sindhu, B.Aruna

Hair plays a very important role in the personality of humans and for their cure by using lots of cosmetic products. Herbal formulations always have activity and comparatively lesser or no side effects with synthetic. Hair formulation of Embica officinalis (Fruits), Bacopamonnieri (Leaves), Trigonella foenumgraecum (Seeds), Murraya koenigii (Leaf), Hibiscus rosasinensis (Flowers) in different concentrations in the form of herbal oil were studied for their hair growth activity, refractive index, acid value, saponification value. Admirable results of hair growth were seen in formulation prepared by different methods of oils preparation technique. Keywords: Hair formulation, Physical parameters, Herbal oil.

1547-1549

Authors: Reza Valizadeh1 , Majid Rezaei-Tavirani2 , Foruzan Kavarizadeh3*

Brain tumor with post-stress symptoms is considered as a rare case. The diagnostic methods of brain tumor are clinical examinations, CT scan, and MRI, and if it is not treated, it will lead to the patient’s death. The best treatment method of brain tumor is brain surgery. In the present research, the brain tumor was studied when the post-stress symptoms in a special case started to appear. The patient is a 48-year-old man suffering from spasm in the left side limbs after an argument. In the patient’s brain CT scan, a lesion was observed in the right frontal lobe, and in the patient’s brain MRI, it was seen in the right frontal. Having been diagnosed with tumor, the patient was referred to a surgeon. Given the findings of the present study, one can assert that the specialists must not overlook patients referring to them with functional neurologic symptoms, and all the symptoms need to be studied thoroughly; if brain tumors are diagnosed early enough, they can be treated through surgery, and their widespread complications can be prevented. Key Words: Brain Tumor, Functional Neurological, Symptom Disorder

1559-1564

Authors: K. Tharshanapriya 1 *, P. Sagadevan 1 K. Jayaramjayaraj 1 and V. Bhuvaneswari 2

Paint products contain several chemical compounds such as organic and inorganic pigments, extenders, binders, solvents and additives’. Painters are continuously exposed to these hazardous substances during painting of both commercial as well as residential buildings. Occupational exposure of these chemical mixtures leads to severe diseases such respiratory infections, head trauma, nasal and paranasal sinus, impair olfactory functions. The use of these toxic chemicals in paints can lead to the changes in the biochemical and genotoxicity among construction painters. Key words: Paint, occupational exposure, hematological, antioxidant and DNA damage.

1570-1574

Authors: Muhammad Iqbal1* , Suhail Ahmed Almani2 , Mukhtiar Hussain Jaffery3 , Aatir H. Rajput4 , Muhammad Muneeb5 , Syed Jehangir6 and Shahrukh Shaikh7

Background: The damaging consequences that diabetes mellitus holds for the body are widely understood. Less focus, however, has been allotted to the consequences it holds for the mind. Diabetes mellitus, especially type-I, has been linked to a compromised performance on various cognitive function domains. The precise pathophysiological route of cognitive dysfunction among diabetics is not fully understandable, but it is probable that modalities that bring about effects on the body, too are responsible for affecting the mind. Objective: To study the effects that diabetes, a physically belittling disease, has on the mind and its ability to function by looking for clinically relevant cognitive impairment in individuals suffering from the disease. Methods: This observational, cross-sectional study included a sample of 200 individuals suffering from diabetes mellitus aged 60 and above, selected using consecutive sampling, and presenting at the medicine unit 2 outpatient department at Liaquat University Hospital. Jamshoro and Hyderabad from January 1, 2016 to April 10, 2016. Verbal informed consent was obtained before administering structured interview administered questionnaires. Cognitive decline was assessed using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and a supplementary self-structured questionnaire for qualitative insight into the cognitive state and its correlates. Result: The presence of clinically relevant cognitive impairment was two times higher among participants with type 1 than type 2 diabetes Mellitus. Both types of diabetes showed statistically significant difference than the normal values of the population. Conclusion: Clinically relevant cognitive impairment is highly prevalent among subjects with childhood-onset type I diabetes mellitus. Chronic hyperglycemia and hypoglycemia are thought to be the causes behind this cognitive impairment. Keywords: Diabetes Mellitus, Childhood-onset, Cognitive impairment, Cognitive Decline.

1581-1586

Authors: Hossein.Rafiei *, Mehrdad Shariati , Jina Khayatzadeh , Sima Afsharnezhad , Majid Farhoodi

Background and Objectives: One of the most harmful heavy metals with deleterious effects on tissues is lead (Pb). In this project, the effects of lead acetate II oral doses on Collagen type II gene expression in mesenchymal stem cells (MSCs) in chondrogenic media were studied. Collagen type II is one of the most plentiful differentiated proteins of the in extracellular matrix (ECM) in cartilage. Methods: Twelve male Wistar rats were randomly divided into 3 groups. Except libitum feed, the first group were fed orally by 50 ppm lead acetate II, the second group were fed orally by 100 ppm lead acetate II while the control group was fed by distilled water for 2 months. After killing, the femoral bone marrow mesenchymal stem cells (BMMSCs) were isolated then cultured in chondrogenic medium. Finally the gene expression of Collagen type II was evaluated by real time PCR. Results: After 2 passages, Population Doubling Time of MSCs in the second group was more than the first while the control group was the least. Real time PCR demonstrated that after feeding rats bone marrow with lead acetate II, Collagen type II gene expression in MSCs in chondrogenic medium decreased significantly in the second group compared with the first, while Collagen type II gene expression in the control group was the most. Conclusion: It seems that accumulation of lead acetate II with the doses 50 and 100 ppm in rat bone marrow in femur lead to reduce Collagen type II gene expression in MSCs in chondrogenic medium thus, public health is a priority. Kew words: Bone Marrow, lead acetate, Mesenchymal Stem Cells, Real-Time PCR, Collagen type II

1593-1598

Authors: Abdolreza Gilavand

Today, the changes in the expectations of the society from the dentists and the need for higher quality dental services have renewed the interests of people to pursue their education in the field of dental sciences. This study has tried to examine the degree of the students’ interest at Jundishapur University of Medical Sciences (AJUMS) to Pursuing a Specialty in the field of dental sciences according to their demographic data. This study is descriptive-analytical and has used a cross-sectional method of analysis during March 2015. The research population includes 484 of Professional Doctorate| (General) of dentistry students in the field of dental sciences at the university. Sampling was done by survey and questionnaire. Among all the students, 118 from the Faculty of Dental Sciences (tuition-free) and 58 from the Campus Unit (tuition-based) completed the questionnaire. To analyze the data descriptive statistics, frequency, frequency percentage, Kolmogorov–Smirnov test, and nonparametric mean comparison of Matt-Whitney U test in the SPSS software, version.21 were used. This study showed that 59% of the students are interested to continue their education (2.36±1.08). No significant difference between the students of the Faculty of Dental Sciences and Campus Unit (P=0.870) and between female and male students (P=0.291) was seen. The most important reasons include, achieving a better economic position, finding a better job, and having a better social status. The reasons for the lack of interest to pursue education include boredom and exhaustion, problems caused by the comprehensive exam, and employment immediately after graduation. Keywords: Dental Sciences, Pursuing a Specialty, University, Students, AJUMS

1613-1618

Authors: K.P.R. Chowdary*, G.Sumalatha, K. Dhanavardhan, K. Prathyusha

Introduction: Diabetes is the most common metabolic disorder in Indian community. It is a silent disease that has become more prevalent with increased age. Despite the advances in understanding the disease and its management, the mortality and morbidity of the disease is increasing.Objective: The objective of the study is to evaluate the prescription pattern, drug utilization and audit for the treatment of diabetes mellitus in a tertiary care hospital in Rajahmundry. Methodology: The study design is a prospective observational study. A total of 150 cases related to anti diabetic treatment were investigated in a tertiary care hospital in Rajahmundry, Andhra Pradesh. Inclusion and Exclusion Criteria include patients with diabetes mellitus admitted as in- patients in the hospital and Patients with age group 20-70 years of both men and women are included. Pregnant and lactating women are excluded from the study and Patients who are unconscious/mentally retarded and who were suffering with psychiatric diseases are excluded from the study.The data sources include patient case sheets, prescriptions issued and discharge medication sheet, WHO guidance on essential drugs and by interacting with physicians and patients. Results and Conclusions: The diabetes is more prevalent among women than in men. Patients in the age group 51-60 years are more prone to diabetes than other age groups. The comorbid diseases in diabetic patients majorly include Hypertension, Hyperlipidemias, Thyroid, and Obesity. Cataract, Chronic foot ulcer, Neuropathy and Mild hypoglycemia are the major clinical manifestations in diabetic patients. Mono drug therapy in 36.6% cases, two drug therapies in 44.6%cases and three drug therapies in 18.6% cases is followed for the treatment of diabetes in the hospital. WHO suggested 18 drugs for mono therapy and 6 two drug combinations for diabetes . Only three drugs(Insulin, Metformin, Glimepiride) out of 18 suggested were used in mono therapy and only one 2 drug combination was used among the 6 suggested by WHO. Three 2 drug combinations other than those suggested by WHO are also used in the hospital. Anti diabetic drugs other than those suggested by WHO are also used to a large extent in the hospital. Hence, it is suggested that the WHO suggested Essential drugs be prescribed in the hospital for better patient care, safety and efficacy. Key words: Prospective observational study, Prescription pattern, Drug utilization, Prescription audit, Anti-diabetic drugs.

1625-1629

Authors: Mohammad Siddique*, Marvi, Shafi Muhammad, Bashir Ahmed, Ghulam Sarwar, Asim Khan, Gul Muhammad, Munir Ahmed, Sohail Riaz

Background: Hypertension is serious chronic conditions that can be treated with herbs. One of these herbs is Haloxylon salicornicum which is being used for many therapeutic purposes from years. Aim and objectives: The present study aims to evaluate the antihypertensive effects of aqueous ethanolic extract of in animal glucose induced hypertensive model. Methods and materials: Aqueous extracts of Haloxylon salicornicum (AEEHS) were administered orally to glucose induced hypertensive rats for 21 days and its antihypertensive effects were determined by monitoring the systolic, diastolic blood pressures and heart rates of rat models. Results: Orally administered AEEHS showed significant reduction in systolic blood pressure, diastolic blood pressure and heart rate as compared to amlodipine. Conclusion: These findings suggest that AEEHS can be used as antihypertensive remedy and needs more study to investigate its potent effects.

1636-1640

Authors: K.P.R.Chowdary*, G Sumalatha, K. Sri Gouri and K.J.S.Dani

Introduction: TB ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). Tuberculosis is caused by a bacteria called Mycobacterium tuberculosis that most often affects the lungs. Tuberculosis is a curable and preventable disease. Early diagnosis and adequate treatment of infectious patients with pulmonary TB are necessary to reduce transmission of tuberculosis and ultimately to achieve elimination of TB. If TB is detected early and properly treated using a combination of medicines for 6 to 9 months, the patients quickly become noninfectious and are eventually cured. Objective: The objective of the observational study is to evaluate the prescription pattern, drug utilization and the audit of anti-TB drugs usage in a tertiary care hospital in Rajahmundry, Andhra Pradesh. Methodology: The study design is a prospective observational study. A total of 80 cases related to treatment of TB were investigated. The inclusion and exclusion criteria include patients with pulmonary TB admitted as in patients in the hospital, patients with age group 15-80years of both men and women, patients with active or inactive TB taking anti-tubercular treatment and pregnant and lactating women. The data sources include patient case sheets, prescriptions issued and discharge medication sheet, WHO guidance on essential drugs and by interacting with physicians and patients. Results and Conclusions: Men are more prone(62.5%) to TB than women(37.5%). In all age groups men are more than females among the TB patients. Hypertension ,diabetes, COPD and thyroid are more prevalent co-morbid diseases in TB patients. 4-drug combinations consisting of rifampicin, isoniazid, ethambutol and pyrazinamide are most widely prescribed(86.25%). WHO suggested 7 essential drugs for TB out of which only 4 drugs were prescribed in the hospital. In most of the cases of mono drug therapy and combination therapy, the drugs are used at larger doses than the WHO suggested doses. Hence it is suggested that the WHO recommended all essential drugs may be used either alone or in combinations at the doses suggested. Key Words: Prospective observational study, Prescription pattern, Drug utilization, Prescription audit, Anti tubercular drugs

1651-1656

Authors: K. P. R. Chowdary*, G. Sumalatha, K. J. V. Haneesha, V. S. L. Deepthi.

Introduction: Antibiotics are currently the most commonly prescribed drugs in hospitals, worldwide. Healthcare is through both public and private sector facilities. About 80% of the healthcare in India is provided by the private sector, and 93% of hospitals are private. Objective: The objective of the study is to evaluate prescription pattern, utilization & audit of antibiotic drugs in governmental and nongovernmental hospitals in Rajahmundry, AP. Methodology: The study design is a prospective observational study. A total of 150 cases related to antibiotic treatment were investigated in Governmental and Non-governmental hospitals in Rajahmundry, AP. Inclusion and Exclusion Criteria include Patients who were hospitalized due to infections and were on antibiotic treatment were enrolled in the study, Patients in all age groups of both men and women are included, Patients who are unconscious/mentally retarded and who were suffering with psychiatric diseases are excluded from the study, Pregnant and Lactating women are excluded from the study. The data sources include patient case sheets, prescriptions issued and discharge medication sheet, WHO guidance on essential drugs and by interacting with physicians and patients. Results and Conclusions: The antibiotic usage is higher in Non-governmental hospitals in the departments of General Medicine (47.44%), and Pulmonary (33.33%) when compared to the Governmental hospitals, 43% in General Medicine and 20.8% in pulmonary department. In the department of Trauma the antibiotic usage is more in Governmental hospital (12.5%) than in Non-governmental hospital (3.8%). The antibiotic usage is more in the age group 41-60 years in both Governmental (38.8%) and Non-governmental (43.59%) hospital. A total of 26 Antibiotic drugs are prescribed either alone or in combination in both Governmental and Non-governmental hospitals. Out of 44 WHO essential drugs only 13 drugs (29.5%) are in usage in government as well as non- government hospitals. About 18.7% and 40.9% of antibiotics used respectively in Government and Non-government hospitals are other than WHO suggested drugs. Non Steroidal Anti inflammatory drugs, Antacids and Multivitamins are most frequently prescribed along with antibiotics in about 90-100% prescriptions. It is suggested that the WHO prescribed antibiotic drugs are only to be used in the doses prescribed to avoid possible Drug interactions and Adverse Drug Reactions. Key words: Prospective observational study, Prescription patters, Drug utilization, Prescription audit, Antibiotic drugs

1699-1705

Authors: Akbar Gohar Abro1* , Arshad Sattar Lakho2 , Abid Ali3 , Aatir H. Rajput4 , Muhammad Muneeb5 and Asad Khan6

Objective: To determine the frequency of vitamin B12 deficiency in patients with Helicobacter pylori infection. Methodology: This cross sectional descriptive study was conducted from 01-01-2015 to 30-06-2015 at Liaquat University Hospital Jamshoro / Hyderabad. All the patients of 19-60 years of age, of either gender with Helicobacter pylori infection for more than 02 weeks duration were further evaluated for serum vitamin B12 level. The data was analyzed in statistical software (SPSS) and the p-value ≤0.05 was considered as statistically significant. Results: During six months study period, total 340 (225 males and 115 females) Helicobacter pylori infected patients were enrolled and entered in the study. The vitamin B12 deficiency was observed in 236 (69.4%) subjects of which 148 (65.8%) were males and 88 (76.5%) were females. The mean ±SD for age of overall population was 42.94±9.86 years while the mean age ±SD for vitamin B12 deficient and non-deficient was 40.76±8.75 and 41.38±8.97 years respectively. The mean ± SD for duration of infection in overall population was 6.93±1.93 weeks while it was 6.72±2.30 and 6.54±1.75 weeks in vitamin B12 deficient and non-deficient individuals. The mean ± SD of vitamin B12 level in deficient and non-deficient population was 143.63±8.75 and 283.95±10.77 respectively. Conclusion: The Vitamin B12 deficiency is more pronounced in Helicobacter pylori infection. In present study vitamin B12 deficiency was observed in 236 (69.4%) patients with male predominance 148 (65.8%) Key Words: Helicobacter pylori, Vitamin B12, Megaloblastic anemia.

1711-1716

Authors: Syeda Rana Nikhat1 *, Prof A.Ravinder Nath2 , V.Rajesh Babu1

The objective of the present investigation is to extract, quantify and characterize the active constituent, 4- hydroxyisoleucine in Trigonella foenum graecum seeds using HPLC and HPTLC methods. Aqueous extract of crushed seeds of Trigonella foenum graecum was prepared and subjected to HPLC and HPTLC analysis. HPLC analysis was performed using C18 reverse phase column and Fluorescence detector with an elution gradient composed of 65 mmol Sodium acetate, l.5% tetrahydrofurane (pH 5.7) and methanol. HPTLC analysis was performed using semiautomatic TLC sampler Linomat V (CAMAG) controlled by WinCATS software. A constant application rate of 80 nLs was employed with a band width of 3.0mm and distance between two bands was 6.2 mm. The plates were developed in 20 × 10 cm twin trough glass chamber containing 25mL of mobile phase as mixture of butanol: acetic acid: water (4: 1: 1, v/v/v) and detected at λ 254nm and 570 nm. HPLC analysis of Standard concentrations of 4-hydroxyisoleucine exhibited a linear plot with average retention time of 8.13 min and sample analysis revealed a retention time of 8.19 min. HPTLC analysis revealed Rf value of 0.45 for both standard and the seed extract at λ 254nm and 570 nm. Keywords: Trigonella, 4-hydroxyisoleucine, HPLC, HPTLC, Fluorescence detector, Retention time, Rf value.

1723-1728

Authors: Saima Jamil, Fahad Saleem*, Qaiser Iqbal, Sajjad Haider

Objective: The objective of this research is to document and evaluate nurses’ knowledge towards clinical pharmacy services offered by pharmacists in public hospital of Quetta city, Pakistan. Methods: The study was designed as a questionnaire based, cross sectional survey. 322 nurses were approached through a self administered questionnaire. Descriptive statistics were applied to explain respondent’s demographic characteristics. Categorical variables were measured as percentages whereas continuous variables were expressed as mean (SD). SPSS v20.0 was used for statistical analysis. Results: A total of 322 questionnaires were distributed and 315 were returned within a response rate of 97%. Majority of the respondents (146 46.3%) were in age range of 28-37 and 269 (85.4%) were working as staff nurse. 255 (81%) had diploma in nursing. A mix response was reported when nurses’ perception towards clinical role of pharmacists was assessed. For the statements identifying medication errors and preventing medication errors, majority of respondents disagree with statements. Majority of respondents (192, 91.7%) disagreed with the statement that pharmacist is drug therapy expert. For the statement that pharmacist can improve the quality of medical care and patient care in hospital setting, 178 (56.5%) and 175 (55.6%) respondents disagreed with statements respectively. Conclusion: Overall, nurses reported poor knowledge of clinical pharmacy services provided by pharmacist in public hospitals. There seems to be multiple factors involved and hence a more comprehensive study is needed to identify specific factors affecting the poor knowledge of nurses. Keywords: Nurses’ knowledge, clinical pharmacy services, pharmacist, public hospitals, Quetta city, Pakistan

1736-1740

Authors: Najeeb Ullah Ansari1 , Sunil Dat Maheshwari2* , Ashok Kumar Lohano3

Objective: To determine the peripheral neuropathy among sufferers of liver cirrhosis Methodology:- This was a observational cross sectional study, conducted at Ward 7 (MU-III), Jinnah Postgraduate Medical Center (JPMC), Karachi for Six months from 10th February 2016 to 9th August 2016. Total 195 patients of liver cirrhosis of more than 5 years duration with Child Pugh (A,B,C) were encompassed in the study using the purposive sampling technique. Nerve conductivity testing with surface electrodes was carried out in all four limbs including motor and sensory fibers of ulnar, median, tibial, and peroneal nerves as well as in sensory fibers of sural nerve. PN was diagnosed if more than one peripheral nerve was affected on nerve conduction study. Results: There were 119 male and 76 female patients with mean age of 45.19±8.41 yrs. The mean duration of disease was 8.85±1.69 years, with range 5(6–11) years. The child pugh class of 29.2% were class-A, 26.7% were class-B, and 44.1% were class-C. The peripheral neuropathy was observed in 59% patients. No any statistically significant association was observed with gender, age, child pugh class, and duration of disease. Conclusion: This study concluded that peripheral neuropathy is a possible complication of liver cirrhosis irrespective of etiology. The neuropathy was more prevalent in male gender, age >45 years and duration of disease 9-11 years. Keywords: Prevalence, Peripheral Neuropathy, Liver Cirrhosis.

1746-1754

Authors: Melissa R Cardoz*and Padmini Ravikumar

Ranitidine Hydrochloride has a very bitter taste. The bitter taste of the drug makes administration of the dosage form difficult, especially to paediatric patients. Oral medicated jellies are novel drug delivery systems overcoming these problems. They are sucrose based formulation thus providing higher compliance. These formulations are also advantageous for geriatric and dysphagic patents. Natural polymers used in jelly formulation are biodegradable, biocompatible, nontoxic, low cost and environment friendly, locally available, better patient tolerated and edible. The aim was to develop and evaluate oral jelly formulations of Ranitidine Hydrochloride. Preformulation studies, organoleptic, physical characteristics, drug content, pH, syneresis, taste masking and in vitro dissolution testing were conducted. The Fourier transform infrared and differential scanning calorimeter studies showed that there was no interaction between drug and excipients. The concentration of gelling agents influenced the spreadability. The formulation F4 showing good pourabilty and gelling property so it was selected for further optimization by varying the degrees brix (⁰Brix). The pH of all the formulations was found between pH 5 to 6. The optimized formulations (F4.3) masked the bitter taste of Ranitidine Hydrochloride and demonstrated acceptable physical properties with 50% drug release in 15 min. The formulation was tested for microbial growth and was found to be stable. Key words: Pediatrics, bitter taste, oral medicated jellies, natural polymers, ranitidine hydrochloride

1762-1767

Authors: Alieh Lotfi Nejad 1* , Mansour Amin 2 and Mitra Salehi 3

Causing pneumonia, sepsis, meningitis, and otitis media often in young children and elderly adults, streptococcus pneumoniae is considered as not only an aggressive pathogen but a normal part of the human respiratory microbiome, as well. To identify S. pneumoniae, some methods which are mostly culture-based are usually used. In general, occasionally being validated by DNA-based methods, culture-based detection methods depend on optochin susceptibility, agglutination, and bile-solubility. In the current study, a total number of 93 nasopharyngeal samples were collected from patients with acute respiratory infection. Isolates of S. pneumoniae were confirmed by α-hemolysis of colonies appeared, optochin sensitivity, and bile solubility. The presence of ply gene was also discovered by PCR. 7 (7.53%) isolates among 93 nasopharyngeal samples were confirmed as S. pneumoniae by all of phenotypic tests, while the PCR assay revealed that 19 isolates (20.43%) were positive for virulence gene, ply. The present study found out the identification of Streptococcus pneumoniae should be based on phenotypic tests and at least a molecular method such as PCR. Keywords: PCR, Streptococcus pneumoniae, Ply, Nasopharynx

1773-1777

Authors: Anam Shaikh* , Quratulain Bachani, Umair Chang

Background: Disorders of the skin, hair, and nails fall within the remit of a dermatologist. The specialty is divided broadly into medical and surgical fields, with clinicians in secondary care often practicing both. Dermatologists are becoming one of the most often visited clinicians as the awareness about the impact of skin diseases and the crucial role of 'skin specialist' is growing widely in general population. Objective: No matter how well trained a clinician; the work burden often undermines the capacity to work effectively. However, the spectrum of patient visits to the dermatologists, the reasons and types of problems, if known, can help make good predictions of the future patient influx & help the clinicians prepare beforehand & be able to deal with the workload effectively. Methods: This observational cross-sectional city wide survey was conducted in Hyderabad. Secondary data was derived from clinic records about patient inflow & their disease classification and frequency along with demographic variables. Primary data was also collected from June to August 2014 using structured self administered questionnaires at Civil Hospital. Results: The most common complaint that patients were presented with was itching (56.7%), followed by complaint of cosmetic worry (29.3%) and pain (14%). The disease classification was diverse but the top 3 diagnosed problems were Pyoderma (19%), Fungal Infection (15.3%) and Acne (12%). The most troubling anatomical area for the patients was the face that brought in 19.3% of the patients. 15.3% of the patients interviewed expressed un-satisfaction towards the health care provided mainly due to the long queues and waiting hours at the clinics. Conclusion: Although satisfactorily manageable (84.7%) at present, the ever increasing patient base of dermatology clinics can get out of hand in the near future. Steps need to be taken to ensure timely health care to the populations which include training clinicians to deal with the impending workload effectively. Key words: Dermatologists, clinician and Pyoderma.

1784-1789

Authors: *Mansoure Gholami and Maryam Shapoori

Zarivar lake is one of the most unique fresh water lakes in the world . A lake with delicate and complex ecosystem that is unparalleled in its own . This lake is located at 2 km from north west of Marivan city and altitude of 1285 m higher than sea surface . Periphytons is a kind of single-celled algae adhered to bed which based on bed type are divided to various cases. In this research , two types of epilithic periphytons and epiphytic periphyton were investigated and identified as well as physio-chemical parameters during the one-year course within 5 stations were investigated Considering the results, was shown that periphyton products was led to a richness in the initial products of Zarivar lake . Keywords: Zarivar lake , Periphytons, Physio-chemical parameters