Pakistan Journal of Pharmaceutical Research

6

Authors: Abdul Majeed

Uric acid is a sort of compound that is produced as a result of purine metabolism. Hyperuricemia (HU) is a condition that is firmly related to gout, which is the type of incendiary joint pain, by the crystallization of uric corrosive inside the joints. The purpose of this study was to assess the frequency of HU in southern Punjab, Pakistan. A total of 1792 patients were recruited using inclusion criteria. Descriptive analysis was performed with SPSS software version 23. The frequency of patients with hyperuricemia was calculated. The frequency of Hyperurecemic patients was higher than the diabetic patients. The frequency of Hyperurecemic patients was higher in Bahawalpur (54%) followed by Khanewal (50%) and Kabir wala (48%). In conclusion, Hyperuricemia in individuals combined with obesity and overweight increasing day by day and it is an area of most importance. Early intervention can prevent this age group from serious health issues later in life.

7

Authors: Abdul Majeed

Purpose: The basic purpose of the current study was to determine the impact of the dietary approach to stop hypertension applying (DASH) pattern of dietary intake on outdoor hypertensive patients based on baseline lipid concentrations and sex. Method: In the current controlled study, 300 patients were assessed through the DASH Trial, where250 patients were assessed for a 6-month run-in period. Patients enrolled in the control group (n=125) were fed with the usual control diet while the intervention group (n=125) had received DASH. Results: Results showed that the combination diet (the DASH eating pattern) reduced the systolic blood pressure by-18.7 ± 9.8mmHg, and diastolic blood pressure by-7.3 ± 6.5mmHg,as compared to the usual (control) diet where a reduction in systolic and diastolic BP was observed to be -3.2 ± 12.7, and 2.7 ± 8.1, respectively. A significant reductions in weight 1.2 (P = 0.255) and body mass index (BMI) 0.3 (P = 0.315) were observed. Conclusion: Among hypertensive patients, the incorporation of non-pharmacological therapy had beneficial effects in blood pressure control and further showed that pharmacists can play a pivotal role in the clinical management of hypertensive patients. Non-pharmacological measures should be part of routine management of hypertension that can reduce the chances of organ damage.

6

Authors: Abdul Maalik1, Sidra Saleem2, Riffatullah3*, Urooj Afreen1

Hypertension and diabetes mellitus disorders are the leading cause of death and initiative of other diseases at the time of delivery or pregnancy. It can leads to maternal, neonatal or fetal morbidity or mortality in all over the world. Therefore, the study has been conducted to determine the effect of hypertension and diabetes mellitus on adverse perinatal outcomes and the study have been conducted in tertiary centers. The frequency of hypertension as well as diabetes mellitus has been explored in the study in pregnancy and its association was found with gestational age and stillbirth. Objective: The study was conducted to find frequency of hypertension and diabetes mellitus on pregnancy and its association with gestational age and stillbirth. Study Design: The population-based study was conducted for the analysis of effect of hypertension and diabetes mellitus on pregnancy and the duration of study was five months from August 2019 to December 2019. Methodology: A prospective population based observation study was conducted for 1st delivery. The data of almost 150 pregnant women was collected who were experiencing hypertension and diabetes mellitus at the time of pregnancy. It was also found in the study either the pregnancy and these conditions have any association or not. Results: It was determined in the study that pregnancy is associated with many complications from which most common are diabetes mellitus and hypertension. The result showed that the age of about 76 out of 150 pregnant women who were dealing with hypertension at the time of pregnancy and the age was range from 31-40. The study also showed that age is also linked with diabetes mellitus during pregnancy such as most of the women 76 out of 150 patients were dealing with diabetes mellitus during gestational period. Conclusion: It was concluded from the results that age is highly associated with various diseases especially hypertension and diabetes mellitus at the time of pregnancy. These diseases are the leading cause of other morbidities as well as mortalities for both mother and neonatal. It is important to handle the situation and take good care about these diseases especially during pregnancy.

7

Authors: Sarah Ashfaque, Ashfaq Ahmad, Mumtaz Hussain*, Rahat Ilyas

Background: Musculoskeletal pain is associated with the pain of muscles, tendons, ligaments and bones that can leads to pain of musculoskeletal. The pain is increasing in people of both developing and developed countries and its cause is not much clear and varies from person to person. Its prevalence depends on social and cultural difference but according to an estimate the prevalence of musculoskeletal pain is 30% ranges from 13.5% to 47%. When people do not take it serious and disease remain untreated leads to chronic musculoskeletal pain that is difficult to treat. The it’s prevalence is higher in the age of 30s to 50s. Objective: The study was conducted to find prevalence of musculoskeletal pain as well as its association with the nature of work. The severity of musculoskeletal pain and its relation with gender has also been studied in this article. Methodology: A cross sectional study was conducted on the people who suffering with musculoskeletal pain due to any reason. The data was gathered of about 150 patients from which 86 were male and 64 were female with different age groups. Along with prevalence of pain, the severity of pain was also studied and observed in the article for getting understanding of effective treatment of musculoskeletal pain. Results: The results determined that 78 out of 150 patients from which 1 was female and 7 were male were suffering with the moderate pain during the disease while 42 patients, only 2 male and 40 female explained about severe pain. The results showed that 125 out of 150 patients claimed that at the time of initial onset of the trouble was their age and their age play important role in worsening their pain. Furthermore, the study revealed that sometimes the situation become very problematic and they have to hospitalize for few days such as 86 patients agreed that they hospitalized during disease for management of pain. Conclusion: Musculoskeletal pain is increasing day by day due to diversity and complexity of work during daily life. Most of the people do work by sitting on chair and does not do any work in which they have to walk or do exercise due to which bones become weak and people experienced pain in bones, muscles, tendons and ligaments. The management of pain during its initial stage is very important because situation can become worse when remain untreated and patients also have to hospitalize due to severe pain.

8

Authors: Faizan Muhammad*, Saniya Mustafa, Muhammad Muzammal, Muhammad Ilyas

Hamstring muscle is posterior thigh muscle between the hip and the knee and chances of injuries in this muscle are very high. The hamstring strain are divided into three types depending upon the nature and severity of pain. These classes named as Grade I tear, Grade II tear, Grade III tear. The career of many athletes have been destroyed due to hamstring injuries. Objective: The study was conducted to determine the prevalence of hamstring strains regarding to gender, age. Furthermore, the association of hamstring problems with pain in different postures was also found in this study. Methodology: A cross-sectional study was conducted to find the prevalence of pain and its association with postures. The data was collected of almost 150 patients with hamstring injuries. The analysis was done to determine the effects of different variables in injuries of hamstring muscles. Results: The results showed that the prevalence of injures of hamstring muscles is higher in male as compare to female. 80 males out of 150 patients were dealing with this disease and rates of disease was much higher in urban areas as compared to rural areas. Mostly, patients feel pain all the time due to injuries as 61 out of 150 claimed that they feel pain due to injury. Conclusion: Hamstring injuries are most common cause of pain in young people and occur due to many reasons. People dealing with this disease feel pain all the time and the pain due to this injury is unbearable. The patients feel pain during all activities such walking, jumping and running.

5

Authors: Nahla Labyad 1 , Safa Aljele 1 , Yousef A. Taher 2 *

Background: Henna adulteration is getting rise, over the world, as the cosmetic desire increased. Hence, health problems are induced due to its adulteration with synthetic substances. This study aimed to perform pharmacognostic and phytochemicals analysis of Royal henna to determine its anatomical features. Method: For this purpose, Royal (different colors) and Lawsonia inermis leaves, a natural henna herb, were purchased from local market, identified and extraction was performed by maceration of dried materials in methanol. Phytochemical screening, microscopic, thin-layer chromatographic (TLC) and florescence analyses were executed. Results: Microscopic studies showed presence of small parts related to senna plant within the Royal red henna extract. The Royal brown revealed presence of natural henna plant coupled with a strange plant carrying dyes unrelated to the flora of henna. While, unknown black particles and fibrous were seen in Royal black henna extract. TLC analysis revealed presence of synthetic materials. All Royal dye showed presence of foreign substances. Phytochemical screening showed presence of different primary and secondary metabolites. Whereas, the florescence evaluation revealed different colors both in visible and ultra violet (254nm and 366nm). So identification and quantification studies for foreign substances are important and needed to avoid consumer health risks.

7

Authors: Saman Shahab Farooqui*, Safila Naveed, Fatima Qamar

Naproxen, a non-steroidal anti-inflammatory drug which affect the activity of cyclooxygenase enzyme. It worked by inhibiting the synthesis of prostaglandins by decreasing the activity of the enzyme, cyclooxygenase, resulted in decrease formation of prostaglandin precursors. It had been indicated in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gout and acute mucoskeletal disorders. The main objective of this study was to identify the best bioequivalent brands available in Karachi, by observing their results in order to make the treatment cost-effective. Three different brands of Naproxen (500mg) were taken in the study that were observed under six quality control parameters i.e. weight variation test, hardness test, thickness test, friability test, disintegration test, and dissolution test as per specified by British and US Pharmacopeia BP/USP. All the test requirements were compiled by all three brands of naproxen. Disintegration time for all three brands was within 15 minutes that follows BP/USP standards. All the brands showed more than 80% drug release within 30 minutes. The study showed that almost all the brands of Naproxen available in Karachi had met the specification for quality control analysis.

12

Authors: Hajra Qayyum*, Marriam Bakhtiar

Background: Infective endocarditis (IE) is a type of endovascular infection caused by bacteria in the bloodstream which get adhered to the damaged heart valve. IE has extensively been associated with oral hygiene, as onset of bacteremia has been observed more often in dental patients. Furthermore, few members of oral microbiota including certain strains of Streptococcus sanguinis have also been isolated from IE colonies. Streptococcus sanguinis is a large group of infectious bacteria including human pathogenic strains. S. sanguinis SK36 is a member of microflora of human mouth and is an opportunistic pathogen of dental plaques. Various other strains of S. sanguinis also constitute human mouth microflora, and have the potential to cause dental plaques, therefore, a possibility is there that they too might have a role in the onset of IE. Objective: In this study, we aim to investigate the possible role of all known strains of S. sanguinis in the onset of IE and cluster them accordingly. Method: To achieve this, 31 strains of S. sanguinis were investigated and clustered into two groups i.e. Pathogenic and Non-Pathogenic. We further divided the pathogenic cluster into two sub-clusters; moderate and severe pathogens, based on their distance from the reference strain and degree of significance of the virulence determinants they possess. 22 virulence determinants were enlisted by literature survey and revealed association with IE. Results: Based on our investigations, we clustered 16 out of 31 strains as pathogenic (4 severe and 12 moderate) and rest of 15 as non-pathogenic of IE. Conclusion: It is concluded that not only SK36 and VMC66 but 14 other strains of S. sanguinis also have the potential to cause IE and there is dire need to conduct a comprehensive study to find out their relationship with IE.

7

Authors: Abdul Maalik1*, Sidra Saleem2, Riffat ullah3, Azmatullah1

Background: Dental caries is oral hygienic related diseases and starts by formation of acid which can cause the breakdown of tooth. It can occur at every age and if left untreated in childhood then it becomes a major problem and thus causes irreversible damage of tooth. There are four main stages of dental decay, the first two stages are not painful but the last two stages are very painful because in these the dental decay move towards the nerves and blood vessels present in tooth. The incidences of dental caries are present in every age from childhood to adults and then at older age. Objective: The main objective of this study to determine that at which age the incidence of dental caries are occur mostly. Methodology: A prospective study was conducted for incidence of dental caries at different age groups. The data was collected from almost 100 people of different age groups having proper oral hygiene health and having no proper oral hygiene health. It is also associated in the study that how childhood negligence in dental caries results into irreversible damages of tooth. Results: It was found from the study that if oral hygiene is not maintained then dental caries can be occur at early age and if maintained then there are very less chances of dental caries. Mostly children don’t focus in maintaining their oral hygiene and thus develop dental carries in early ages and when these caries left untreated it become irreversible tooth damage. Conclusion: The chances of developing dental caries depend upon the hygienic condition of mouth. The study concluded that occurrence of dental caries occur at any age and in early childhood the dental caries are not painful and it is healthy to treat it at 1st stage so that the further damage of tooth can be prevented.

8

Authors: Aqsa Afzal*, Syed NisarHussain Shah, Muhammad Fawad Rasool, Nabeela Ameer

Purpose: To investigate the effect of pharmacist dietary interventions on lipid levels of dyslipidemic patients. Methods: A randomized controlled trial was carried out on 266 dyslipidemic patients being studied period of 6 months in patients of Southern Punjab. Controlled group patients followed the standard medical care by the physician and intervention group followed with interventionary dietary advices by the clinical pharmacist who were based on ATP III Guidelines. Results: The results between the control and intervention groups were compared by using independent t-test and paired t-test using α value of 0.05. Statistically significant reductions in weight (kg) and BMI (kg/m2) were observed in both groups (p value <0.0001) but mean reductions were more in intervention group as compared to the control group (-3.47, -1.74) respectively. Similarly, significant reductions were also observed between patients of both groups in Total Cholesterol (TC), Triglycerides (TG), Low density lipoproteins (LDL) (αvalue <0.0001) but mean reductions were found increased in intervention group in comparison to control group in TC, TG, LDL (-28.77 mg/dL, -33.90 mg/dL, -25.29 mg/dL) respectively. Statistically insignificant difference was observed in High density lipoproteins (HDL) level in both intervention and control group (p-value =0.47, 0.30) respectively but mean value of intervention group increased (0.78 mg/dL) while mean value of control group decreased (-1.19 mg/dL). Slight addition in mean HDL level was noticed in intervention group 2.49 mg/dL (p value <0.0001) as compared to control group. Conclusion: Pharmacist dietary interventions can improve lipid levels of dyslipidemic patients.

6

Authors: Adeel Usman1, Muhammad Uzair2, Muhammad Asif Wazir1 and Asad Saleem Sial*1

Since the creation of the planet earth, human beings are curious about the nature and obtain benefits from nature including the treatment of many diseases. Asparagus setaceus Kunth is commonly available plant belongs to family Asparagaceae, commonly used as diuretic, antiepileptic, applied topically in skin diseases, treat urination, gynaecology and andrology problems, orally for dysentery and diarrhea treatment and treat pulmonary infections. The aim of present study is to standardize the plant material. For this purpose, leaves and roots of the Asparagus setaceus Kunth were collected, identified, dried and extraction was performed. Macroscopic, microscopic analysis, phytochemical screening and florescence analysis were also performed. The macroscopic studies revealed different plant structures. The microscopic studies showed different cells and their arrangement within the plant. The phyto-chemical screening reveals presence of different primary and secondary metabolites. Whereas the florescence analysis revealed different colors both in visible and ultra violet (254nm and 366nm). Biological and toxicological studies are needed to be performed to establish the plant monograph for safety profile.

10

Authors: Syed Nisar Hussain Shah and Misbah Rafique*

This paper aims at studying and analyzing polyphenolic content found in grape seed extract (GSE) through different conventional & modern extraction techniques. It also evaluates antioxidant and anti-aging properties of polyphenols extracted from grape seed. Owing to its anti-oxidant properties, polyphenols may help in slowing down skin aging process and may also be used in cosmetic formulations that can retard or slow down the process of aging by scavenging free radicals produced in the skin due to environmental degradation. Antioxidant potential/capacity of GSE has also been evaluated through in vitro and in vivo evaluation techniques.

14

Authors: Syed Nisar Hussain Shah1, Rabia Sumreen2, Hina Javed*2, Bushra Nasir1, Rao Khurram Ayoub2 and Atif Akber 3

In present study, Propylene glycol (PG) and Polyethylene glycol (PEG) were used as permeation enhancers to increase percutaneous absorption and release of CCT gel through silicone membrane. Gel formulations containing Clarithromycin (Macrolide antibiotic) and Cetirizine HCl (a non-sedative, anti-histaminic H-1 receptor) were formulated and optimized by using Response Surface Methodology (RSM) containing different ratios of PG and PEG. PG(X1) and PEG(X2) were taken as two independent variables whereas cumulative amount of Clarithromycin was used to calculate dependent (response) variables (Y1…Y7). From all formulated gels, Clarithromycin was released and permeated through silicon membrane using Franz diffusion cell at 37±1ºC. Fick’s laws of diffusion were used to calculate permeation kinetic parameters like lag time (tlag), diffusion co-efficient (D), K, permeation co-efficient (Kp), Flux (J), enhancement ratios (ER) and input rate (IR). The physical properties of all gel formulations like clarity, pH, viscosity, solubility, partition co-efficient (Ko/w), homogeneity, spreadability and Ex-vivo Panel test, Draize’s irritation test were performed. Analysis of variance (ANOVA) was conducted to evaluate the results which showed that the independent variables have remarkable effects (p < 0.05) on dependent variables. Multiple linear regression analysis was used to compare the results among control and different formulations of CCT gels. Contour plots were also constructed to show the response between dependent and independent variables. Two gels G4 and G5 were optimized. In optimized gels maximum cumulative amounts permeated through silicon membrane were high as compared to Gc. It was found that permeation was increased with the increase in concentration of both permeation enhancers in combination i.e. PG and PEG. Thus it was concluded that PG and PEG can be successfully used in combination as permeation enhancers for transdermal delivery of CCT gel.