Naureen Shehzadi

Effect of Calcium Channel Blockers on Lower Urinary Tract Symptoms: A Systematic Review

Background Numerous medications are known to be associated with the development of lower urinary tract symptoms (LUTS). One such medication group is calcium channel blockers (CCB). Objective To critically examine the literature regarding the involvement of CCB in manifestation of LUTS in humans. Methods A systematic literature search was conducted on PubMed, SciELO, Scopus, and OpenGrey databases to find all potentially relevant research studies before August 2016. Results Five studies met the inclusion criteria and were included in this review. Three out of five studies stated that CCB were involved in either precipitation or exacerbation of LUTS. As for the remaining two studies, one study found out that only the monotherapy of CCB was associated with increased prevalence of nocturia and voiding symptoms in young females, whereas the other study reported an inverse association of CCB with LUTS. The methodological quality of studies was considered high for four studies and low for one study. Conclusion Healthcare providers should make efforts for an earlier identification of the individuals at risk of LUTS prior to the commencement of CCB therapy. Moreover, patients should be counselled to notify their healthcare provider if they notice urinary symptoms after the initiation of CCB.

Knowledge of Ebola virus disease among a university population: A cross-sectional study

HighlightsThree supposed cases of Ebola took the headlines and caused fear in PakistanA cross‐sectional assessment of knowledge of Ebola among university populationResults suggest that knowledge of Ebola among university population is inadequateUniversity students and employees have some misconceptions regarding Ebola &NA; This cross‐sectional study aimed to evaluate the knowledge of a Pakistani university population (students and employees) regarding Ebola virus disease. A total of 2,200 individuals were approached and 1,647 were enrolled in the study. We observed that the vast majority of study participants (91.8%) had inadequate knowledge of Ebola virus disease (knowledge score ≤ 12). Our findings highlight the need to increase the knowledge of Ebola virus disease by using multidimensional approach involving awareness campaigns, print, electronic, and social media.

Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study

Objective: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy. Method: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013. Results: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD. Conclusion: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

Method Development and Stress Degradation Profile of 5-Benzyl-1,3,4-Oxadiazole-2-Thiol Studied by UV Spectroscopy

Considering the pharmacological activities of 5-benzyl-1,3,4-oxadiazole-2-thiol (OXPA), the present study aimed to develop and validate a UV-spectroscopic method according to the ICH guidelines to be used to study degradation profile of the compound. The method was developed at 263 nm, the wavelength giving maximum absorbance. Linearity of the method was evaluated by analyzing a series of standard solutions. Then, recovery, accuracy and sensitivity were determined. The compound was subjected to a number of stress conditions to determine it in the presence of degradants (specificity). The proposed method showed linearity in a concentration range (0.33 - 40.0 μg/mL) with correlation coefficient (R2) = 0.998. The recovery was within 100.63 – 102.46%, intraday and inter-day accuracy were found to be 99.10 – 102.46% with relative standard deviation less than 2%, and the LOD and LOQ were found to be 0.099 and 0.330 μg/mL, respectively. The OXPA was degraded with the passage of time under acidic conditions and oxidized completely in 35% H2O2, whereas the degradation was 58.47% in 3% H2O2. Dry heat (80°C) exposure for 48 h resulted in 1.09% degradation, whereas UV exposure resulted in complete loss of the compound. These results indicate that the method is simple, sensitive, accurate and specific, hence may be used to carry out quantitative work on OXPA.

Linking traditional anti-ulcer use of rhizomes of Bergenia ciliata (Haw.) to its anti-Helicobacter pylori constituents

Abstract The rhizomes of Bergenia ciliata (B. ciliata, Family: Saxifragaceae) are widely used for treating gastric ulcers in folk medicine in Asia. It was hypothesized that anti-ulcer activity of B. ciliata is due to its anti-Helicobacter pylori (H. pylori) activity. The anti-H. pylori activity was investigated on six clinical bacterial isolates using agar well-diffusion and broth micro-dilution methods. The anti-H. pylori activity of amoxicillin (standard) was the highest (Zone of inhibition; ZI = 25 mm, minimum inhibitory concentration; MIC=0.125 µg/µL) whereas among all the extracts of the rhizomes, methanol extract showed the highest activity (ZI = 16 mm, MIC = 12.50 µg/µL). Bioassay guided isolation of methanol extract using chromatographic and crystallization techniques isolated bergenin (ZI = 21mm, MIC = 0.391µg/µL) as constituent responsible for anti-H. pylori activity. The present study describes for the first time anti-H. pylori activity and possible mechanism of anti-ulcer properties of rhizomes of B. ciliata. Graphical abstract

Psychometric Validation of the Urdu Version of the Jenkins Sleep Evaluation Questionnaire

Background: Jenkins sleep evaluation questionnaire (JSEQ) is an easy, self-reported instrument to assess sleeping disturbances. This cross-sectional, cross-cultural adaptation and validation study was aimed to translate and validate JSEQ into Urdu (national language of Pakistan). Methods: JSEQ-Urdu was developed by a 2 step forward/back translation by Urdu and English language experts, respectively. Content validity was determined by content validity index (CVI). The final Urdu version was administered to 75 pharmacy students at Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan. The reliability of final Urdu version was assessed by Cronbach’s alpha and interclass correlation (ICC) coefficients. Furthermore, an exploratory factor analysis (EFA) was conducted to assess the dimensionality of the instrument. Results: The CVI for all four items of JSEQ-Urdu reached 1. All corrected item-total correlation values were positive and above 0.30 (range: 0.443-0.550). Cronbach’s alpha value of the questionnaire was satisfactory (0.69). Two weeks test-retest reliability was determined in 43 respondents and the ICC was found to be excellent (0.89). Similar to the original version, the results of our EFA revealed a single factor model in JSEQ-Urdu. Conclusion: JSEQ-Urdu is an easy, less time consuming, valid and reliable tool to assess sleeping problems among Urdu-speakers. Key words: Patient Reported Outcome Measures, Psychometric, Sleep disturbances, Urdu.

Reverse-Phase Chromatographic Determination and Intrinsic Stability Behavior of 5-[(4-Chlorophenoxy)Methyl]-1,3,4-Oxadiazole-2-Thiol

Abstract The study describes the development and preliminary validation of a simple reverse-phase chromatographic method for determination of a novel drug candidate, 5-[(4-chlorophenoxy) methyl]-1,3,4-oxadiazole-2-thiol (OXCPM), in bulk and stressed solution, in order to find out the intrinsic stability behavior of the compound. Isocratic elution was carried out at a flow rate of 1.0 mL min-1 through a Promosil C18 column maintained at 25 °C, using the mobile phase comprising acetonitrile and aqueous o-H3PO4 (pH 2.67) (1:1, V/V). Detection was performed at 258 nm. The response of the detector was linear in a concentration range of 1.25-50.00 μg mL-1 with the correlation coefficient of 0.9996 ± 0.0001. Cumulative intra-day, inter-day and inter-instrument accuracy (99.5 ± 1.0, 100.2 ± 1.0 and 100.3 ± 0.4 %, resp.) with RSD less than 5 % indicated that the method was accurate and precise. The resolution and selectivity factor (>2 and >1, resp.), particularly in copper metal- and dry-heat-stress solutions, depicted the selectivity of the method. OXCPM remained stable under hydrolytic (acidic and neutral pH, ≤ 37 °C), photolytic and moist heat stress conditions. Under alkaline conditions (hydrolytic and photolytic), polar products were formed that eluted very fast through the column (tR < 3.75 min). At room temperature, the compound was susceptible to oxidation by hydrogen peroxide and transition metals. The ionogram of most of the stress solutions indicated the presence of a product having m/z 256, which might be a result of N- or Smethylation or -SH oxidation. The results of the study indicate that the method is selective, sensitive and suitable to be used for determination of OXCPM in bulk and under stress conditions.

Evaluation of medication use in Malaysian predialysis patients

Chronic kidney disease (CKD) patients suffer from multiple comorbidities and complications as a cause or consequence of kidney disease. Information regarding medication- prescribing patterns in predialysis patients is sparse. We conducted a retrospective study to evaluate the medication prescription patterns among predialysis patients. Medical records (both paper based and computerized) of patients at CKD Resource Centre, Hospital Universiti Sains Malaysia, were reviewed. A total of 615 eligible cases were included in the study. The mean number of medications prescribed per patient was 8.22 ± 2.81, and medication use was correlated to the renal function (stage 3a < stage 3b < stage 4 < stage 5; P <0.001). The top three prescribed medication groups were found to be lipid-lowering agents, calcium channel blockers, and antiplatelet agents. Some medication classes such as nonaluminum/noncalcium phosphate binders, erythropoietin-stimulating agents, and renin-angiotensin-aldosterone system blockers, particularly in advanced stage, were found to be underutilized. In conclusion, predialysis patients are prescribed a large number of medications. Our findings highlight the need for assessing the impact of current medication-prescribing patterns on morbidity and mortality rates in Malaysian predialysis population.

Glutathione sulfotransferase inhibition activity of a self-fermented beverage, Kanji

Abstract Context: Kanji, a liquid preparation of roots of Daucus carota L. ssp. sativus (Hoffm.) Arcang. var. vavilovii Mazk. (Apiaceae), may inhibit glutathione sulfotransferase (GST) activity due to ferulic acid content. Objectives: GST inhibition activity and characterization of Kanji and methanol extract of D. carota roots, and oral absorption pattern of ferulic acid from Kanji in rats. Materials and methods: GST inhibition activity of Kanji and methanol extract of D. carota roots in concentration range 0.001–100.00 mg/mL was determined using Sprague Dawley rat liver cytosolic fraction. Methanol extract upon column chromatography gave ferulic acid, which was used to characterize Kanji and determine its oral absorption pattern in Wistar rats. Results: The GST inhibition activity of Kanji (100.00 μg/mL), methanol extract of D. carota roots (100.00 μg/mL) and tannic acid (10.00 μg/mL, positive control) was found to be 0.162 ± 0.016, 0.106 ± 0.013 and 0.073 ± 0.004 μM/min/mg, respectively. Different Kanji samples and methanol extract contained ferulic acid (0.222–0.316 mg/g) and 0.77 mg/g, respectively. Ferulic acid did not appear in plasma after oral administration of Kanji. Discussion: Kanji having solid contents 80.0 μg/mL, equivalent to 0.0025 μg/mL ferulic acid, does not inhibit the activity of GST. The oral administration of Kanji, in human equivalent dose (528 mg/kg, 16.67 μg ferulic acid), to rats indicated poor absorption of ferulic acid. Conclusion: Kanji having solid contents 14–36 mg/mL does not inhibit GST activity, hence may not interfere with drugs that are the substrates of GST, if taken concomitantly.

Chemical and pharmacological comparison of modern and traditional dosage forms of Joshanda

Abstract Recently, a traditional remedy (Joshanda) has been replaced largely by modern ready-to-use dosage forms, which have not been compared to the original remedy. Therefore, the present study aimed to compare a number of modern dosage forms with traditional remedy. Seven brands, 3 batches each, were compared with a Lab-made formulation with reference to analytical (proximate analyses, spectroscopic and chromatographic metabolomes) and pharmacological profiles (anti-inflammatory and antibacterial activities). Chemical and pharmacological differences were found between Lab-made Joshanda and modern dosage forms. Such variations were also found within the brands and batches of modern formulations (p < 0.05). The Lab-made Joshanda showed significantly higher pharmacological activities as compared to modern brands (p ). The results of the present study indicate that modern dosage forms are unstandardised and less effective than the traditional remedy. Characteristic profiles obtained from Lab-made Joshanda may be used as reference to produce comparable dosage forms.