@article {314, title = {Clinical Outcome of Herbal Medicine-related Problems for Respiratory Viral Infections}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {10}, year = {2021}, month = {December 2021}, pages = {138-143}, type = {Research Article}, chapter = {138}, abstract = {

Background: The use of herbal medicine to treat dissimilar respiratory conditions has been assumed for many decades. This survey analysis explores the clinical outcomes of herbal medicine-related problems for respiratory viral infections in Saudi Arabia. Design and Setting: A self-administered, structured questionnaire was sent to the public online, counting questions on the responders{\textquoteright} demographics and questions gaging different clinical outcomes of herbal medicine-related problems when treating respiratory viral infections in Saudi Arabia. Data analysis was performed through SPSS program version 26. Results: 486 participants responded to this questionnaire. 89.92\% of the responders were from the west area in Saudi Arabia, 56.49\% were in the age group between 18 and 30 years old. 18.32\% were healthcare practitioners, while 53.85\% of these practitioners were physicians. 18.74\% of the responders applied herbal medications three times daily for respiratory viral infections. Only 4.31\% of the responders established having side effects during the past year from herbal medications, while 3.58\% visited a pharmacy for these side effects. Their healthcare professionals asked 20.04\% about the use of herbal medications. Factors increasing the occurrence of adverse events were: that residents of the western region (p value=0.002), age group between 18 and 30 (p-value=0.046), females (p-value\<0.001), low monthly income (p-value=0.013) and non-healthcare professionals (p-value=0.001). Conclusion: Although the occurrence of herbal medication-related problems is not common in Saudi Arabia, it can need medical assistance. Awareness of the public of the herbal medications adverse events is decisive.

}, keywords = {Clinical, Herbal medicine, Outcome, Problems, Viral Infections Saudi Arabia.}, doi = {10.5530/ijpcs.2021.10.19}, author = {Yousef Ahmed Alomi and Ghadeer Alhazmi and Murouj Almaghrabi and Ghaida Alzahrani and Mohammad Almatrafi} } @article {241, title = {Cardiovascular Medications Therapeutic Interchanges: A Narrative Reviews}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {9}, year = {2020}, month = {May 2020}, pages = {51-58}, type = {Review Article }, chapter = {51}, abstract = {

Objective: To review the cardiovascular medications therapeutic interchanges. Methods: It is an extensive search, or fifty databases included the following through the Saudi Digital Library (SDL) searching engine. It included the various types of studies (meta-analysis, randomized controlled studies and observational studies) in the English language with human study only for the update May 2017. The search in terms of therapeutic interchange, medication, therapy, type of disease or medication base on therapeutics class of anti-psychiatric. The medication list and switch from one drug to alternative based on the literature found the search that has included comparative safety, efficacy and cost of the type of medication for each disease and national or international evidence-based guidelines. Results: The total number of studies after an extensive search with a specific term search was 487 studies. Of those, there were 107 duplicated studies, and 380 studies included for future evaluation. After evaluation, there were 64 studies about therapeutic interchange of cardiovascular medications. Conclusion: The cardiovascular therapeutic interchange studies are wide-ranging and common available findings in the literature. Most of the studies have observational non-randomized. Comparative studies published in management guidelines as an alternative interchange of this matter. Cardiovascular therapeutic interchanges are highly recommended for execution in the Kingdom of Saudi Arabia.

}, keywords = {Cardiovascular, Drug, Literature, Review, Therapeutic interchanges, Therapy}, doi = {10.5530/ijpcs.2020.9.10}, author = {Yousef Ahmed Alomi and Faiz Abdullah Bahadig} } @article {244, title = {Chronic Diseases Therapeutic Interchanges Drug Therapy: A Narrative Reviews}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {9}, year = {2020}, month = {August 2020}, pages = {98-102}, type = {Review Article }, chapter = {98}, abstract = {

Objective: To review the chronic diseases (gastrointestinal disorders, rheumatic arthritis etc.) therapeutic interchanges drug therapy. Methods: It is an extensive search, or fifty databases included the following through the Saudi Digital Library (SDL) searching engine. It included the various types of studies (meta-analysis, randomized controlled studies and observational studies) in the English language with human study only for the update May 2017. The search in terms of therapeutic interchange, medication, therapy and type of disease or medication based on therapeutics class of anti-psychiatric. The medication list and switch from one drug to alternative based on the literature found the search that has included comparative safety, efficacy and cost of the type of medication for each disease and national or international evidence-based guidelines. Results: The total number of studies after an extensive search with a specific term search was 487 studies. Of those, there were 107 duplicated studies, and 380 studies included for future evaluation. After evaluation, there were 19 studies about therapeutic interchange of chronic medications (Rheumatoid arthritis (RA) or Gastrointestinal disorder (GIT). Of those 19 studies, eight studies included for evaluation. Conclusion: Gastrointestinal and rheumatic arthritis medications, therapeutic interchange more practical and prevent the economic burden on healthcare systems. The implementation of therapeutic interchange of those medications is highly recommended at healthcare institutions in the Kingdom of Saudi Arabia.

}, keywords = {Chronic diseases, Gastrointestinal, Literature, Medications, Review, Rheumatic arthritis, Therapeutic interchanges}, doi = {10.5530/ijpcs.2020.9.19}, author = {Yousef Ahmed Alomi and Faiz Abdullah Bahadig} } @article {68, title = {The Clinical Outcomes of Pharmacist Interventions in Total Parenteral Nutrition services in Riyadh City, Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {June 2019}, pages = {135-140}, type = {Research Article}, chapter = {135}, abstract = {

Objectives: Total parenteral nutrition (TPN) is the perilous component of nutritional care for neonatal, pediatric and adult patients. TPN is designated for someone who cannot or should not consume nutrients through their regular oral pathway. In this study, we explored the clinical outcomes of pharmacist intervention in Parenteral Nutrition at the public hospital in Riyadh city, Saudi Arabia. Methods: In prospective cohort studies, we simulated the data of 12 months of 2015 related to TPN services for neonatal, pediatric and adult patients. Most of the TPN units at hospitals works eight hours per day and seven days per a week. The hospital in Riyadh, Saudi Arabia has 300 beds. The pharmacist intervention consisted of an International Study Model, measure level of activity, rational of clinical intervention, recommendation, and patient with outcome impact. The data were analyzed through Survey Monkey system. Results: The total number of pharmacist interventions were 402 of recognized TPN-related problems. The total number of TPN orders was 394 prescribed to 82 patients. The majority of patients were neonates 303 (75.56\%) followed by Pediatrics 97 (24.19\%). The highest number of critical care interventions were found to be potentially serious 108 (28.8\%) and potentially significant 174 (46.4\%). The documented rationale of clinical intervention activities was inappropriate dose 93 (24.8\%) drug therapy omission 50 (13.3\%) and inappropriate route of administration 41 (10.9\%). Most of the patient outcomes were laboratory value improved 170 (45.33\%) and patient condition improved 137 (36.53\%). Conclusion: TPN clinical pharmacist had an essential vital role of preventing a TPN-related problem, improve patient outcome, and avoid the unnecessary supplementary cost. Increasing TPN clinical pharmacist assigned for all TPN services at all health care system in Saudi Arabia.

}, keywords = {Assessment, Clinical outcomes, Interventions, Pharmacist, Total Parenteral Nutrition program}, doi = {10.5530/ijpcs.2019.8.23}, author = {Yousef Ahmed Alomi and Aisha Omar Fallatah and Nisreen Al-Shubaar and Abdulaziz Abdullah Qohal and Lila Yahya Alameer} } @article {45, title = {Cost Analysis of Activities for Network Drug Information Centers at the Ministry of Health Hospitals in Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {January 2019}, pages = {45-51}, type = {Research Article}, chapter = {45}, abstract = {

Objectives: In this study, we aimed to analyze the cost of network drug information services at the Ministry of Health (MOH) hospitals in Saudi Arabia. Method: In this study, we simulated the 2-month cross-sectional survey data of all drug information centers at the MOH hospitals. Any drug store that has provided services to the healthcare professionals and the public participated in the questionnaire. National, regional and local drug information centers in the healthcare institutions participated in this survey. All type of hospitals or primary care centers (e.g. public, pediatric, maternity and psychiatry) were included in this study. The survey consisted of two parts: the first part collects demographics data and the second part analyzes the cost of activities of drug information centers. The clinical activities were derived from the model of the American College of Clinical Pharmacy (ACCP). The type cost consisted of related central drug information activities, the cost of the patient-centered drug information activity and the cost of Administrative drug information activities. All cost used US dollar currency. Results: The survey was distributed to 60 drug information centers and a total of 46 centers responded to the survey; the response rate was 76.66\%. Most of the hospitals (11 (23.9\%)) had 100{\textendash}199 beds and the others (11 (23.9\%)) had 200{\textendash}299 beds. The total daily cost of drug information activities was 6,002.18 USD. The highest cost of drug information activities was central drug information activities (2,654.69 USD (44.23\%)) followed by the administration of drug information activities (2,280.59 USD (37.99\%)) and patient-specific drug information activities (1,066.9 USD (17.77\%)). The highest daily cost of drug information activities among central drug information center was responding to drug information inquiries ((536.24 USD)) followed by the residential training ((9274.46 USD)) and pharmacist{\textquoteright}s training ((263.14 USD)). Conclusion: The central activities of drug information centers costed the highest. Expanding the services to patient-specific activities will decrease morbidity, mortality and justify cost analysis at MOH hospitals in Saudi Arabia.

}, keywords = {Activities, Cost Analysis, Drug Information Centers, Ministry of Health, Network, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.9}, author = {Yousef Ahmed Alomi and Ban Abdullah Aldosary} } @article {198, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Antibiotic Pediatrics Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s7-s10}, type = {Research Article}, chapter = {s7}, abstract = {

Objectives: The aim of this study to explore the cost analysis of selected pediatrics antibiotics formularies in the Kingdom of Saudi Arabia. Methods: It is a retrospective cost analysis of pediatrics formulations at 300-beds pediatrics and maternity hospital in Riyadh city, Saudi Arabia. The pharmacy section received the specific formulation from physician then the expert pharmacist applied the international standard of clinical compounding through providing to healthcare staff over eight hours per days for five days per a week. The pediatrics formulations consisted of selected four antibiotics (Nitrofurantoin, Oseltamivir, Chloroquine and Clindamycin). The analysis of the cost included the variable expenses included personal cost, material and supply cost, Costs fixed including direct cost, non-salary cost and overhead cost. The cost was derived from the Ministry of Health information database. All cost used US dollar currency. The study analyzed the cost of anti-hypertension pediatrics formulations through the Microsoft Excel sheet version 10th. Results: The estimated average total standard cost of pediatrics formulations per hour was (53.82 USD). The average estimated cost of Nitrofurantoin per each preparation was (14.13 USD) which consisted of standard cost (0.31 USD) and the direct cost was (13.82 USD). The average estimated cost of Oseltamivir per each preparation was (16.95 USD) which consisted of standard cost (0.33 USD) and the direct cost was (16.62 USD). The average estimated cost of Chloroquine per each preparation was (6.645 USD) which consisted of standard cost (4.36 USD) and the direct cost was (6.645 USD). The average estimated cost of Clindamycin per each preparation was (14.478 USD) which consisted of standard cost (2.018 USD) and the direct cost was (12.46 USD). Conclusion: There are varieties in the cost analysis between selected pediatric formulation and manufactured ready-made products. The pharmacist should select the cheapest one among them. The cost analysis of pediatrics formulation was used for health insurance coverage and to meet the updated pharmacy strategic plan and Saudi vision 2030 in the Kingdom of Saudi Arabia.

}, keywords = {Antibiotic, Clinical, Compounding, Cost, Formulations, Ministry of Health, Pediatrics, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.37}, author = {Yousef Ahmed Alomi and Malika Alhadab and Faiz Bahadig and Mohammad Jabir Al Harbi and Mona Lubbad and Ebtesam Nazal} } @article {199, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Anticonvulsant Pediatrics Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s11-s14}, type = {Research Article}, chapter = {s11}, abstract = {

Objectives: The aim of this study is to explore the cost analysis of pediatrics anticonvulsant formulations in Saudi Arabia. Methods: It is a retrospective cost analysis of pediatrics formulations at 300-beds pediatrics and maternity hospital in Riyadh city, Saudi Arabia. The pharmacy section received the specific formulation from physician then the expert pharmacist applied the international standard of clinical compounding through of providing to healthcare staff over eight hours per days for five days per a week. The pediatrics formulations consisted of selected four anticonvulsant medications. The analysis of the cost included the variable expenses included personal cost, material and supply cost, Costs fixed including direct cost, non-salary cost and overhead cost. The cost was derived from the Ministry of Health information database. All cost was used US dollar currency. The study analyzed the cost of anticonvulsant pediatrics formulations through the Microsoft Excel sheet version 10th. Results: The estimated average total standard cost of pediatrics formulations per hour was (53.82 USD. The average estimated cost of Levetiracetam per each one preparation was (53.313 USD). The total annual cost of Levetiracetam was (18,126.42 USD). The average estimated cost of Topiramate per each one preparation was (22.66 USD). The total annual cost of Topiramate was (1,087.68 USD). The average estimated cost of Rufinamide per each one preparation was (29.342 USD), while the total annual cost of Rufinamide was (293.42 USD). Conclusion: This is the first study about cost analysis of anticonvulsant pediatrics formulations in KSA and Middle East. There are some differences in the cost analysis between the pharmacy preparations and manufactured related to internal and external reasons. The pharmacist should select the cheapest one among them the preparations. The cost analysis of pediatrics formulation meets the Saudi vision 2030 strategic plan in the Kingdom of Saudi Arabia.

}, keywords = {Anticonvulsant, Clinical, Compounding, Cost, Formulations, Ministry of Health, Pediatrics, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.38}, author = {Yousef Ahmed Alomi and Malika Alhadab and Faiz A. Bahadig and Mona Lubbad and Ebtesam Nazal and Khulud Khalid Alnami} } @article {197, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Antihypertensive of Pediatric Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s2-s6}, type = {Research Article}, chapter = {s2}, abstract = {

Objectives: The primary objective of this study was to explore cost analysis of pediatric formulations in Riyadh city, Saudi Arabia. Methods: This is a retrospective study of cost analysis of pediatric formulations at 300-bed pediatric and maternity hospital in Riyadh city, Saudi Arabia. The pharmacy section of this hospital receives the specific formulation from the physician. Then, the expert pharmacist applied the international standard for clinical compounding and provides services to the healthcare staff and patients over 8 hr per day for 5 days per week. The pediatric formulations consisted of but not limited to antibiotics, anti-tuberculosis (TB) medications and anti-hypertensive medications. The cost analysis included the variable expenses such as personal cost, material cost and supply cost and fixed expenses such as direct cost, non-salary cost and overhead cost. The cost was derived from the Ministry of Health information database. All costs used have been analyzed in US dollar currency. In this study, we analyzed the cost of antihypertensive medications for pediatric use through the Microsoft Excel software (version 10). Results: The estimated average total standard cost of pediatric formulations per hour was 53.82 USD and consisted of 58.58\% (31.53 USD) for personal cost, 25.14\% (13.53 USD) for overhead cost, 3.34\% (1.8 USD) for material and supply cost and 12.93\% (6.96 USD) for the non-salary cost. The average estimated cost of Propranolol, Captopril, Methyldopa, Amlodipine and Hydralazine per each preparation was (8.27 USD, 2.37 USD, 6.88 USD, 17.385 USD) and (49.44 USD), respectively. Conclusion: To the best of our knowledge, this is the first study which demonstrated the cost analysis of antihypertensive pediatric formulation in the Kingdom of Saudi Arabia. The pediatric formulations with cost analysis can involve health insurance coverage. Targeting the cost analysis of all pediatric formulation is highly recommended to fit with Saudi vision 2030 in the Kingdom of Saudi Arabia.

}, keywords = {Analysis, Antihypertensive, Clinical, Compounding, Cost, Formulations, Pediatric, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.36}, author = {Yousef Ahmed Alomi and Fatimah Fouad Al Doughan and Faiz A. Bahadig and Malika Alhadab and Mona Lubbad and Ebtesam Nazal} } @article {200, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Anti-tuberculosis Pediatrics Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s15-s18}, type = {Research Article}, chapter = {s15}, abstract = {

Objectives: In this study, we explored the cost analysis of selected pediatric antituberculosis formulations available at the pharmacy of a pediatrics and maternity hospital in Riyadh city, Saudi Arabia. Methods: This is a retrospective cost analysis study of pediatric anti-tuberculosis formulations conducted at a pediatrics and maternity hospital having 300 beds in Riyadh city, Saudi Arabia. The pharmacy section of this hospital receives the specific formulation from the physician. Then the expert pharmacist provides the clinical compounding services to healthcare staff and patients over 8 hr per day for 5 days per a week. The pediatric formulations consisted of selected anti-tuberculosis medications. The cost analysis included variable expenses such as personal cost, material cost and supply cost. Fixed costs included direct cost, nonsalary cost and overhead cost. All costs were derived from the Ministry of Health information database. All costs were analyzed in terms of US dollar currency by using the Microsoft Excel software version 10. Results: The estimated average total standard cost of pediatric anti-tuberculosis formulations per hour was (53.82 USD), which included 58.58\% (31.53 USD) personal cost, 25.14\% (13.53 USD) overhead cost, 3.34\% (1.8 USD) material and supply cost and 12.93\% (6.96 USD) non-salary cost. The average estimated cost of rifampicin per preparation was (11.36 USD). The total annual cost of rifampicin was (1363.20 USD). The average estimated cost of pyrazinamide per preparation was (6.835 USD). The total annual cost of pyrazinamide was (68.35 USD). The average estimated cost of isoniazid per preparation was (8.515 USD). The total annual cost of isoniazid was (85.15 USD). Conclusion: Two anti-tuberculosis pediatric formulations (rifampicin and isoniazid) were available for various prices, whereas pyrazinamide was not available as pediatric formulation either locally or in USA and UK. The pharmacist should prepare all anti-tuberculosis pediatric formulation when needed. The cost analysis of all anti-tuberculosis pediatric formulations should be determined in order to meet health insurance and the strategies of New Saudi Vision 2030 in the Kingdom of Saudi Arabia.

}, keywords = {Anti-tuberculosis, Clinical compounding, Cost, Ministry of Health, Pediatric formulations, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.39}, author = {Yousef Ahmed Alomi and Faiz A. Bahadig and Malika Alhadab and Mona Lubbad and Ebtesam Nazal and Mayssa Ahmed Assiri} } @article {201, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Autoimmune and Gastrointestinal Pediatric Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s19-s23}, type = {Research Article}, chapter = {s19}, abstract = {

Objectives: To explore the cost analysis of selected autoimmune and gastrointestinal pediatric formulations in Riyadh city, Saudi Arabia. Methods: This is a retrospective cost analysis study of autoimmune and gastrointestinal pediatric formulations at a pediatrics and maternity hospital in Riyadh city, Saudi Arabia. The extemporaneous pharmacy section regularly receive prescriptions with specific formulation from physician. The expert pharmacist applies the international standard of clinical compounding for all pediatric formulation related issue over 8 hr per days for 5 days per a week. The pediatric formulations consisted selected autoimmune and gastrointestinal medications. The cost analysis includes variable expenses such as personal cost, material cost and supply cost and fixed costs includes direct cost, non-salary cost and overhead cost. All costs were derived from the Ministry of Health information database. All costs were considered based on US dollar currency. In this study, we analyzed the cost of autoimmune and gastrointestinal pediatric formulations through the use of Microsoft Excel software version 10. Results: The estimated average total standard cost of pediatric formulations per hour was (53.82 USD). The average estimated cost of hydrocortisone per preparation was (12.896 USD). The total annual cost of hydrocortisone was (1547.52 USD). The average estimated cost of prednisolone per preparation was (4.6 USD). The average estimated cost of allopurinol per preparation was (6.99 USD) and the average estimated cost of sildenafil per preparation was (25.05 USD). The average estimated cost of omeprazole per each one preparation was (24.07 USD) and the total annual cost of omeprazole was (7221 USD). The average estimated cost of ranitidine per preparation was (5.248 USD) and the total annual cost of ranitidine was (2760.45 USD). The average estimated cost of baclofen per preparation was (21.266 USD) and the total annual cost of baclofen was (7655.76 USD). Conclusion: Based on the cost analysis, the cost of selected pediatric autoimmune and gastrointestinal pediatric formulations were higher than the ready-made products manufactured by pharmaceutical companies. The pharmacist should select the cheapest one among them. The cost analysis of pediatric formulation can be used to cover health insurance and meet the updated pharmacy strategic plan and New Saudi Vision 2030 in the Kingdom of Saudi Arabia.

}, keywords = {Autoimmune, Clinical, Compounding, Cost, Formulations, Gastrointestinal, Ministry of Health, Pediatrics, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.40}, author = {Yousef Ahmed Alomi and Malika Alhadab and Mona Lubbad and Faiz A. Bahadig and Ebtesam Nazal} } @article {204, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Excipients and Vehicles of Pediatric Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s32-s35}, type = {Research Article}, chapter = {s32}, abstract = {

Objectives: To explore cost analysis of excipients of pediatric formulations in Saudi Arabia. Methods: It is a retrospective cost analysis of pediatric formulations at 300-beds pediatrics and maternity hospital in Riyadh city, Saudi Arabia. The pharmacy section received the specific formulation from physician then the expert pharmacist applied the international standard of clinical compounding through by providing to healthcare staff over eight hours per days for five days per a week. The pediatric formulations consisted selected excipients of pediatric formulations. The analysis of the cost included the variable expenses included personal cost, material and supply cost. Fixed costs including direct costs, non-salary cost and overhead cost. The cost was derived from the Ministry of Health information database. All cost was used US dollar currency. The study analyzed the cost of excipients of pediatric formulations through the Microsoft Excel sheet version 10th. Results: The estimated average total standard cost of pediatric formulations per hour was (53.82 USD and consisted of 58.58 \% (31.53 USD) for personal cost, 25.14 \% (13.53 USD) for overhead cost, 3.34\% (1.8 USD) for material and supply cost, 12.93 \% (6.96 USD) for non-salary cost. The average estimated cost of Simple Syrup per each preparation was (1.974USD). The total annual cost of simple syrup was (426.38 USD). The average estimated cost of methyl cellulose 1\% plus simple syrup per each preparation was (3.721USD). The total annual cost of methyl cellulose 1\% was (759.1USD). The average estimated cost of methyl cellulose 1\% per each preparation was (2.5 USD). The total annual cost of methyl cellulose 1\% was (584.8 USD). The average estimated cost of methyl cellulose 2\% per each preparation was (3.655 USD). The total annual cost of Methyl Cellulose 2\% (438.6 USD). Conclusion: This is the first of cost analysis of excipients of pediatric formulations in Saudi Arabia. Most of excipients of pediatric formulations products not registered in the famous countries. The hospital pharmacy updates annually all cost analysis of excipients pediatric formulations. The pharmacist should select the best and appropriate excipients for the formulations. The cost analysis project as part of updated the pharmacy strategic plan with new Saudi Vision 2030.

}, keywords = {Clinical, Compounding, Cost, Excipients, Formulations, Ministry of Health, Pediatrics, Saudi Arabia, Vehicles}, doi = {10.5530/ijpcs.2019.8.43}, author = {Yousef Ahmed Alomi and Malika Alhada and Faiz A. Bahadig and Mona Lubbad and Ebtesam Nazal} } @article {203, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Nephrology Pediatrics Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s28-s31}, type = {Research Article}, chapter = {s28}, abstract = {

Objectives: To explore cost analysis of selected renal pediatric formulations in Riyadh city, Saudi Arabia. Methods: It is a retrospective cost analysis of pediatric formulations at 300-beds pediatrics and maternity hospital in Riyadh city, Saudi Arabia. The pharmacy section received the specific formulation from physician then the expert pharmacist applied the international standard of clinical compounding through by providing to healthcare staff over eight hours per days for five days per a week. The pediatric formulations consisted selected renal products. The analysis of the cost included the variable expenses included personal cost, material and supply cost. Fixed costs, including, direct costs, non-salary cost and overhead cost. The cost was derived from the Ministry of Health information database. All cost was used US dollar currency. The study analyzed the cost of Nephrology pediatrics formulations through the Microsoft Excel sheet version 10th. Results: The estimated average total standard cost of pediatric formulations per hour was (53.82 USD). The average estimated cost of Hydrochlorothiazide per each preparation was (5.204 USD) and the total annual cost of Hydrochlorothiazide was (2,071.2 USD). The average estimated cost of Acetazolamide per each preparation was (5.72 USD) the total annual cost of Acetazolamide was (366.1 USD). The average estimated cost of Spironolactone per each preparation was (2.513 USD) and the total annual cost of Spironolactone was (1,507.8 USD). The average estimated cost of Sodium citrate per each preparation was (1.23 USD) with a total annual cost of Sodium citrate was (599.01 USD). The average estimated cost of Citric Acid per each preparation was (1.136 USD) with a total annual cost of Citric Acid was (81.782 USD). Conclusion: Cost analysis of pediatrics formulation with emphasis on medications used for renal diseases is primary tool of pharmacoeconomic and health insurance. The pharmacist play role in the preparation of renal medications and cost analysis related issue. This is new study in Kingdom of Saudi Arabia and Gulf or Middle East countries with and meet the new Saudi vision 2030 in the Kingdom of Saudi Arabia.

}, keywords = {Clinical, Compounding, Cost, Formulations, Ministry of Health, Nephrology, Pediatrics, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.42}, author = {Yousef Ahmed Alomi and Malika Alhadab and Faiz A. Bahadig and Mona Lubbad and Ebtesam Nazal} } @article {202, title = {Cost Analysis of Clinical Compounding in Saudi Arabia: Oral Electrolyte Pediatrics Formulations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {November 2019}, pages = {s24-s27}, type = {Research Article}, chapter = {s24}, abstract = {

Objectives: To explore cost analysis of selected oral electrolytes pediatrics formulations in the Kingdom Saudi Arabia. Methods: It is a retrospective cost analysis of pediatrics formulations at 300-beds pediatrics and maternity hospital in Riyadh city, Saudi Arabia. The pharmacy section received the specific formulation from physician then the expert pharmacist applied the international standard of clinical compounding through of providing to healthcare staff over eight hours per days for five days per a week. The pediatrics formulations consisted selected four selected electrolytes. The analysis of the cost was included the variable expenses like personal cost, material and supply cost. Fixed costs include direct cost, non-salary cost and overhead cost. The cost was derived from the Ministry of Health information database. All cost was used US dollar currency. This study analyzed the cost of anti-hypertension pediatrics formulations through the Microsoft Excel sheet version 10th. Results: The estimated average total standard cost of pediatrics formulations per hour was (53.82 USD). The average estimated cost of potassium chloride 10\% per each preparation was (2.053 USD) and the total annual cost of potassium Chloride 10\% was (172.452 USD). The average estimated cost of potassium chloride 7.5\% per each preparation was (1.342 USD) with the total annual cost of potassium chloride 7.5\% was (228.14 USD). The average estimated cost of sodium bicarbonate 8.4\% per each preparation was (0.7551 USD) with the total annual cost of sodium bicarbonate 8.4\% was (54.36 USD). The average estimated cost of calcium carbonate 200 mg/mL per each preparation was (5.45 USD) with the total annual cost of calcium carbonate 200mg/mL was (1,046.4 USD). The average estimated cost of sodium chloride 5.8\% per each preparation was (1.117 USD) which the total annual cost of sodium chloride 5.8\% was (167.55 USD). Conclusion: Most the electrolyte pediatrics formulations which are not available in the local or international market. Pharmacists should continue to prepare them with lower economic burden. The study was first done in KSA and meet new health strategic plan of Saudi vision 2030 in the Kingdom of Saudi Arabia.

}, keywords = {Clinical, Compounding, Cost, Electrolyte, Formulations, Ministry of Health, Pediatrics, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.41}, author = {Yousef Ahmed Alomi and Faiz A. Bahadig and Malika Alhadab and Mona Lubbad and Ebtesam Nazal} } @article {40, title = {Cost Efficiency of National Drug Information Center Services Through Ministry of Health Hotline Calling Center (937) in Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {January 2019}, pages = {17-20}, type = {Research Article}, chapter = {17}, abstract = {

Objective: Since January 2013, the national drug information center (NDIC) has started providing services and since December 2013, it is answering all the public and professional inquiries made through the Ministry of Health (MOH)-Hotline Calling Services (937). Therefore, in this study, we explored the cost avoidance analysis of national drug information inquiries by the hotline services in Saudi Arabia. Methods: We simulated the drug information inquiries related to the adults and children for the duration of 12 months of 2014 through MOH-hotline calling services (937). At least 10 on-call clinical pharmacists and expert trained pharmacists were receiving calls made from public and professionals inquiring about drug information. The data were collected in the drug information data collecting form through manual documentation system of drug information inquiries. Results: The drug information pharmacist implicated that the high-cost avoidance at the public side came from the dose standardization (30,310 USD (37.5\%)) of the total cost avoidance followed by the drug administration and adverse drug reaction (16,532 USD (20.45\%) and 9,347.5 USD (11.56\%), respectively), which represent more than 50\% of the total cost avoidance from the public side. With regard to professional inquiries, the drug information pharmacist implicated that the highest cost avoidance was through inquiries related to drugs in pregnancy, which was around 7,527.50 USD (26\%) of the total cost followed by the drug administration, drug{\textendash}drug interaction and drug identification (4,792 USD (16.5\%); 4,141.50 USD (14.3\%); and 4,135.50 USD (14.2\%), respectively), which represent more than 50\% of the total cost avoidance from the professional side. Conclusion: NDIC was the first in calculating cost avoidance from answering drug information inquiries from professional and public separately in the Middle Eastern countries. It is highly implicated in the drug information services in the healthcare organization in the Kingdom of Saudi Arabia.

}, keywords = {Cost, Drug Information Center, Efficiency, Hotline, Ministry of Health, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.4}, author = {Yousef Ahmed Alomi and Hajer Yousef Almudaiheem} } @article {44, title = {Cost of Total Parenteral Nutrition Services at the Ministry of Health, Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {January 2019}, pages = {39-44}, type = {Research Article}, chapter = {39}, abstract = {

Objectives: The estimation of cost of total parenteral nutrition (TPN) is a part of the pharmacoeconomic program at the Ministry of Health (MOH), Saudi Arabia. In this study, we explored the cost analysis of TPN services by using American Model with local cost. Methods: Simulation was performed for all 6 months of TPN services for neonate, pediatric and adult patients. King Salman Hospital in Riyadh, Saudi Arabia was chosen as the study site; it has 300 beds. The physician or the pharmacist prescribed TPN to their patients. The pharmacist reviews and prepares TPN. The nurse administers TPN and follows up with the doctor or the pharmacist. TPN was prepared through sterile 797 standards and automated compounding facilities. The costing was derived from MOH information database. The cost was calculated based on the variable expenses including personal cost, material cost and supply cost. Fixed costs included direct cost, non-salary cost and overhead cost. All costs were estimated in US dollar currency and local prices. Results: A total number of 112 patients were prescribed with (1631) TPN orders; the total volume of TPN was 619,161.90 mL. Of these, 103 (91.96\%), 6 (5.36\%) and 3 (2.68\%) were prescribed for neonatal, adult and pediatric patients, respectively. Of those with TPN orders, 1484 (90.99\%), 108 (6.62\%) and 39 (2.39\%) were prescribed for neonatal, adult and pediatric patients, respectively. The total average number of orders per day was 4.47. Of those, 4.07, 0.3 and 0.11 was for neonatal, adult and pediatric patients, respectively. The average duration of TPN for adults, neonatal and pediatric patients was 18, 14.4 and 13 days, respectively. The total average direct cost for active ingredient in the TPN was 61.81 USD. Of those, 38.54 USD (62.35\%), 16.63 USD (26.91\%) and 6.64 USD (10.74\%) was for pediatric, adult and neonatal patients. The estimated cost of TPN services for neonatal, adult and pediatric patients was 863.74 USD, 691.3 USD and 618.16 USD per day, respectively. The total annual and daily estimated expenditures of TPN orders were 629,865.02 USD and 212.22 USD; 44,795.24 USD and 207.39 USD; and 5,303.77 USD and 68.00 USD respectively for neonatal, adult and pediatric patients. The total annual and daily estimated cost were 314,764.70 USD and 3,055.97 USD; 22,398.12 USD and 3,733.02 USD; and 2,652.00 USD and 884.00 USD respectively for neonatal, adult and pediatric patients. Conclusion: In this study, we performed cost-estimation of the TPN in Saudi Arabia. This is the first study at MOH in Saudi Arabia. It is an essential basic element of pharmacoeconomic program and cost analysis of TPN-related healthcare services.

}, keywords = {Cost, Ministry of Health, Saudi Arabia, Total Parenteral Nutrition}, doi = {10.5530/ijpcs.2019.8.8}, author = {Yousef Ahmed Alomi and Aisha Omar Fallatah and Amjad Ahmad AL qahtani and Nesreen Al-Shubbar and Maha F Al-Yahya and Estiqlal Hussain Al-Smail} } @article {109, title = {Comparative Analysis of Alternate Day and Daily Regimen of Atorvastatin in Dyslipidaemic South Indian Patients}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {December 2016}, pages = {97-102}, type = {Research Article}, chapter = {97}, abstract = {

Background: Atorvastatin is the most commonly used drug for the treatment of dyslipidaemia. Long term administration of statins helps in the reduction of cardiovascular morbidity and mortality associated with dyslipidaemia. Number of studies have shown that alternate day dosing of statins is efficacious and safe alternative to daily dosing. Objectives: To compare the efficacy and tolerability of daily and alternate day regimen of Atorvastatin in the treatment of na{\"\i}ve dyslipidaemic South Indian patients. Materials and Methods: It is an open labeled, prospective, parallel, comparative interventional study. Ninety patients satisfying the inclusion criteria were randomized in to group 1 (n=45) and group 2 (n=45) and received atorvastatin 10 mg daily and alternate days respectively for 3 months. Pretreatment and post treatment anthropometric measurements, biochemical and lipid parameters were recorded. Patients were followed at fortnightly intervals for 3 months to check the patient compliance and adherence to treatment. Data were analyzed by suitable statistical methods. Results: There was a statistically significant reduction of total cholesterol, triglycerides, LDL, VLDL and increase of HDL cholesterol in both groups. Post treatment between group comparison shows a significantly higher reduction of LDL in group 1 than group 2 patients. All other lipid parameters were significantly similar between the groups at 12 weeks follow-up. Daily and alternate day treatment were well tolerated by the patients of both the group and there was no untoward incident during the study period. Conclusion: Alternate day administration of atorvastatin causes a beneficial alternation of lipid parameters which helps in reducing the cost and adverse effects.

}, keywords = {Adverse events, Alternate day, Atherosclerosis, Atorvastatin, Hyperlipidaemia}, doi = {10.5530/ijpcs.5.4.1}, author = {Shanmugasundaram Rajamani and Maharani Balagurumoorthy} } @article {89, title = {Comparative Study of Atorvastatin and Rosuvastatin in Combination with Fenofibrate in Mixed Hyperlipidemia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {March 2016}, pages = {25-31}, type = {Research Articles}, chapter = {25}, abstract = {

Aim: To compare the effects of Atorvastatin and Rosuvastatin in combination with fenofibrate in patients with mixed Hyperlipidemia. Materials and Methods: It was an open label, randomized, parallel group, comparative, prospective clinical study. A total of 70 subjects diagnosed with mixed hyperlipidemia were screened and were randomly allocated into two groups of thirty each. Initial readings of lipid levels like TC, TG, HDL, LDL and VLDL for both the groups were taken as baseline values. Then, Group I received Tab Atorvastatin 10 mg + Fenofibrate 160 mg and Group II received Tab Rosuvastatin 10 mg+ Fenofibrate 160 mg once a day at night for 12 weeks. Patients were assessed after 12 weeks and their Lipid profile was done. Results: Patients who received a combination of atorvastatin with fenofibrate had a reduction of Total cholesterol by 39\%, Triglycerides by 47\%, LDL-C by 50\% and VLDL-C by 35\% respectively. In group treated with combination of rosuvastatin with fenofibrate there was a decrease in TC by 54\%, TGs by 58\%, LDL-C by 52\% and VLDL-C by 56\% respectively. At the same time, HDL-C levels were increased by 14\% in the group treated with rosuvastatin with fenofibrate as compared to atorvastatin with fenofibrate treated group which increased the HDL-C levels by 6\%. Conclusion: Both the treatment regimens significantly decreased TC, TG, LDL-C, VLDL-C, but the reduction was more and statistically significant in Rosuvastatin and fenofibrate combination group when compared with atorvastatin and fenofibrate treated group at the end of 12 weeks.

}, keywords = {Atherosclerosis, Cholesterol, Heart, Lipoprotein, Statins}, doi = {10.5530/ijpcs.5.1.5}, author = {Rohit Dixit and Shankar Jagan} } @article {78, title = {Comparative Study of Hypolidemic effects of Ethanolic extract of Rhizomes of Curcuma longa (turmeric) Versus Pioglitazone in Alloxan induced Diabetic Rats}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {March 2016}, pages = {5-11}, type = {Research Article}, chapter = {5}, abstract = {

Background: Rhizomes of Curcuma Longa belonging to the genus, Curcuma is widely used for medicinal purpose. Its ethanolic extract has been used traditionally as a hypolipidemic. Objectives: The present study was undertaken to evaluate the hypolipidemic effects of ethanolic extract of Rhizomes of Curcuma longa in Alloxan induced diabetic rats with high fat diet and compared with of Pioglitazone, which has anti-diabetic and action. Materials and method: Alloxan monohydrate was used to induce diabetes mellitus in albino rats in the dose of 120 mg/kg Intraperitonelly and hyperlipidemia was induced by feeding animals with high fat diet orally. The body weights of the rats in every group was recorded weekly. Six groups of 6 animals in each received normal saline for normal control, normal saline for diabetic control, turmeric extract (TE) 300 mg/kg/day for euglycemic rat, Diabetic rat with high fat diet 10 mg/kg/day (turmeric extract 300 mg/kg/day), diabetic rat with high fat diet 10 ml/kg/day (turmeric extract 500 mg/kg/day), Diabetic rats with High fat diet 10 ml/kg/day (pioglitazone respectively for 4 weeks). After overnight fasting, 2 ml of blood was collected in from orbital sinuses of all animals. Various biochemical parameters were estimated like blood sugar and lipid profile. The data was analyzed statistically using student{\textquoteright}s paired and unpaired t-test. Results: Turmeric extract significantly raised HDL levels both in healthy and diabetic rats. TE (500 mg/kg) is more efficient as compared to 300 mg/kg dose, as TE (500 mg/kg) has also reduced VLDL, LDL levels in Group V which was statistically highly significant (p\<0.001). Conclusion: Present study revealed that the turmeric has hypolipidemic action and can be safely used in the treatment of mild to moderate cases of hyperlipidemia.

}, keywords = {Alloxan, Curcuma Longa, Diabetic Rats, Hypolipidemic, Turmeric}, doi = {10.5530/ijpcs.5.1.2}, author = {Jeevangi Santoshkumar and Deepak D. Mariguddi and S. Manjunath} } @article {77, title = {Comparison of Ultrasound Guided Technique with Conventional Landmark Technique for Supraclavicular Brachial Plexus Nerve Block in Patients Undergoing Upper Limb Surgery}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {March 2016}, pages = {1-4}, type = {Research Article}, chapter = {1}, abstract = {

Background: Brachial plexus blockade is a time tested anesthetic technique for upper limb surgeries. Among the various approaches of brachial plexus block, supraclavicular block, once described as the {\textquotedblleft}spinal of the arm,{\textquotedblright} offers dense anesthesia of the brachial plexus for surgical procedures at or distal to the elbow. Landmark technique has been traditionally used for performing this block. But blind technique often requires multiple trial-and-error needle attempts, resulting in increase in procedure time, procedure-related pain and complications including pneumothorax, which is very risky. In developing countries like India, ultrasound is a relatively new technique and is increasingly being used for performing nerve blocks for acute as well as chronic pain procedures. Objective: We performed this study to evaluate safety and clinical usefulness of ultrasound technology for supraclavicular brachial plexus blocks. Methods: We included 60 adult patients of either sex undergoing surgeries for fracture of lower end of humerus or fracture of forearm bones. Patients were divided into two groups. In one group, surface landmark technique was used while in other group, supraclavicular nerve block was performed under ultrasound guidance by double injection technique. All patients received 10 ml each of 2\% lignocaine with adrenaline, 10 ml 0.5\% bupivacaine and 10 ml of saline. Surgery was started after confirming adequacy of block. Ineffective blocks were replaced with general anesthesia and insufficient pain control during surgery was supplemented with fentanyl. Results: There was no significant difference between patient groups with regard to demographic data. Supraclavicular plexus nerve block was placed in all 60 patients. Block failure was seen in 5 patients in landmark technique group and in one patient in USG group. The time of onset of sensory and motor block was shorter in USG group than landmark technique group. Intra-op analgesic was required in 5/30 patients in blind group and 3/30 patients in USG group. Post-op analgesia was for longer duration in USG guided group as compared to blind group. Conclusion: Ultrasound guidance is clinically very useful for supraclavicular brachial plexus block. It allows visualization of underlying structures, movement of needle and direct spread of local anesthetic and thus making the procedure safer and more effective.

}, keywords = {Landmark, Nerve block, Supraclavicular brachial plexus block, Ultrasound, Upper limb surgery}, doi = {10.5530/ijpcs.5.1.1}, author = {Punam Raghove and Karampal Singh and Susheela Taxak and Mangal Ahlawat and Sarla Hooda} } @article {128, title = {Comparison of In vitro Antioxidant Activity of Olmesartan and Amlodipine}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {4}, year = {2015}, month = {Dec 2015}, pages = {90-93}, type = {Research Article}, chapter = {90}, abstract = {

Introduction: Free radical oxidative stress has been implicated in the pathology of a wide variety of clinical disorders. Antioxidants are agents which scavenge the free radicals and prevent the damage caused by them. Angiotensin II receptor blockers used in the treatment of hypertension, have also been reported to protect organs such as kidney and heart. Althoug, the mechanisms of these protective effects are not fully understood, it is generally thought that their antioxidant effects likely play a role. Amlodipine, a calcium channel blocker, seems to exert atheroprotective effects through its antioxidant properties related to its chemical structure and independent of its calcium channel-blocking effect. Though research has proved that olmesartan and amlodipine exhibit antioxidant activity independent of their antihypertensive effects, there are not many in vitro studies to analyse which drug is a better antioxidant. Objective: This in vitro study was done to compare the antioxidant activity of olmesartan and amlodipine. Materials and Methods: In this study, we demonstrated the antioxidant activities of 10 mg/ml stock solutions of olmesartan and amlodipine in vitro. DPPH (1,1 Diphenyl 2-picryl hydrazide) and Nitric oxide free radical scavenging assays were done. Results: Olmesartan showed significant (49.48\%) and consistent free radical scavenging activity by DPPH and Nitric oxide radical scavenging assays. Free radical scavenging activity of amlodipine was more significant (56.89\%) than olmesartan but was inconsistent and non-concentration dependent. Conclusion: Hence this in vitro study has proved that olmesartan has better antioxidant activity than amlodipine.

}, keywords = {Amlodipine, DPPH, Free radicals, Nitric Oxide, Olmesartan, Oxidative Stress}, doi = {10.5530/ijpcs.4.4.4}, author = {Rajathilagam Thiruvengadam and Seethalakshmi Sankar} } @article {113, title = {Cost, Benefit and Risks Associated with in-Campus and off-Campus Accommodations of Medical Students: A cross-Sectional Study}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {4}, year = {2015}, month = {Sept 2015}, pages = {58-62}, type = {Original Article}, chapter = {58}, abstract = {

Background: Students{\textquoteright} accommodation might influence their growth, behaviour and study performance. There is no clarity yet about safety issues, trends in substance abuse and on effect of type of accommodations on students{\textquoteright} academic performance. Objectives: To compare students{\textquoteright} perceptions regarding in campus and off campus accommodations with respect to cost, benefit and risks associated with them and also to investigate whether type of accommodation affect medical students{\textquoteright} academic performance. Materials and Methods: In this cross sectional study, the data was collected using newly designed validated questionnaires from students who had stayed in campus accommodation (n=100) and students who had stayed in off campus accommodation (n=100). Data was analyzed using SPSS version 16. The group wise comparison was made using Mann-Whitney test. A p value of \< 0.05 was considered as statistically significant. Results: The difference in the direct cost related to in campus and off campus accommodation was INR 43, 800/month with in-campus accommodation exceeding over off campus accommodation. Off-campus accommodation was perceived as more comfortable than in-campus accommodation, promoting collaborative learning and alcohol and substance abuse (p\<0.05) compared to in-campus accommodation. In addition, students who stayed in the campus performed significantly better academically than those who stayed outside the campus. Conclusion: The outside hostel accommodation is favorable to students in terms of direct cost and benefits. However, risks, including alcohol and substance abuse must be considered and appropriate precautions should be taken and counseling must be provided to students to avoid these risks.

}, keywords = {Academic Performance, Accommodation, Benefits, Cost, Medical Students}, doi = {10.5530/ijpcs.4.3.5}, author = {Vasudha Devi and Sabrina Najiha Binti Mohamad Ashari and Syahirah Binti Abd Rashid and Muhammad Azim Bin NurAdlan and Mohamed Mazlan Bin Mohamed Musadiq} } @article {142, title = {Cerebroprotein Hydrolysate in Treatment of Vascular Dementia - a Case Report}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {December 2014}, pages = {75-78}, type = {Case Report}, chapter = {75}, abstract = {

Vascular dementia (VD) is a dementia due to vascular factors and is one of common causes of dementia. Neurotrophic factors and anticholinesterases are useful in the management of disorders such as dementia or stroke. A new phar-macological agent called cerebroprotein hydrolysate has been used in the management of dementia with promising results. Here we present a case report where cerebroprotein hydrolysate showed promising improvement in the man-agement of vascular dementia.

}, keywords = {Cerebroprotein hydrolysate, Dementia, Vascular, Vascular dementia}, author = {Mosam Phirke and Anup Bharati and Avinash De Sousa and Nilesh Shah and Sushma Sonavane} } @article {125, title = {Chelation of Lanthanum (La3+) by Various Thiols - an in vitro Study}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {June 2014}, pages = {34-38}, type = {Short Communication}, chapter = {34}, abstract = {

In the present study the interaction of various thiols (L-glutathione, L-cysteine, N-acetyl cysteine and D-penicillamine) with LaCl3 was studied in vitro by modified Ellman{\textquoteright}s method. Experiments carried out at various concentrations inferred gradual decrease in thiol concentration with the increase in La3+ concentration in aqueous solutions. Maximum interac-tion between thiols and La3+ was observed at pH 7.5 and 35{\textdegree}C as indicated by the lowest values of residual thiol con-centration. The order of reactivity was DPA\>GSH\>NAC\>Cys, where reactivity increased with increasing pKa of their thiol group. The possible products of reaction are proposed to be La(RS)3 complex or oxidized form with disulfide bond (RSSR).

}, keywords = {Chelation, Ellman{\textquoteright}s modified method, Lanthanum, Thiols}, author = {Muhammad Yaqoob and Muhammad Farid Khan and Muhammad Tausif Chaudhry and Izhar Ahmad Shaikh} } @article {117, title = {Comparative Evaluation of Antimicrobial and Anticonvulsant Induced Cases of Steven Johnson Syndrome and Toxic Epidermal Necrolysis}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {March 2014}, pages = {1-6}, type = {Research Article}, chapter = {1}, abstract = {

Background: Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) constitute a spectrum of severe, potentially life threatening, mucocutaneous adverse drug reactions. Antimicrobial agents and anticonvulsants are the most commonly implicated drugs. This study was aimed to compare and analyse the differences in the incubation peri-od, clinical presentation and outcome in patients of SJS/TEN caused by the antimicrobials and anticonvulsants. Materials and Methods: Patients of SJS, TEN and SJS/TEN overlap admitted in the dermatology ward of our hospi-tal, in whom an antimicrobial agent or an anticonvulsant were found to be probable causative agent by Naranjo score were assigned to Group A and B respectively. Inpatient records of the selected patients were studied to compare the differences. Results: Total of forty patients (twenty each of Group A and B) were included in the study. Fluoroquinolones followed by chloroquine were the most commonly implicated antimicrobials. The anticonvulsants most commonly implicated were phenytoin followed by carbamazepine. Incubation period in the antimicrobial group was significantly shorter [Group A (7.32 {\textpm} 5.4 days) vs Group B (28.58 {\textpm} 19.35 days)] with p value \< 0.001. The duration of stay, in the derma-tology ward, was significantly longer (p value\< 0.05) in the cases of TEN caused by antimicrobials (20.1 {\textpm} 7.49 days) as compared to those caused by anticonvulsants (14.5 {\textpm} 5.36 days). Three patients in Group A and one patient in Group B expired. Conclusion: A shorter incubation period and a higher morbidity and mortality were seen in the antimicrobial induced cases as compared to the anticonvulsant group.

}, keywords = {Anticonvulsants, Antimicrobials, Steven Johnson syndrome, Toxic epidermal necrolysis}, author = {Surabhi Dayal and Brahmita Monga and V. K. Jain and Kamal Aggarwal and Anuradha} } @article {129, title = {Comparative Study of Psychomotor Performance Amongst Fixed Dose Combinations of First and Second Generation H1 Antihistaminics in Adult Healthy Volunteers}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {September 2014}, pages = {46-52}, type = {Research Article}, chapter = {46}, abstract = {

Background: Fixed dose combination (FDC) of first and second generation H1 antihistaminics with paracetamol and phenylephrine are widely used and are the most frequent form of self-medication. Though previous studies have shown that H1 antihistaminics cause psychomotor and cognitive impairment, to the best of our knowledge, no studies have utilized the FDC of antihistaminics to evaluate their effect on psychomotor performance. This study was planned to observe the effects of such combinations on CNS. The mainstay of the study was to compare the psychomotor perfor-mance upon administration of fixed dose combination of 1st and 2nd generation H1 antihistaminics along with paracetamol and phenylephrine in adult healthy volunteers. Materials and Methods: This was double blind cross over study conducted in 12 adult healthy volunteers. Following single dose of FDC of the 1st (chlorpheniramine maleate) and 2nd (cetrizine) generation anti-histaminics with paracetamol and phenylephrine, volunteers were subjected to perform a battery of validated tests to evaluate their cognitive and psychomotor performance (simple reaction time, arithmetic ability test, digit substitution test, digit cancellation test, immediate and delayed recall rests and a Stanford drowsiness scale) 2 hrs post dose. Data was analysed using anal-ysis of variance test with Tukey{\textquoteright}s Multiple Comparison Test. A p value of \< 0.05 was considered statistically significant.\ Results: FDC containing cetrizine did not show significant difference from the other FDC containing chlorpheniramine maleate in any of the tests which had been performed, except for a mildly sedative action of cetirizine containing FDC.\ Conclusion: FDC of antihistaminics do not cause impairment of cognition and psychomotor performance. Also, 2nd generation antihistaminics are not free from adverse effect like sedation. The possible reasons behind the obtained results are addition of paracetamol and low doses of antihistaminics in FDCs, laxity of tests and single dose administration.

}, keywords = {Anti-histaminics, Cetrizine, Chlorpheniramine, Fixed dose combinations, Psychometric test}, author = {Yogita S Karandikar and Sharma Apoorva} } @article {134, title = {Comparison of Safety, Efficacy and Cost Effectiveness of Intravaginal Misoprostol and Intracervical Dinoprostone for Induction of Labour}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {September 2014}, pages = {68-72}, type = {Research Article}, chapter = {68}, abstract = {

Background: Misoprostol is more efficacious than dinoprostone for induction of labour. But the adverse effects pro-duced by misoprostol were different. The aims of this study was to compare the safety, efficacy, cost effectiveness of intravaginal misoprostol and intracervical dinoprostone for induction of labour and their effects on intrapartum complications, mode of delivery and neonatal outcome. Materials and Methods: This is a randomized, parallel, two tailed, prospective, open label comparative trial. Sixty pregnant women were included in the study and it was carried out in the Department of Obstetrics, Government General Hospital, Kurnool Medical College, Kurnool during the period Dec. 2009 - June 2010. Out of 60 patients, 30 received miso-prostol 25 mcg intravaginally and 30 received dinoprostone 0.5 mg intracervically. Analysis and comparison of various parameters like induction- delivery interval, mode of delivery, neonatal outcome, foeto-maternal complications and cost of the drug were done. Mean and standard deviation of all observations were calculated and tabulated with the help of {\textquoteleft}Microsoft Excel{\textquoteright}. Comparison was done by applying student{\textquoteright}s t -test. Statistical significance was assigned at P\<0.05. Results: Misoprostol is more efficacious for cervical ripening and labor induction than dinoprostone. Misoprostol group had more number of vaginal deliveries, lesser requirement of oxytocin for labor augmentation, more number of vaginal deliveries within 12 hrs, less induction failures and was cost effective. However, it was reported to have slightly higher incidence of uterine contractility abnormalities and foetal complications. Conclusion: Misoprostol is more efficacious than dinoprostone. However uterine contraction abnormalities, fetal com-plications should be carefully assessed by close monitoring of labor by intrapartum cardiotocography and partogram.

}, keywords = {Cervical ripening, Induction - delivery interval, Induction failure, Labor induction, Tachysystole}, author = {Dara Aruna Kumari and Gujjala Radhika} } @article {123, title = {Comparison of Two Zidovudine Based HAART Regimens used in Treatment of HIV Infection}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {June 2014}, pages = {28-33}, type = {Research Article}, chapter = {28}, abstract = {

Background: India has third highest number of HIV patients. Zidovudine based regimens are the first line of treatment in these patients. This study was undertaken to compare three prognostic markers with this treatment in patients infected with HIV. The objective of the study was to compare the changes in the CD4 counts, hemoglobin and weight between HIV infected patients receiving zidovudine, lamivudine and nevirapine (ZLN) against those receiving zidovu-dine, lamivudine and efavirenz (ZLE). Materials and Methods: Retrospective data was collected from the ART centre, Chigateri Hospital, Davangere. Patients who were on the study regimens for atleast six months were considered for analysis. Changes in CD4 counts, hemoglobin levels and weight were analyzed with paired {\textquoteleft}t{\textquoteright} test for intra group variation and unpaired {\textquoteleft}t{\textquoteright} test for inter-group variation. Results: CD4 counts were analyzed in 339 patients and in both the groups the counts improved significantly (ZLN: n=252, ZLE: n=87 and p \< 0.001 in both groups) after six months of treatment but the improvement was much better in patients who received ZLN regimen (p = 0.005). 281 patients were analyzed with respect to hemoglobin and improve-ment was seen in ZLE group (n=77, p = 0.001) but not in ZLN group (n=204, p = 0.36) with treatment and intergroup analysis was in favor of ZLE (p = 0.03). Weight was analyzed in 356 patients and it improved significantly in both ZLN group (n=264, p = 0.001) and ZLE group (n=92, p = 0.001) but the intergroup comparison did not reveal any signifi-cance (p = 0.21). Conclusion: A regimen consisting of zidovudine, lamivudine and efavirenz is better in treating a HIV patient with decreased hemoglobin. So this regimen can be preferred in anemic patients with HIV.\ 

}, keywords = {Efavirenz, HAART, Lamivudine, Nevirapine, Zidovudine}, author = {Narendranath Sanji and Dinakar KR and Vaneet Aggarwal and Navin A Patil and Somashekar HS and Keerthisagar J and Reshma SR} } @article {189, title = {Case of Fosphenytoin Induced Acute Cerebellar Dysfunction and Pituitary Bleed Causing Central Diabetes Insipidus in a Case of AML M2 during Allogenic Hematopoietic Stem Cell Transplant}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {Dec 2012}, pages = {111-114}, type = {Case Report}, chapter = {111}, abstract = {

Neuroprotectors such as phenytoin, fosphenytoin, clonazepam or levetiracetam are often used prior conditioning regimen to prevent seizures caused due to busulfan, during bone marrow transplant. Fosphenytoin and levetiracetam are used instead of phenytoin as they are readily soluble and do not need a vehicle such as polyethylene glycol or ethanol which increases risk of tissue and cardio toxicity. We report a case of acute toxicity in the form of cerebral bleed during intravenous administration of fosphenytoin and its subsequent management in patient undergoing busulfan treatment prior to allogenic transplant.

}, keywords = {Bone Marrow Transplantation, Busulfan, Conditioning Regimen, Fosphenytoin, Levetiracetam, Neuroprotector, Phenytoin}, author = {Eriat Govind and Radheshyam Naik and Srinivas BJ and Intezar Mehdi} } @article {190, title = {Chylothorax : a Aase Report}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {Dec 2012}, pages = {115-117}, type = {Case Report}, chapter = {115}, abstract = {

Chylothorax, an accumulation of chyle in the pleural cavity, is a rare complication of penetrating or blunt trauma to the neck. It could result from damage to or obstruction of thoracic duct. Though rare in incidence, chylothorax can lead to significant morbidity and mortality. A milky fluid with high level of triglycerides in pleural fluid confirms diagnosis. This report is about a rare case of left chylothorax secondary to bull horn injury in the right side of neck and its manage-ment. A 48 year old male patient presented with bull horn injury on right side of neck with left side chylothorax. Initial management was conservative with pleural drainage. Later because of persistent chylous pleural fluid more than 1500- 2000/day for more than 5 days, we explored and ligated the thoracic duct in the neck. Post operative period was uneventful and patient was symptom free at 6 months follow up. Isolated thoracic duct injury in trauma cases is even rarer. Early diagnosis and timely surgical management saves the patient.

}, keywords = {Chylothorax, Post Operative Day, Thoracic Duct Injury}, author = {Priti P Shah and Shahaji Deshmukh and Tulshibagwala and Ravi Kharat} }