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   2016| July-September  | Volume 8 | Issue 3  
    Online since June 22, 2016

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Knowledge, attitudes, and quality of life of type 2 diabetes patients in Riyadh, Saudi Arabia
Ibrahim Suliman Al-Aboudi, Mohammed Azmi Hassali, Asrul Akmal Shafie
July-September 2016, 8(3):195-202
DOI:10.4103/0975-7406.171683  PMID:27413347
Objective: The purpose of this study was to investigate the association between knowledge and attitude with health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus in Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional descriptive study was undertaken with a cohort of 75 patients attending the University Diabetic Center at King Abdulaziz University Hospital, Riyadh, Saudi Arabia. The EuroQoL-five-dimensional (EQ-5D) scale was used to assess HRQoL. EQ-5D was scored using values derived from the UK general population survey. The brief diabetic knowledge test in questionnaire format developed by the University of Michigan Diabetes Research and Training Center and the attitude toward self-care questionnaire based on the diabetic care profile were used. Results: Fifty-eight (77.35%) respondents were male with a mean 12.6 ± 8.4 years of a history of diabetes. Thirty-four (45.3%) were in the age group of 45–55 years with a mean age of 54 ± 9.2 years. A moderate level of HRQoL (0.71 ± 0.22) was recorded in the study cohort. The mean EQ-5D score was lower in females compared to male patients (0.58 ± 0.23 vs. 0.74 ± 0.20). The mean score of Michigan Diabetic Knowledge Test was 8.96 ± 2.1 and the median score was 9.00. Of 75 diabetic patients, 14.7% had poor knowledge; 72% had moderate knowledge, and only 13.3% had good knowledge. The average attitude score of all respondents was 6.38 ± 2.11. There was a significant positive association between attitude and EQ-5D score. Conclusion: HRQoL and knowledge scores were moderate in type 2 diabetic patients in Riyadh, Saudi Arabia. Patient attitude toward the disease was positive, and this was positively associated with HRQoL; most respondents believed they are responsible for their care. It is likely that a high quality of diabetes self-management education program will provide benefits and affect significantly on type 2 diabetes patients in Saudi Arabia.
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Inhibitor designing, virtual screening, and docking studies for methyltransferase: A potential target against dengue virus
Jagbir Singh, Mahesh Kumar, Rani Mansuri, Ganesh Chandra Sahoo, Aakash Deep
July-September 2016, 8(3):188-194
DOI:10.4103/0975-7406.171682  PMID:27413346
Aim: Aim of this work was to design and identify some S-adenosyl-L-homocysteine (SAH) analogs as inhibitors of S-adenosyl-L-methionine-dependent methyltransferase (MTase) protein using computational approaches. Introduction: According to the current scenario the dengue has been a global burden. The people are being killed by dengue virus in an abundant number. Despite of lot of research being going on dengue worldwide, there is no single drug which can kill its virus. This creates an urge for new drug target identification and designing. MTase has been reported as an effective target against dengue virus as it catalyzes an essential step in methylation and capping of viral RNA for viral replication. Materials and Methods: The crystal structure of MTase in complex with SAH was used for designing new analogs of SAH. SAH analogs designed were analyzed on the basis of docking, ADMET, and toxicity analysis done using Discovery Studio 3.5. Results: Seventeen analogs found noncarcinogenic, nonmutagenic, as well as good ADMET properties and good drug-like profile. Conclusion: These SAH analogs, inhibitors of MTase may act as drugs against dengue virus. Further synthesis and biological testing against dengue virus is under observation.
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Utilization study of antidiabetic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines
Sushrut Varun Satpathy, Supratim Datta, Binu Upreti
July-September 2016, 8(3):223-228
DOI:10.4103/0975-7406.175975  PMID:27413351
Objective: Diabetes has gradually emerged as one of the most serious public health problems in our country. This underlines the need for timely disease detection and decisive therapeutic intervention. This prospective cross-sectional observational study aims at analyzing the utilization pattern of antidiabetic agents in a remote North-East Indian tertiary care teaching hospital in the perspective of current standard treatment guidelines. Materials and Methods: Diabetic patients receiving antidiabetic medication, both as outpatients and inpatients in our hospital over a period of 12 months (May 2013–May 2014), were included in this study. The data obtained were sorted and analyzed on the basis of gender, type of therapy, and hospital setting. Results: A total of 310 patients were included in the study. Metformin was the single most frequently prescribed antidiabetic agent (66.8%) followed by the sulfonylureas group (37.4%). Insulin was prescribed in 23.2% of the patients. Combination antidiabetic drug therapy (65.1%) was used more frequently than monotherapy (34.8%). The use of biguanides (P < 0.0001) and sulfonylureas (P = 0.02) in combination was significant as compared to their use as monotherapy. A total of 48% of all antidiabetic combinations used, comprised metformin and sulfonylureas (n = 96). Insulin use was significantly higher as monotherapy and in inpatients (P< 0.0001). The utilization of drugs from the National List of Essential Medicines was 51.2%, while 11% of antidiabetics were prescribed by generic name. Conclusion: The pattern of utilization largely conforms to the current standard treatment guidelines. Increased use of generic drugs is an area with scope for improvement.
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Enhancement of inhibitory neurotransmission and inhibition of excitatory mechanisms underlie the anticonvulsant effects of Mallotus oppositifolius
Kennedy Kwami Edem Kukuia, Elvis Ofori Ameyaw, Eric Woode, Priscilla Kolibea Mante, Donatus Wewura Adongo
July-September 2016, 8(3):253-261
DOI:10.4103/0975-7406.183226  PMID:27413356
Context: Mallotus oppositifolius is a shrub that is used traditionally to treat epilepsy, but its potential has not been scientifically validated. Aims: This study investigated the anticonvulsant properties and possible mechanism of action of the 70% v/v hydroalcoholic extract of the leaves of M. oppositifolius.Materials and Methods: Inprinting control region (ICR) mice (25–30 g) were pretreated with the M. oppositifolius leaf extract (10–100 mg/kg) before administering the respective convulsants (pentylenetetrazole [PTZ], picrotoxin [PTX], strychnine [STR], 4-aminopyridine [4-AP], and pilocarpine). The effect of the extract in maximal electroshock seizure (MES) model was investigated also. Statistical Analysis: Data were presented as mean ± standard error of the mean and were analyzed with one-way analysis of variance (ANOVA) or two-way ANOVA where appropriate with Newman–Keuls or Bonferroni post hoc test respectively. P< 0.05 was considered significant. Results: In both PTX and PTZ test, extract delayed the onset of seizures and reduced the frequency and duration of seizures. In the STR-induced seizure test, the extract significantly delayed the onset of seizures and reduced the duration of seizures. The extract also delayed the onset of clonic and tonic seizures as well as increasing the survival of mice in the 4-AP-induced seizure test. It further reduced the duration of tonic limb extensions in the MES test. In the pilocarpine-induced status epilepticus, the extract significantly delayed the onset of clonic convulsions and reduced the frequency and duration of seizures. Moreover, the anticonvulsant effect of the extract was attenuated by flumazenil, a benzodiazepine/gamma-aminobutyric acid (GABA) receptor antagonist. Conclusion: These findings show that the extract has anticonvulsant effect possible mediated by GABAergic, glycinergic neurotransmission, and potassium channel conductions. It may also be acting by antagonizing muscarinic receptor activation and N-Methyl-D-aspartate receptor activation.
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Synthesis, characterization and in silico biological activity of some 2-(N,N-dimethyl guanidinyl)-4,6-diaryl pyrimidines
Rajasekhar Komarla Kumarachari, Sivakumar Peta, Abdrrahman Shemsu Surur, Yenus Tadesse Mekonnen
July-September 2016, 8(3):181-187
DOI:10.4103/0975-7406.171678  PMID:27413345
Introduction: As pyrimidine is a basic nucleus in DNA and RNA, it has been found to be associated with diverse biological activities.Pyrimidine derivatives were reported to possess anticonvulsant, antimicrobial, anti-inflammatory, antitumor, and antihistaminic. Recently, our team reported the anti-inflammatory and antimicrobial evaluation of some pyrimidines. Objective: To synthesize, predict and evaluate biological activity of some 2-(N,N-dimethyl guanidinyl)-4,6-diaryl pyrimidines. Experimental: seven new pyrimidines were synthesized by following the standard procedures using substituted aromatic aldehydes, methyl ketones and metformin. After the biological activity was predicted using PASS, Molinspiration and Osiris property explorer, their anthelmintic activity was evaluated using Pheretima posthuma. The structural assignment of the title compounds (P1-7) has been made on the basis of elemental analysis, infrared, 1H-nuclear magnetic resonance and Mass spectral studies. Results: All the synthesized compounds were found to obey Lipinski's rule. All the synthesized compounds scored good bioactivity values as GPCR ligands and kinase inhibitors. Among the test compounds, P5 was found to be more potent anthelmintic inducing paralysis in 36-48 minutes and death in 40-51 minutes. Conclusion and Recommendation: The synthesized compound (P5) possessing methoxy group at position-4 of the benzene ring located at position-4 of pyrimidine exhibited good anthelmintic activity. The study revealed the necessity of synthesizing many more compounds with other substituents at position-4 of the benzene ring located at position-4 of pyrimidine.
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A feasibility study: Use of actigraph to monitor and follow-up sleep/wake patterns in individuals attending community pharmacy with sleeping disorders
Zaswiza Mohamad Noor, Alesha J Smith, Simon S Smith, Lisa M Nissen
July-September 2016, 8(3):173-180
DOI:10.4103/0975-7406.171739  PMID:27413344
Introduction: Community pharmacists are in a suitable position to give advice and provide appropriate services related to sleep disorders to individuals who are unable to easily access sleep clinics. An intervention with proper objective measure can be used by the pharmacist to assist in consultation. Objectives: The study objectives are to evaluate: (1) The effectiveness of a community pharmacy-based intervention in managing sleep disorders and (2) the role of actigraph as an objective measure to monitor and follow-up individuals with sleeping disorders. Methods and Instruments: The intervention care group (ICG) completed questionnaires to assess sleep scale scores (Epworth Sleepiness Scale [ESS] and Insomnia Severity Index [ISI]), wore a wrist actigraph, and completed a sleep diary. Sleep parameters (sleep efficiency in percentage [SE%], total sleep time, sleep onset latency, and number of nocturnal awakenings) from actigraphy sleep report were used for consultation and to validate sleep diary. The usual care group (UCG) completed similar questionnaires but received standard care. Results: Pre- and post-mean scores for sleep scales and sleep parameters were compared between and within groups. A significant difference was observed when comparing pre- and post-mean scores for ISI in the ICG, but not for ESS. For SE%, an increase was found in the number of subjects rated as “good sleepers” at post-assessment in the ICG. Conclusions: ISI scores offer insights into the development of a community pharmacy-based intervention for sleeping disorders, particularly in those with symptoms of insomnia. It also demonstrates that actigraph could provide objective sleep/wake data to assist community pharmacists during the consultation.
  3 4,999 189
The enlightenment from Malaysian consumers' perspective toward cosmetic products
Ain Ayob, Ammar Ihsan Awadh, Juliana Jafri, Shazia Jamshed, Hawa Mas Azmar Ahmad, Hazrina Hadi
July-September 2016, 8(3):229-234
DOI:10.4103/0975-7406.174232  PMID:27413352
Backgrounds: Variety of cosmetic products was used in our daily life, yet the amount and types of the cosmetic products used by the consumers were varied, which may be due to the different perspectives held by each of the consumers. Objectives: To explore consumers' perspectives toward cosmetic products. Methods: An interview guide was developed with a set of 12 semistructured questions. Participants in Kuantan, Pahang were recruited via the purposive sampling, and they undergo in-depth face-to-face interviews. All of the interviews were audio-recorded, transcribed verbatim, and were analyzed via thematic content analysis. Results: For the awareness of cosmetic products, less aware about the cosmetic products in Malaysia were noted among the participants. In terms of perceptions about the cosmetic products, participants expressed positive perceptions toward natural cosmetic products, quality were seen as synonymous with branded products and halal certification. Next, for the attitude toward the use of cosmetic products, participants were influenced by ingredients, product brand, and halal certification. Based on personal experiences, they provide complaints and suggestions for the enhancement of cosmetic products' quality. Conclusions: Participants were found to have less awareness about the cosmetic products in Malaysia. Besides, they realized about the chemical ingredients and halal certification for the cosmetic products. Therefore, they held positive perceptions and practiced positive attitudes toward natural and halal cosmetic products. Finally, adverse reactions from the use of cosmetic products were commonly experienced by the participants, which contributed mainly by the ingredients. Thus, they hoped for serious approached to be enacted to solve this problem.
  2 4,430 189
Malaysian consumers' awareness, perception, and attitude toward cosmetic products: Questionnaire development and pilot testing
Ain Ayob, Ammar Ihsan Awadh, Hazrina Hadi, Juliana Jaffri, Shazia Jamshed, Hawa Mas Azmar Ahmad
July-September 2016, 8(3):203-209
DOI:10.4103/0975-7406.171681  PMID:27413348
Background: Increased usage of cosmetic products has caused a growing concern about the safety of these products, and yet little is known about cosmetics from the consumers' perspective. Hence, this study's aim is to develop a valid and reliable tool for assessing consumers' awareness, perceptions, and attitudes toward cosmetic products. Materials and Methods: A questionnaire was developed in the English language based on information collected from a literature search, in-depth interviews conducted with consumers prior to this study and consultations with experts. Subsequently, the questionnaire was subjected to translation, validation, and test-retest reliability. A final version of the questionnaire was piloted among 66 consumers via convenient sampling. A descriptive analysis was performed, and the internal consistency and the differences between variables in the questionnaire were analyzed. Results: The developed and translated questionnaire produced repeatable data for each of the domains (Spearman's correlation ≥ 0.7, P< 0.001). The internal consistency for awareness, perceptions and attitudes indicates good internal consistency (Cronbach's alpha value of more than 0.7 for each domain). Significant differences were found between the perception scores for the race, religion, and monthly expenses for cosmetic products, respectively, and the same pattern was found for the attitude scores, but monthly expenses for cosmetic products was replaced by monthly income. Conclusion: The results achieved via the Bahasa Malaysia questionnaire indicated that the developed and translated questionnaire can be used as a valid and reliable tool for assessing consumers' awareness, perceptions, and attitudes toward cosmetic products in Malaysia in future studies.
  2 5,615 344
Amelioration of oxidative DNA damage in mouse peritoneal macrophages by Hippophae salicifolia due to its proton (H+) donation capability: Ex vivo and in vivo studies
Mainak Chakraborty, Indrajit Karmakar, Sagnik Haldar, Avratanu Das, Asis Bala, Pallab Kanti Haldar
July-September 2016, 8(3):210-216
DOI:10.4103/0975-7406.172663  PMID:27413349
Introduction: The present study evaluates the antioxidant effect of methanol extract of Hippophae salicifolia (MEHS) bark with special emphasis on its role on oxidative DNA damage in mouse peritoneal macrophages. Material and Methods: In vitro antioxidant activity was estimated by standard antioxidant assays whereas the antioxidant activity concluded the H+ donating capacity. Mouse erythrocytes' hemolysis and peritoneal macrophages' DNA damage were determined spectrophotometrically. In vivo antioxidant activity of MEHS was determined in carbon tetrachloride-induced mice by studying its effect on superoxide anion production in macrophages cells, superoxide dismutase in the cell lysate, DNA damage, lipid peroxidation, and reduces glutathione. Results: The extract showed good in vitro antioxidant activities whereas the inhibitory concentrations values ranged from 5.80 to 106.5 μg/ml. MEHS significantly (P < 0.05) attenuated the oxidative DNA damage. It also attenuated the oxidative conversion of hemoglobin to methemoglobin and elevation of enzymatic and nonenzymatic antioxidant in cells. Conclusion: The result indicates MEHS has good in vitro-in vivo antioxidant property as well as the protective effect on DNA and red blood cell may be due to its H+ donating property.
  2 3,132 139
Self-medication practices among female students of higher educational institutions in Selangor, Malaysia: A quantitative insight
Shazia Qasim Jamshed, Pei Se Wong, Heng Chin Yi, Gan Siaw Yun, Muhammad Umair Khan, Akram Ahmad
July-September 2016, 8(3):217-222
DOI:10.4103/0975-7406.172662  PMID:27413350
Background: World Health Organization has defined self-medication as the selection and use of medications (including herbal and traditional product) by individuals to treat self-recognized illnesses or symptoms. The prevalence of self-medication is reported to be higher among female students. Objective: To investigate the awareness and self-medication practices among female students of higher education institutions in Malaysia. Method: A descriptive, cross-sectional study was conducted in four higher education institutes of Selangor, Malaysia. Convenience sampling approach was used to collect data from a sample 475 students. A “pretested” questionnaire was used as a study instrument. Results: A total of 461 questionnaires were returned (response rate 97.05%). The prevalence of self-medication among female students in higher educational institutions was 57.2% (n = 262). The most common source of self-prescribed medicine was a pharmacy or clinics (n = 206; 45%). It was found that antipyretics were the most common medications used without doctor's consultation (n = 212; 89.1%). Analgesics and antipyretics (n = 79; 62.7%) were highly recommended by students to their family and friends. The common reason for self-medication was prior successful experience (n = 102, 81.0%). The majority of respondents (n = 280; 61.1%) reported that they believed over-the-counter medications were as effective as medications prescribed by a doctor. Conclusion: The prevalence of self-medication practice among female students in the sample of the four higher education institutions was moderate. More studies are required to generalize these findings across Malaysia.
  2 4,868 168
Familiarity, perception, and reasons for electronic-cigarette experimentation among the general public in Malaysia: Preliminary insight
Ramadan Mohamed Elkalmi, Akshaya Srikanth Bhagavathul, Adamu Ya'u, Sami Abdo Radman Al-Dubai, Tarek M Elsayed, Akram Ahmad, Wael Mohamed
July-September 2016, 8(3):240-247
DOI:10.4103/0975-7406.180768  PMID:27413354
Objectives: The objectives of this study were to assess the general public views and familiarity toward electronic cigarette (e-cigarette) in Kuantan, Malaysia. Methodology: A total of 277 Kuantan people were involved in this study. The questionnaire was distributed at random in shops, businesses, and public places in Kuantan. Statistical analysis was performed using SPSS (version 17.0). Results: From 400 participants, a total number of 277 (160, 57.7% men and 117, 42.4% women) respondents completed the questionnaire. The mean age was 26.89 ± 9.8 years old. The majority of the study participants were male (57.7%), Malay (83.8%), Muslims (83.8%), singles (69%), and employed (75.8%), with about 83 (29.9%) of the respondents were smokers. The prevalence of e-cigarettes smokers was found to be only 1.4% (n = 4). About one-third of the respondents (n = 72, 26%) have tried e-cigarette before. Job status was significantly associated with smoking e-cigarette among the population (P = 0.02). Main factors for a person to start e-cigarette smoking were curiosity (37.5%) and cheaper price (40.8%). Majority of respondents agreed that e-cigarette would not affect health as normal cigarette, and that variety of flavors contribute to better enjoyment (51.6% and 66.7%, respectively). Conclusion: The results of the current study demonstrate that the prevalence of e-cigarettes smoking and its popularity, familiarity, and knowledge are still insufficient among Kuantan population. Further studies should be done to tackle this problem before it getting worse.
  2 5,115 327
An evaluation of drug promotional literatures published in scientific medical journals
Pooja M Vachhani, Manish N Solanki, Mira K Desai
July-September 2016, 8(3):248-252
DOI:10.4103/0975-7406.180769  PMID:27413355
Objectives: Evaluation and comparison of ethical standards of published drug promotional literatures (DPLs) between different Indian and non-Indian scientific medical journals regarding compliance to the World Health Organization (WHO) and International Federation of Pharmaceutical Manufacturers and Associations (IFPMAs) guidelines. Materials and Methods: A cross-sectional, observational study was carried out at pharmacology department. DPLs published in Indian and non-Indian scientific medical journals available at central library of medical college during the period of 6 months were collected according to selection criteria. DPLs were evaluated and compared for compliance to ethical standards of drug promotion laid by the WHO and IFPMA. Data were analyzed using Fisher's exact test. Results: Out of total 178 DPLs, 103 DPLs were from Indian journals and 75 DPLs were from non-Indian journals. When compared regarding compliance to all the 11 ethical criteria of WHO, no significant difference was found between DPLs published in Indian and non-Indian journals. However, DPLs from indian journals contained significantly less information regarding dosage regimen (P = 0.0096), adverse drug reactions (P = 0.0028), warnings (P = 0.0104) and major drug interactions (P < 0.0001) as compared to non-Indian journals. Compliance to all the five IFPMA criteria was significantly higher in DPLs of non-Indian journals (88%) than Indian journals (39%) (P < 0.0001). Conclusion: Noncompliance to ethical standards of WHO and IFPMA guidelines is more common in DPLs of Indian journals as compared to non-Indian journals. Thus strict implementation of regulatory measures regarding DPLs published in Indian medical journals is recommended.
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Emergency contraception: Knowledge and attitude toward its use among medical students of a medical college in North-West India
Rajiv Kumar Gupta, Sunil Kumar Raina, Aruna Kumari Verma, Tejali Shora
July-September 2016, 8(3):235-239
DOI:10.4103/0975-7406.175974  PMID:27413353
Context: Emergency contraception (EC) is use of drug or device to prevent pregnancy after unprotected sexual intercourse. Unlike other regular methods of contraception which are taken prior to the sexual act, EC is used after the unprotected sex. Aim: To assess the knowledge and attitude toward use of emergency contraceptives among medical students. Setting and Design: A cross-sectional questionnaire based study was conducted among all the medical students in the Government Medical College in North-West India. Subjects and Methods: A questionnaire seeking information on knowledge and attitude of undergraduate medical students was administered over a period of 4 weeks in the month of February and March 2014. Statistical Analysis: The data were entered in MS excel and expressed using percentages. Chi-square test was used as a test of statistical significance. Results: About 61.6% (247/401) of the participants were aware about the timing of use of EC. Audio visual media (76.6%; 307/401) was the most common source of information for of these medical students. Conclusions: The lack of appropriate in-depth knowledge of EC among future health care professional should alarm the medical teaching system as EC is the only method that can be used to prevent pregnancy after unprotected sex or contraceptive accident.
  1 3,795 197
What is the process of obtaining informed consent in a clinical trial? Is it ever justifiable to include someone in a clinical trial without prior informed consent from the individual?
Akosua Adom Agyeman, Richard Ofori-Asenso
July-September 2016, 8(3):262-263
DOI:10.4103/0975-7406.174231  PMID:27413357
  - 2,455 91
Pharmaceutical care to improve medication knowledge among patient with chronic kidney disease
Wan Zanariah W. A. Manan, Fong Chui Wei, Firdaus Abd Rahman, Long Chiau Ming
July-September 2016, 8(3):263-264
DOI:10.4103/0975-7406.175976  PMID:27413358
  - 2,732 97