Pharmacy articles list

The skin provides an effective barrier and only limited number of drugs can penetrate in adequate amounts. This study aims to identify the relationship between the physicochemical properties and permeation across mouse skin of non-steroidal anti-inflammatory drugs in view of their feasibility to transdermal delivery. Biphenylacetic acid, diclofenac base, diclofenac sodium, indomethacin and piroxicam are the drugs studied. Number of physicochemical properties studies were performed. Drug permeation studies across hairless mouse skin were carried out using an in-vitro finite dosing diffusion cell. The relationship between physicochemical properties of the drugs studied and their percutaneous penetration was studied. Purity for the compounds studied ranged from 99.09% to 100% in which 99.89% purity was obtained for diclofenac base. At 7.4, the % ionized of piroxicam was found to be 95.12%, while for other drugs were in the range of 98.01% and 99.96%. The true partition coefficient values in the n-octanol/water system are in the range of 1.85 and 2.85, while in the n-octanol/phosphate system ranged from 2.14 to 3.70. Observed solubility in water, phosphate buffer and n-octanol ranged from 0.033 to 0.322, 0.202 to 0.329 mg per ml, and 2.19 to 16.10 mg per ml, respectively. A linear relationship was found between water solubility and melting point between steady-state rates of permeation across intact and viable skin, between n-octanol solubility and maximum predicted flux and between molecular volume and the ratio of maximum predicted flux. Predicted flux calculated was compared with the experimental data which resulted in a high correlation. Physicochemical criteria which were determined the feasibility of non-steroidal anti-inflammatory drugs studied for transdermal delivery were identified. The relationships obtained in this study provide an essential physical and chemical properties that govern transport of non-steroidal anti-inflammatory drugs across hairless mouse skin.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypoglycemia is a common complication of intensive diabetes mellitus therapy. This study was aimed to review the profile of admitted Libyan cases of non-pregnant adults and adolescents. A retrospective study for patients admitted to Tripoli Diabetes Hospital, Tripoli, Libya. Data were collected from medical files of diabetic patients with hypoglycemia from January 2017 to July 2018. Thus, during this period, a total of 29 cases with hypoglycemia were admitted to the hospital. Their age was ranged from 18 to 86 years in which 76.0% were female, 25.0% were non-smokers, 59.0% were married and 55.0% were non-employers. Patients with diabetes mellitus (86%) showed hypoglycemia attack per month of 3.90 ± 2.25. From the 25 cases with diabetes mellitus, 7.0% were newly diagnosed (> one year), 45.0% their duration of diabetes mellitus were more than 9 years and 35.0% were less than nine years. Their Hemoglobin A1C was on target (6.5–7.0%) in 21.0% of the cases, in which 17.0% were on below target range (< 6> 7.0%). 14.0% were on glibenclamide, 3.0% on glimepiride and 69.0% on insulin. Patients on insulin therapy twice daily in 28.0%, triple in 17.0% and basal bolus regime in 24.0%. Hypoglycemia unawareness was presented in 17.0%, hypoglycemia was major in 45.0% of the cases, and in 38.0% were in daytime. Insulin induced hypoglycemia were in 66.0%, and suicidal attempt were in 10.0%. Exercise induced hypoglycemia 10.0% and 3.0% of cases with malignancy induced hypoglycemia. Co-exist systemic illness was mainly absent in 69.0% but cardiovascular diseases in 14.0% and renal diseases in 7.0%. Majority of cases were discharged in good condition (86.0%) and 14.0% discharged against medical advice. Hypoglycemia mostly occurs in patients with diabetes mellitus treated with insulin and in most the cases were reversible and saved with good management. Thus, patient education is a fundamental issue in prevention and reducing complications of hypoglycemia in patients with diabetes mellitus.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Tuberculosis is communicable disease which is common and often deadly infectious disease caused by mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem in the world. The aim of this study is to assess prevalence and associated risk factors of pulmonary tuberculosis. Treatment and development of multidrug-resistant tuberculosis were also considered. Drugs for Pulmonary tuberculosis confirmed cases used in calculating tuberculosis prevalence in Libya which is obtained from archive department of Abu Seta Hospital. Data obtained from 427 files during 2019 determine the incidence and epidemiology of tuberculosis in Libya. For a total of 427 confirmed cases of pulmonary tuberculosis, about 75.0% of the cases were male and most of the patients (55.0%) were within the age group of 20 - 40 years old. Of the study patients, 114 patients (26.7%) were viral infected and most of the viral infected cases were in the age group of 20 - 40 years and the majority of this age group patients (n = 41, 53.2%) were infected with HIV/HCV, while the least percentage in this group age were infected with HIV/HBsAg (01.3%). Among 427 cases, 73 cases (17.1%) were comorbid with other chronic diseases. Of the 73 cases, 54 cases (74.0%) were diabetes mellitus whereas only 1.4% of them had bronchial asthma, Parkinsonism and renal failure. The drug therapy of active tuberculosis disease needs combination chemotherapy to escape the selection of naturally occurring drug-resistant mutants. Amongst current anti tuberculosis drugs, the rifamycins hold the highest potential for shortening treatment and improving effects. Prevalence of smear positive tuberculosis and bacteriologically confirmed that a high rate of tuberculosis among unemployed population. This study reported that the highest incidence rate is found in people who are smokers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Community pharmacy has undergone a rapid expansion with various services moving away from the traditional supply function to other patient-focused services. Thus, the aim of this study is to examine consumer views and expectations toward the services provided in Libyan private community pharmacies, as well as customers' skepticism and their general satisfactions toward these services. The study is descriptive, cross-sectional survey and self-designed administered questionnaire. Study population comprised 0f adult patients or costumers who visited the community pharmacies. Out of the 600 questionnaires were personally handed, 462 of the distributed questionnaires were returned (response rate 77%). The majority of the participants reported that community pharmacy staff dealing with customers in polite ways (75%) and providing privacy and sufficient consideration (60%). Respondents agreed that the staff listens attentively and satisfied with encounter time by 60% and 50%, respectively. For provision of drug information as “how the drug work in the first-time use”, “customer experience of the side effects” and “their ability to using the prescribed medicine properly” were reported by 45%, 30% and 30%, correspondingly, while 60% of the respondents denied that staff provided the medication storage information. Regarding the customer skepticism toward community pharmacy services, 55% respondents agreed that services of community pharmacies tend to just concern on commercial aspects and 60% of respondents believed that services concern toward the business matter more likely than patient health. Interestingly, 85% of the respondents acknowledged the role of community pharmacy as indispensable healthcare setting. The availability of the pharmaceutical product and the cost of pharmacy products satisfied by 40% and 20% of the respondents, respectively. In conclusion, this study demonstrated low customer satisfaction with regard to community pharmacy services in the southern region of Libya. Community pharmacy staff should have an understanding of the codes of conduct and the ethical requirements for their practice of pharmacy profession.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

There has been an increasing awareness about the importance of herbal plants in therapeutic uses which are safe, efficient and induce little side effects This study was based on the evaluation of antibacterial activity of ethanolic extracts of the leaves of Oleaeuropaea (Olive tree) and Ficuscarica (Fig tree), alone and in combination, against enterococcus faecalis (E. faecalis) strain using well diffusion method and minimum inhibitory concentration. The results revealed that the Oleaeuropaea leave extract is more potent than the Ficuscarica leave extract against E. faecalis, as the zone of inhibition was 23 mm and 3 mm, respectively. By mixing both extracts, the results showed a slight synergistic effect, as the zones of inhibition were 20 mm, 24 mm, 24 mm and 25 mm for 1:1, 1:3, 1:6 and 1:9 ratios of the Oleaeuropaea leave and the Ficuscarica leave extracts, respectively. The minimum inhibitory concentration for E. faecalis growth was 200 mg/ml for the Oleaeuropaea leave alone, Ficuscarica and mixed with Ficuscarica. The present findings conclude a potent antibacterial activity of the olive and fig leave, and, their potential as a source of drug in the treatment of E. faecalis infections is suggested.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

In health care delivery systems, if you are not part of the solution, then you must be part of the problem. Over the last few decades, clinical pharmacy encourages pharmacists and pharmacy support staff to move their focus from product-oriented role towards new direct engagement with patients, to make the most of the benefits that patients obtain from the medicine they take, or the problems they encounter with their medicines use. In the USA, pharmacists’ participation in physicians ward rounds was shown to reduce adverse drug events by 78% and 66% in general medical and intensive care settings [1. 2]. A study covering 1 029 US hospitals indicated that centrally based and patient-specific clinical pharmacy services are associated with reduced mortality rates [3]. The services involved were medicine information, clinical research performed by pharmacists, active pharmacist participation in resuscitation teams and pharmacists undertaking admission medication histories. New pharmacists’ roles in healthcare systems around the globe have moved and developed significantly over the past few years, particularly with expansion of the scope of practice which allows pharmacists to focus on the clinical aspects of direct patient care [4, 5]. Pharmacists are drug therapy experts of health care team. Therefore, pharmacists, today, are the arbiters of effective and safe use of medicines. Medication therapy management is one of the major areas in which physicians more and more rely on pharmacists to benefit their patients.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Inflammation is said to be a healthy component of the body immune system's reaction. Inflammation is characterised by four key symptoms: pain, redness, heat or warmth and swelling. As secondary metabolites, plants may produce a wide range of phytochemical compounds, which possess anti-inflammatory characteristics. Herbal remedies are important therapies for a wide range of ailments all over the world. There are around 7 500 species of medicinal plants, including representatives from over 17 000 flowering plant species. Even when synthetic chemistry has developed out their expectations, the use of natural ingredients in the manufacture of drugs used in contemporary medicine is unparalleled. By interfering with the biology of inflammation, anti-inflammatory medications may assist to minimise tissue damaging and increase patient’s comfort. Because of the bulky figure of species reachable for study, the effective development of novel naturally taking place anti-inflammatory drugs is mostly dependent on a multidisciplinary approach to discovering new chemicals. Despite the statistic that many review papers have been produced in this field, the conventional of them simply examined the issue from an area perspective. Several non-steroidal anti-inflammatory drugs have been shown to reduce inflammation and pain by decreasing the isoform of the cyclooxygenase enzyme's digestion of arachidonic acid, hence lowering prostaglandin production. Non-steroidal anti-inflammatory drugs have a host of harmful effects. There are, however, medicinal herbs with anti-inflammatory pharmacological properties that have few or no negative effects.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142, 72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The prevalence of vitamin D deficiency has recently been recognized in different parts of the world, even affecting healthy populations. The deficiency of vitamin D can lead to rickets in children and osteomalacia in adults. Few studies have been done to evaluate the status of vitamin D in the medical community around the world. No studies have been done in Libya to evaluate the status of vitamin D in medical students. The aim of this study was to evaluate the prevalence of low level of vitamin D in among healthy Libyan medical students of first year in University of Tripoli, Tripoli. Prospective study was conducted on 100 medical students of first year in Faculty of Medicine with a mean age of 19.5 years, 38 males and 62 females. Blood samples were taken and investigated for different biochemical parameters including serum calcium, serum vitamin D and serum parathyroid hormone levels. Questionnaire containing different data was completed for each student including personal data (age, address, nationality, and other data related to vitamin D deficiency. The prevalence of vitamin D deficiency in all the participated students was 74% (58.7% in males and 83.8% in females), while 21% had vitamin D insufficiency (28% in males and 16.12% in females). Only 5% of the students that had normal vitamin D was males. The mean 25-hydroxy vitamin D level was 19.49 ± 8.56 ng/ml in males and 12.08 ± 6.70 ng/ml in female students. Statistical analysis revealed that there is a highly significant difference among the student in vitamin D deficiency. In conclusion, low concentration of vitamin D is highly prevalent among the medical students included. An urgent action has to be taken in order to prevent adverse consequences of low vitamin D in young population.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Petroleum refineries are largest chemical industries that are responsible for emission of several pollutants into the atmosphere. Benzene and its metabolites are regarded as the most hazardous compounds that are emitted by petroleum refineries. These contribute to toxic oxidants, which cause many serious health risks to petroleum refineries workers. This study was aimed to analyze the effects of chemical exposure on hematological and biochemical parameters among workers at Zawia oil refinery and Mellituh oil and gas refinery companies. A total of 200 workers participated in this study which consisting of two equal groups (each group: n = 100). The first group consists of petroleum refineries workers and the second group consists of non-oil work civil servants serving were recruited as exposed and control subjects, respectively. The results of blood picture, liver enzymes and kidney functions were compared between the groups. Mean white blood cells counts, platelet counts, and hematocrit count were significantly higher, while the mean red blood cells count was insignificantly changed in petroleum refineries workers. While the mean hemoglobin and corpuscular hemoglobin concentration levels were significantly lower, whereas the mean corpuscular volume and mean corpuscular hemoglobin levels were insignificantly changed in petrol refineries workers. Liver enzymes and renal functions were significantly higher in petrol refineries workers. The present findings indicate that occupational exposure to benzene causes significant alterations in hematological and biochemical parameters and workers are at high risk of developing blood, hepatic or renal related disorders. Protection and frequent medical attention should be given to petroleum refineries workers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Among the consequences of armed conflict, the effect on the mental health of the civilian population is one of the most significant aspect of psychiatric disorders. Studies of the general population show a positive increase in the incidence and prevalence of mental disorders. This study is aimed to determine the relationship of the national crisis on the mental health conditions of university students and their academic performance. Specifically, this study was aimed to evaluate the national crisis effects on the mental health and the academic performance as well as the association of the national crisis, mental health and academic performance. 40 sample size of pharmacy students at the academic year 2019-2020 at Attahadi University, Tripoli, Libya were used in this study and a survey of validated questionare for mental health was considered. The findings revealed that the effects of national crisis on the mental health of the students disclosed the verbal interpretation of rarely grade. Indeed it can be found that mental health of the students was not of greatly affected in this sample. The academic performance of the students disclosed that academic year levels one and three have verbal interpretation of good and academic year level two has fair. Though the academic performance of the students did not show a verbal interpretation of weak or very weak. It is still worthwhile to note that none of them has reached the very good and the excellent performance. It can be concluded that a need for the students coping strategies be enhanced for them to reach their maximum potential with their academic performance. This study shows also that a weak positive relationship among the variables. Though it’s not that high, indeed, the mental health of the students can be a predictor to their academic performance.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Good prescription writing is essential for dispensing the right drug formulation and dose. When prescriptions are not legible, inaccurate and do not include complete information, there is a possibility of prescribing errors occurring, which leads to adverse events. Poor handwriting is another important issue that makes the information unclear; especially look-alike drug names that may be confused by the pharmacist. World Health Organization has issued a practical manual for Good Prescribing that includes the essential information that should be included in a prescription. In this study, we attempt to investigate the problem of bad prescribing habits in out-patient prescriptions in Benghazi, Libya. Two hundred seventy-five out-patient prescriptions were collected from two private pharmacies on four consecutive days. These prescriptions were scanned for any errors or missing information depending on the standard criteria established by World Health Organization in its practical manual "Guide to Good prescribing". The collected data were processed and statistically analyzed by using SSPSS to calculate the percentage of missing information. Eleven percent (11.0%) of the prescriptions had no address or name of the prescriber on them while 58.0% had no date written on them and in 21.0% the prescriber did not sign the prescription. The age of the patient was only written on 38.0% of the prescriptions. The name of the medication was not clearly written in 18.0% of the prescriptions, while the dosage form of the medication was not written at all in 18.0% and not clearly written in 20.0% of the prescriptions. The total amount of the prescribed drug was not written in 30.0% of the prescriptions. It is to conclude that prescribers included in this study wrote prescriptions with a lot of missing and unclear information as per WHO guidelines for a good prescribing. This shows the weak attitude of Libyan prescribers toward the different aspects of “Good Prescribing”.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Community pharmacist plays an essential role in educating the epileptic patients about their disease and medications. Improving the patient’s awareness may lead to improve their compliance and decrease drug-drug interaction and ultimately improve their quality of life. Pharmacist can detect the emergence of health problems and can help prevent progression of comorbidities. Considering the complexity of treating epilepsy and the lack of information about pharmacists’ contributions to epilepsy management, pharmacist performed pharmaceutical counselling, pharmaco-therapeutic follow-up and systematic measurement and evaluation of findings and increase medication adherence of patient with epilepsy. This study was aimed to assess the community pharmacist's knowledge about epilepsy and their treatment by antiepileptic drugs in Libya. The design of the study is a cross sectional study. The knowledge was collected through a questionnaire which included 35 questions divided into three sections: demographic data, general information about epilepsy and information about epilepsy and antiepileptic drugs. The questionnaire was prepared and validated by consultant training in Ali Omer Asker Hospital in Tripoli for two months. The findings indicate that over 200 patients are altered viewed, of whom, only epileptic patients were observed. The majority of the participants were female, qualification degree BSc and years of experience from one to five years. Unfortunately, some of the participants (40.0%) had poor knowledge and about 60.0% of them had good knowledge. This study indicates that the importance of community pharmacist in Libya requires more improvement to achieve the existing function and that the impact of continuous study of everything related to diseases and medicines is important to obtain a qualified pharmacist who can become an effective agent for a change.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Consumption of energy drinks was significantly associated with sleep problems, which are progressively used regardless of negative health effects particularly among adolescents and young adults. The goal of this study is to examine the relationship between energy drinks and sleep patterns on college students by more than one parameter. Target number of students was taken to be 1 000 participants and the study reached 434 participants were invited via self-administered questionnaire at Libyan International Medical University students during 2020 and 2021 in all levels which consisted of 20 questions and the main measurements are dependency, negative effect of energy drink and effect of energy drink on sleep. The results showed that the consumption prevalence rate of energy drinks amongst participants is 59.4%. The majority of participants enrolled in this study are male (52.5%) and 47.5% were female students. In conclusion: energy drinks consumption is a risk factor of poor sleep quality between Libyan International Medical University students. An awareness must be increased about energy drinks consumption to confirm the relation to sleep quality and general health.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Attempts have been made to formulate controlled release drug dosage forms using chitosan as a release controlling polymer. Granules of combination of chitosan, hydroxylpropyl cellulose, lactose, starch and Ibuprofen were prepared by wet granulation method using 1.0% lactic acid solution. The granules were physico-chemically characterized in terms of density, porosity, angle of repose, carr’s index and housner ratio and was found to be free flowing with good compressibility. FTIR spectroscopy was used and confirmed that there is no interaction between the drug and the added polymers. In vitro release of Ibuprofen, in phosphate buffer at pH 7.4, showed a steady and slow increase in the percentage of drug released over 24 hours as the percentage of chitosan was increased in the formulations compared to that from commercial tablets which released over 80.0% of their content in only two hours. The kinetic analysis using different mathematical models of the data revealed that the release kinetics of the drug form these formulations is somewhere between diffusion controlled, Fickian (anomalous) and non-Fickian which refers to a combination of diffusion and erosion controlled release. Thus, the high correlation coefficient of the data of drug release from most granules when zero order kinetics was applied revealed that there is a constant drug release with time for 24 hours.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The prevalence rate of vitamin D deficiency over the last decades has grown up rapidly worldwide among young adults. Therefore, the aim of this study is to explore knowledge, attitude and practice of Libyan medical students of Sebha University regarding vitamin D deficiency. Out of a total of 200 questionnaires, 148 completed questionnaires were returned (74.0% response rate). The majority of respondents did not measure their vitamin D levels (62.1%). Participants who indicated they exposing to sunlight for less than 15 min were 47.2% while 74.9% exposing to less than 30 min with highly significant difference in gender (p < 0.001). All the males did not use sunscreen creams compared with females (43.5%). Nearly two-thirds of the participants (61.4%) denied drink milk almost daily with significant differences based on the gender (p < 0.005) while 56.0 % of the participants reported eat fish, 60.8% of the students denied eating fast food and 74.3% eating eggs daily or weekly. However, 49.3% of the students are usually drinking of tea and coffee after meals, and do not usually practice exercise (53.3%), however, disagreed that their food has a low amount of calcium (30.4%). Most of the students agreed with the benefits of vitamin D (72.0%). Based on the assessment of awareness of the participants about vitamin D information, the average of correct answers percentage of the respondents was 47.1%. The most frequent sources of vitamin D information were the internet which accounted for 49.3%, followed by relatives and friends (31.7%). Some of the respondents (58.7%) reported that unawareness is the main cause of vitamin D deficiency. This study highlights the lack of awareness about the importance of vitamin D among medical students. This finding provides the institutions of medical education in Libya with an evidence base for a deficit knowledge regarding young health which could be utilized it to draw a strategy to correct health behaviors of students and community through medical education programs.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Aim: To evaluate the hepatoprotective activity of the chloroform extract of the selected Glinus lotodies linn plant by using Paracetamol induced hepatic injury in albino rats. Methods: The chloroform extract of Glinus lotodies linn was allowed for screening hepatoprotective activity on Paracetamol induced Albino rats and they were compared with standard and negative control. Results: The drug treatment Chloroform Extract of Glinus lotodies linn [CEGL] was carried out at two low dose levels 200mg and 400mg/ kg, both of which along the standard Silymarin 100mg/kg treated group showed a significant reduction in the elevated enzyme levels (P < 0.01). Liver section shows normal cells compared to control. Conclusion: These data suggests a dose dependent hepatoprotective activity of CEGL. At the end of this study, a strong conclusion can be drawn that the Chloroform Extract of Glinus lotoides linn possess hepatoprotective activities induced by Paracetamol in Albino rats.

Sudha Rameshwari.K Assistant Professor

Hemodialysis patients suffer from poor health-related quality of life which results in a higher risk of hospitalization and mortality. This study investigates the importance of pharmaceutical care and role of pharmacist for hemodialysis patients to optimize drug therapy, minimize drug related problems and thereby improving their health-related quality of life. The study was conducted to evaluate the impact of pharmaceutical care interventions on health-related quality of life of hemodialysis patients in Benghazi, Libya. Randomized control study was carried out after getting an ethical approval from the committee of the hospital. Health-related quality of life was assessed using SF-36 instrument for all the patients (n = 80). Among them, 40 patients were received the normal care along with brief medication review and counselled by pharmacists for two months. Then, health-related quality of life was assessed again for those 40 patients who received the pharmaceutical care. Data was analyzed using an appropriate methods. The results showed that the quality of life for hemodialysis patients was poor in both physical and emotional aspects. After implementation of appropriate pharmaceutical care to the patients, their quality of life improved significantly. Health-related quality of life is an important determinant of treatment effectiveness in dialysis patients

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

In some countries, a high percentage of the population relies on traditional plants for treating certain diseases. The aim of this study was to investigate the effect of G. alypum extract (GAE) and Alhagj marorum extract (AME) on lipid profiles in experimentally induced hypercholesteremic rats and on the blood pressure of experimentally induced hypertensive rats. Male Wistar rats weighing 200 - 300 g were divided into five groups: group 1 received a normal diet (negative control), group 2 received a high lipid diet containing coconut oil (10 g/kg/day), cholesterol (4 g/kg/day) and cholic acid (0.20 g/kg/day) (positive control), group 3 received a high lipid diet together with clofibrate (50 mg/kg/day), group 4 received a high lipid diet together with AME (200 mg/kg/day) and group 5 received GAE (200 mg/kg/day). The experiment continued for two weeks, then the rats were sacrificed and blood samples were collected for estimation of cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein. To induce hypertension, rats were divided into two groups (n = 8 in each group). Group 1 received normal saline (control) and Group 2 received dexamethasone (0.40 mg/kg, i.p.) for seven consecutive days. Later, the rats were anesthetized using thiopental and the carotid artery was cannulated for recording blood pressure. AME (40 mg/kg) or GAE (40 mg/kg) were injected through a cannula placed into the internal jugular vein at a dose volume of 0.1 ml. Systolic and diastolic blood pressure were measured before and after plant extract administration. The results showed that clofibrate GAE extract and ANE extract significantly decreased cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein as compared to high-lipid diet-treated rats. Data also indicated that administration of GAE or AME extract significantly decreased systolic and diastolic blood pressure in experimentally induced hypertensive rats. In conclusion, GAE and AME have antihyperlipidemic and antihypertensive activities and further investigation is needed to clarify the mechanism of these effects.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hepatitis B virus infection is a major health problem worldwide. More than 400 million people are suffering from this infectious disease. Alhagi Maurorum (camel thorn, CTE) is used in Libyan folk medicine for hepatitis. The aim of this study is to investigate the effect of the camel thorn on the hepatitis B virus. After a pharmacological and toxicological screening of camel thorns on experimental animals in our laboratories, in an open-label study, 15 patients of either gender were chosen at random with their consent (consent form signed). The patients had no liver cirrhosis and were not alcoholics. Following clinical testing, the patients were given a low, safe dose of camel thorn powder (2.6 g soaked in boiling water for 10 minutes) three times per day for six months. The viral load was measured before treatment and three and six months after the beginning of the experiment by polymerase chain reaction. The complete blood picture, the level of transaminases, bilirubin, creatinine, blood glucose, lipid profile, thyroid function, and prothrombin were assessed before and after three months after the beginning of the experiment. Our data showed no significant changes in the complete blood picture, creatinine, blood urea, glucose level, bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lipid profile, prothrombin, and thyroid function. The levels of viral load before, three months after, and six months after the beginning of our study were 1689 ± 289, 558 ± 160, and 271 ± 026 IU per mL, respectively. From this study, we may conclude that the camel thorn is safe and showed activity against viral hepatitis B, however, further investigations are needed by increasing the number of patients and using higher doses of plant extract to explore its mechanism of action. Finally, the mechanism of camel thorn may be related either to its antiviral effect or to the stimulation of either endogenous interferon or the immune system.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences