Pharmacy articles list

Paracetamol is one of the most found over the counter drugs worldwide. It is widely used as an analgesic and antipyretic drug. Many commercial types of paracetamol tablets are available under different brand names in the Libyan drug market. The present study was conducted to evaluate post-marketing quality parameters for three brands of paracetamol tablets marketed in Libya. All three brands were evaluated for weight variation, hardness, friability, disintegration time and uniformity of content following British pharmacopeia guidelines. The outcomes of this study showed all tested brands complied with the British pharmacopeia specifications for the weight variation test, friability test (0.05%-0.17%), and hardness test (171.3N-197.6 N). In addition, two brands passed the British pharmacopeia requirements for the disintegration time test, whereas one brand exceeded the allowed disintegration time by about five minutes. Furthermore, high performance liquid chromatography was used to determine paracetamol content. Although the average amount of paracetamol drug available in these brands is not very close to 100%, where one brand achieved the lowest value (438.1 mg), the loaded dose of paracetamol in selected tablets in the three brands was within the British pharmacopeia standard specifications for the uniformity content test. Therefore, it can be concluded that almost all the three tested brands of paracetamol tablets that are available in the Libyan drug market meet the British pharmacopeia specification for quality control analysis.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Furosemide is a widely potent diuretic drug used in the management of edema and hypertension. Various brands of furosemide are available in the Libyan market and should be subjected to different quality control tests to assess their pharmaceutical equivalence. This study aimed to assess and compare the quality and the pharmaceutical equivalence of some generic brands of furosemide 40 mg tablets marketed in Libya. The pharmaceutical quality of four brands of furosemide tablets was investigated using official and unofficial compendia standards including uniformity of weight, friability, thickness, hardness, drug content and dissolution rate. The results obtained showed acceptable external features as well as the thickness, diameter and uniformity of weight for all the furosemide tablets. The tested brands complied with the official specifications of friability, hardness and drug content. In conclusion, all four brands can be considered as bioequivalence and thus can be pharmaceutically substituted in clinical practice.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Type 2 Diabetes mellitus contributes to the development or progression of many chronic and age-related pathological processes. One of the major risk factors for morbidity and mortality among patients with diabetes is renal and vascular disease as well as heart disease. Type 2 diabetes mellitus was associated with a significantly increased age of kidney disease with higher urea and creatinine levels. 76 Libyan subjects participated in the study. The subjects were divided into three categories. One group hosts diabetes case (n=40) while the other group serves as a control (n=12) and the other group has no type 2 diabetes mellitus but urea and creatinine levels are elevated (n=36). After oral informed consent of the study participants, 5 ml of venous blood was drawn under sterile conditions for whole blood analysis. Fasting blood sugar was analyzed. Urea and creatinine levels were compared between diabetic and non-diabetic patients. However, a statistical analysis was performed using IBM SPSS version 26 where the correlation between parameters was analyzed by an independent samples t-test. In this study, patients with type 2 diabetes mellitus caused a significant increase in urea and creatinine compared to the control group. The study indicated that type 2 diabetes mellitus increases the damage to the kidney function.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Pharmacists are expected to play major roles as members of diverse perioperative care teams besides implementing medication safety standards, pharmacist’s roles include optimizing drug therapy and other clinical interventions. Yet, developing general perioperative management as another crucial role operation room, pharmacists play and incorporating it into pharmaceutical education would be important. Enriching perioperative care provided by pharmacists can contribute toward improving the clinical competence of these professionals. Presently, there are no pharmacists in Zawia who participate in perioperative care. The objective of this study was to assess the pharmacist's knowledge of general anesthesia and drugs used to anesthetize patients who suffer from hypertension. A cross-sectional study was conducted in Zawia City, Tripoli in 2023. A self-designed questionnaire was distributed to 100 pharmacists. The study found that more than half of the pharmacists have humble knowledge about the drugs used in anesthesia, the findings indicated weakness in their information about drugs used to manage hypertension in surgery, and 36.0% know that sodium nitroprusside is used to control blood pressure during the operation. In conclusion, this study reported that some of the study's pharmacist participants had weak points that contributed to a high percentage of incorrect knowledge. These weak points may be attributable to poor educational preparation or a lack of training before the pharmacists began working in hospitals.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The need for natural medicine and nutrients from natural product sources cannot be overstressed. Plant parts like leaves, stem, root, seed, nut and flowers supply enormous minerals, phytochemicals and other bioactive constituents apart from the primary metabolites. Terminalia Catappa (T. catappa) is a combretaceous plant often found in tropical and subtropical regions. The plant has many uses as an ingredient of various drugs such as anti-oxidants, anti-inflammatory, anti-cancer, and anti-diarrheal. Thus, the main objective of this study was to determine the proximate, mineral and physicochemical analysis of T. catappa seed nuts. The proximate composition was determined according to the previous standard methods and elemental analysis by Atomic Absorption Spectrophotometry and Flame Photometer. Proximate composition revealed a moisture content of 02.34%, ash 03.89%, fibre content 08.50%, crude protein 29.66%, fat 21.98% and carbohydrate 33.63%. Elemental analysis of the plant have indicated the presence of iron, zinc, calcium, magnesium, potassium, sodium, copper and chromium in the aqueous extract. Physicochemical parameters of the plant revealed a specific gravity of 0.9182, viscosity 33.62 mm2/s, refractive index 1.4642, acid value of 0.102 mg KOH/g, saponification value of 151.28 mg KOH/g, iodine value 47.19 g I2/100 g and peroxide value 8.93 meq/kg. In conclusion, the findings from this study confirmed that almond nut oil has a long shelf life which may explain its applications in pharmaceutical, non-pharmaceutical and personal care industries.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Crinum jagus, family- Amaryllidaceae, commonly called river lily is an important medicinal plant used in the treatment of cough. It is an anti-venom agent used among the rural people in south-western Nigeria. The research is aimed to investigate the phytochemical constituents and analgesic activity of Cinium jagus bulb in BALB/c mice. The bulb was extracted with methanol in a soxhlet extractor apparatus. Phytochemical screening was performed according to standard methods. Alkaloid fraction was obtained using separation by extraction and characterized by infra-red (I.R) analysis. Acute toxicity test was done before analgesic activity was determined in BALB/c albino mice using the hot plate model. The result indicated the presence of some bioactive constituents like alkaloids, terpenoids and saponin. I.R bands were observed at 1064.74 cm 1 (C-O) stretch of alcohol; 1415.80 cm-1 (C-H) bend of alkyl groups and 1639.55 cm-1 (N-H) stretch of amine among others. The extract significantly increased the mean latency time of mice on the hot plate when compared with control with 100 mg/kg at 120 minutes. This study indicates that the Crinum Jagus bulb possesses analgesic potential.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Diabetes mellitus is a common and chronic metabolic disorder. Uncontrolled diabetes mellitus leads to body organ damage if not treated properly. Educational intervention is necessary from health-care providers such as pharmacists to prevent or reduce organ damage and complications among the diabetic patients. Several studies have demonstrated the contribution of pharmacists in achieving a better control of diabetes mellitus. Thus, this study intended to assess the knowledge and practice regarding foot care among Libyan diabetic patients in Al-Bayda city. In addition, to determine the association between knowledge and practice regarding diabetic foot care with selected demographic variables. This is a cross sectional study conducted at Diabetes Center Aljabal Al akhdar in Al-Bayda between April and August, 2022. A total of 400 participants with diabetes were enrolled and interviewed by using a self-design questionnaire for knowledge and practice of foot care after taking verbal agreement. Data was analyzed by using SPSS software version 26.0. In this study, 191 subjects were male (47.8%) and 209 subjects (52.3%) were female. On the topic of foot care, 51.8% of the participants stated they did know how to perform correct foot hygiene and 33.5% stated that drying should consist of passing a towel between their toes. Female subjects statistically had more knowledge than male subjects on the right footwear and correct way of nail cutting (p < 0.01 and p < 0.001, respectively). In relation to practice, the frequency of patients with a good practice was 126 (31.5%) and with poor practice was 274 (68.5%). Evaluating the parameters dry, moisturize and nail cutting, women showed a significant difference in relation to men, with a high significance level in the three parameters. In conclusion, the knowledge and practice of foot care in Libyan patients with diabetes were poor. So, an educational program is recommended to improve the awareness of foot care. Diabetic patients should be provided information about self-care of their feet by health care providers such as pharmacists to prevent and delay onset of foot complications and improve the quality of life.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Lycium schweinfurthii is a shrub belonging to the Solanaceae family which widely grows in North Africa and Mediterranean regions. The plant leaves have traditionally been used for gastrointestinal diseases as peptic ulcer in Libya. This study aimed to investigate the effect of Lycium schweinfurthii extract on the central nervous system in mice including anticonvulsant, antidepressant and muscle relaxant activities. The methanolic extract was prepared by fractionation technique. Albino male mice weighing 22 ± 2.0 gm were used and equally divided into equal number and weight for each experiment (n = 6). The best effective pharmacologically dose of 400 mg/kg, i.p. of the methanolic extract was selected to explore the anticonvulsant activity for picrotoxin-induced convulsion in mice (5.0 mg/kg), antidepressant activity of forced swimming test of depression and muscle relaxant action by motor coordination test of hanging wire. Fluoxetine (10.0 mg/kg), imipramine (15.0 mg/kg) and diazepam (5.0 mg/kg) were used as reference compounds. Lycium schweinfurthii extract exhibited a significant prolonged delay in the onset time of induced convulsion and significant decrease in the frequency of convulsion as well as a significant decrease in the duration time of attacks. Pretreatment with flumazenil (2.0 mg/kg) was found to increase the frequency and duration of convulsions without profound change in the onset time produced by Lycium schweinfurthii. For antidepressant activity, the plant leave extract significantly decreased immobility time duration without a muscle relaxant effect. The results suggest that the methanolic extract of Lycium schweinfurthii leave has anticonvulsant and antidepressant-like activities without any muscle relaxant effect in mice. Thus, Lycium schweinfurthii may have a neuropharmacological potential use in human.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Chronic kidney disease is a public health problem affecting people worldwide. This study was aimed to examine the characteristics of patients with chronic kidney disease and to identify prevalence of drug-related problems among Libyan patients. This is a descriptive retrospective study carried out in Southern-west part of Libya, Sebha City. Information abstraction forms were used for collection of data. The investigators reviewed the medications, medical records and laboratory data to identify drug-related problems.1 000 patients' files during 2019-2020 were examined and only 120 files were selected for this study. The majority of the participants were male (73, 61.0%) and the mean age was 56.1 years. 576 comorbidities among the selected patients were identified (73.61%) and the average number per patients was 4.8 concurrent diseases. There were 1 350 medications prescribed and the average of prescribed drugs per patient was 11.25. The majority of patients use more than 10 drugs (64, 53.3%) and the average length of staying in the hospital was 5.58 days. 502 drug-related problems were identified with an average of 4.18 per patient. Untreated conditions such as Hyponatremia and anemia were the highest rate of drug-related problems identified (199, 39.6%) followed by improper drug selection (82, 16.3%) such as cefotaxime, vancomycin and aminoglycoside for chronic kidney disease and drug use without indications such as antibiotics (68, 13.5%) and over-therapeutic dose such as metoclopramide(63, 12.5%). In conclusion, all the patients have polypharmacy and the majority have comorbid conditions and chronic kidney disease with frequent drug-related problems, thus, to lower the incidence rate of drug-related problems, therapeutic interventions are needed. Subsequently, it is a crucial to involve clinical pharmacist in hospital to improve the care of patient with chronic kidney disease.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Transglutaminase 2 (TG2) is an inducible transamidating acyltransferase that catalyzes Ca2+-dependent protein modifications. TG2 enzyme disruption has been implicated in several different disease processes and disorders such as Huntington and Parkinson’s diseases, cancers such as breast, ovarian and pancreatic cancers. Coeliac disease (CD) is the one disease state that TG2 activity plays a crucial role. To date, a gluten-free diet is the only accepted form of therapy for CD. Because of the important role of TG2 enzyme in the initiation of CD, therefore, this study was aimed at the identification of TG2 inhibitors from natural sources, as a potential intervention in CD therapy. Competitive amine inhibitors are the most widely used TG2 inhibitors because they are commercially available, chemically stable and relatively non-toxic in living systems. The natural products chosen for this study were dietary flavonoids. Flavonoids were extracted from different food samples. The flavonoids food extracts were subjected to the TG2 activity assays to examine their effect on the enzyme activity. The assays were carried out under optimal conditions of pH, Ca2+ and with N, N-dimethylcasein (acyl-donor) or casein (acyl-acceptor) as acyl-donor substrates and biotin cadaverine (acyl-acceptor) or TVQQEL as (acyl-donor) substrates. TG activity was measured by two different microplate assays, Biotin-labeled cadaverine incorporation assay and Biotin-labeled peptide cross-linking assay. In the TG2 amine incorporation activity, all of food extracts display a significant inhibition effect towards the human recombinant transglutaminase2 (hrTG2) and guinea pig transglutaminase 2 (gplTG2) (20 - 50% of inhibition). While in the TG2 cross-linking activity, the majority of food extracts displayed an inhibition effect on the gplTG2 cross-linking activity (50 - 70% of inhibition) but only the strawberry and kale extracts showed an effect on hrTG2 activity (40 - 50% of inhibition). The inhibition of TG2 activity can be considered as a potential therapeutic target in the treatment of CD.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Around the world, several oral health measures have been implemented. The most popular method is to use a toothpaste. However, chewing sticks are still used in many cultures around the world in a conventional manner. Chewing sticks have a mechanical cleansing action similar to a toothbrush in addition to their antimicrobial effect. The purpose of this study is to evaluate the effect of Miswak on the growth of Candida species and to compare it to that of toothpaste. A cross-sectional study was carried out on 120 selected randomly volunteers from January to April, 2022. Two groups of participants were used for two weeks. The participants were separated into a group used Miswak and a group use ordinary toothpaste. Samples were collected before and after two weeks in these two groups. Samples were immediately processed for microbiological phenotypic conventional methods and in vitro susceptibility testing of the microbial isolates to antimicrobial. The findings show that a significant effect of Miswak against an oral cavity candida species. Total candida count was 27.5 ± 18.48, P = 0.001 (Mean ± SD) from Miswak group and 247.0 ± 90.14, P = 0.979 (Mean ± SD) in toothpaste group. The most frequent Candida isolates organisms were C. albicans: 22 (36.67%) in the Miswak group and 24 (40.0%) in the toothpaste group, the second isolate was C. dubliniensis: 04 (6.69%) in the Miswak group and 12 (20.0%) in toothpaste group followed by C. glabrata: 02 (3.33%) in Miswak group. In conclusion, Miswak has a considerable antifungal impact immediately and after two weeks of use.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Self-medication of antibiotics is an irrational use of drugs, contributing to microbial resistance, increasing health care cost and higher mortality and morbidity. This study was aimed to assess self-medication with antibiotics without a medical prescription in the community of Libya. This is a cross-sectional study conducted from June to December, 2022 and the total number of participants was 200. The design of the study and sample size were modified according to the proficiency of pharmacists and the medical and non-medical population of Libya. The questionnaire was developed in English and Arabic language and was distributed through social media platforms. The questions were used after a thorough literature search and assessing the validity and reliability. The significant signs regarding reasons for the treatment by self-medication drugs of antibiotics, because of its various drugs of antibiotic by pharmacist (n = 80, 40.0%) and family (n = 90, 45.0%) compare with experience and physicians by used prescription was 13 (06.50%) and significant sings regarding by nasal congestion self-medication of various antibiotics (n = 100, 50.0%). This sign must be practiced based on a previous physician’s prescription. The antibiotics are often self-administered as patient feel that they will save money and time but this can lead to substantial adverse drug reaction, antibiotic resistance, treatment failure and drug-related toxicity. This study respondent's medical and non-medical public of Libya who should be relatively informed and educated about the risk of treatment by self-medication of antibiotics with the development of resistance.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

With a few years of teaching medical students and witnessing the status of medical education and health care delivery in Libya, for a decade or more, a reflection of what is happening in Libya, the country which has given respect and economic freedom to a teacher like me. The Republic of India, a South Asian country is the seventh largest nation by area, the second most populous country and the most populous democracy in the globe. One of the fundamental rights of the Indian constitution is the ‘Right to life’ which translates to “Right to Health”. India is a Federal country with 29 states and eight union territories [1]. Indian health care is taken care of by the States by organizing and delivering health care and the Central Government takes responsibility for international health treaties: medical education, prevention of food adulteration, quality control in drug manufacturing, national disease control and family planning. Indian health care under the public sector is provided free to people who are below the poverty line. Indian Public Health sector caters to 18.0% of total patient care and 44.0% of total in patient care. The total expenditure for health care is around 04.0% of the GDP and out-of-pocket expenses are around 69.0%. If it is calculated the cost of health care is around 1700 Indian rupees/capita/year [2]. It is true of Libya also. It has its national health a policy with free medical care and policy to cater to the needs of the Libyan people. With the civil unrest, and a transient locally elected government, Libya finds itself in very critical situation related to its economy and public services including public health. The hospitals built and their destruction because of the civil war lie in a very demanding conditions with poor supply chains and logistics to maintain the necessary demand and supply situation. The health care personnel physicians, nurses and public health workers are competent. They have to operate in a trying condition to save lives with limited healthcare facilities in the form of drug, medicine and medical equipment.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Acenocoumarol is the only oral antivitamin K anticoagulant prescribed and marketed in Algeria for the prevention and treatment of thromboembolic diseases. Nevertheless, the difficulty of handling this drug linked to a narrow therapeutic index and to great inter- and intra- individual variabilities of the response to the treatment poses a major public health issue because of its iatrogenic risk. To improve the management of patients on acenocoumarol and optimize its dosage adjustment and reduce iatrogenic secondary to vitamin K antagonists, our main objective work is to assess the knowledge, attitude and practice of health care professionals regarding this anticoagulant agent. We conducted a multicenter descriptive cross-sectional study from April to May 2021. We interrogated 152 health professionals of all ages, all sexes and all grades from different health departments in Oran City (Algeria) prescribing anticoagulants, through a validated questionnaire made up of 26 questions. Statistical analysis was achieved by SPSS version 20 software. Thus, 59.9% were women with a sex ratio of 0.67, 92.8% knew that acenocoumarol belongs to the antivitamin K class, 45.0% chose INR and PT as follow-up parameters, 36.0% chose INR alone and 78.9% were unaware of acenocoumarol dose adjustment algorithms as well as 82.0% were unaware of the existence of pharmacogenetics testing. 54.0% use the recommendations of the HAS for dosage adjustment of patients on acenocoumarol. 07.9% suggested using pharmacogenetic tests to improve the dosage adjustment of acenocoumarol, 06.6% suggested patient follow-up and 05.9% suggested therapeutic patient education as well as 74.3%, wanted to do training on. Therefore, this study highlighted gaps in the medical practice of physicians in terms of dosage adjustment, pharmacogenetics and its impact on dosage optimization. However, the evaluation of their knowledge was considered unsatisfactory. To overcome this lack of knowledge, it seems necessary to make physicians aware of the contribution of pharmacogenetics of acenocoumarol in Algeria.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Multiple choice questions (MCQs) and short essay questions (SEQs) are common methods of the assessment of medical students in courses of pharmacology. Poorly constructed test items (questions) are a widespread problem resulting in failure to assess learning objectives. It has been reported that there are 36.0% to 65.0% flawed test items in medical education assessment tools. Thus, the objective of this study was to evaluate MCQs by determining the item writing flaws (IWFs) and to evaluate the SEQs by determining the cognitive level of each item. Four pharmacology tests were administered to third-year pharmacy students at Department of Pharmacology, Faculty of Pharmacy, Omar Al-Mukhtar University, Bayda, Libya. These were evaluated by determining the IWFs and the level of the cognitive domains. Based on Buckwalter’s modification of Bloom’s taxonomy cognitive level, for the SEQs, 30.0% of the questions were attempted to check recall of information, 26.0% were attempted to evaluate understanding and interpretation of data and 43.0% of the questions were attempted to check the application of knowledge for solving a particular problem. For the MCQs, 94.6% of the questions were attempted to evaluate the understanding and interpretation of data. For the IWFs, there were more than 40.0% of flawed questions. The most common writing flaws were the negative stem (47.4%), unfocused item (16.0%), non-homogenous in grammar and contents (10.0%), all the above (10.0%) and clang association (05.0%). In a short essay, the SEQs were of excellent quality because they were equally distributed among the three levels of cognitive (level I, II and III). On the other hand, the most common mistakes IWFs of the MCQs were the negative stem (47.0%) and the idea was not clearly and concisely stated in the stem (16.0%). This study concludes that questions in SEQs are valid to measure the learning objective but MCQs were not in pharmacology courses in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Pain according to WHO has been one of the greatest issues to plague man, in the bid to handle this issue of pain, man has sought to look for other means to reduce pain to its bare minimum. This study is aimed at investigating the analgesic activity of the methanolic extract of the African weaver ant using acetic acid-induced writhing, hot plate method, and formalin-induced pain models in Swiss mice. In the acetic acid test, the methanolic extract of Oecophylla longinoda (OL) was administered orally at 200 and 400 mg/kg body weight while aspirin was administered at 100 mg/kg and tween 80 served as standards. In the hot plate and formalin models, the extract was administered orally at two doses of 200 and 400 mg/kg while pentazocine at 10 mg/kg and tween 80 at 10 mg/kg served as standards. The methanolic extract of OL exhibited significant analgesic activity in all the models, with none less than the standard significant difference (p < 0.05) by increasing the reaction time of the mice after treatment in comparison to the control. The 400 mg/kg extract in the acetic acid-induced writhing response has a percentage inhibition of 52.7%, which shows how well the extract inhibits pain in mice. The methanolic extract significantly reduced pain response in mice, with a p-value of 0.03, 0.02, and 0.001 in all the test models, respectively. OL increased the pain threshold over time and significantly reduced the writhing response that mice experience from acetic acid. Furthermore, pretreatment with OL significantly and dose-dependently decreased the early and late phases of formalin-induced pain in mice. Thus, these findings suggest that the methanolic extract of OL acts on central and peripheral pain pathways.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Diabetes mellitus (DM) is a complex and chronic illness requiring continuous medical care. Type 2 diabetes (T2D) is commonly associated with obesity, hypertension, and a tendency to develop thrombosis, and an increase risk of cardiovascular diseases (CVD). Diabesity is a term used to indicate the coexistence of obesity and DM. Diabesity increases as obesity is an emerging epidemic in modern societies, the co-incidence with DM is also rising, so a joint plan of anti-obesity and anti-hyperglycemia for the management approaches. Therefore, this study aimed to identify the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on body weight and glycemic response in obese Libyan patients with T2D at the National Diabetes Centre in Tripoli, between July 2013 and May 2022. This prospective study included obese adults with T2D who were newly prescribed GLP-1RA therapy for six months with dulaglutide once weekly or liraglutide once daily. The study included 170 diabetic patients who were started on GLP1-RA as add on therapy to their treatment, with a regular follow-up with dietitian and their physicians to adjust their glucose-lowering medications, then comparing the effect of these agents on body weight and the level of glycated hemoglobin before and after 24 weeks of treatment. Most of the patients (n = 99, 58.23%) were in the age period from 54 to 74 years old and 101 of whom were female subjects (59.4%), with a mean duration of DM equal to 8.8 ± 7.3 years. The patients were divided randomly into two groups, the first group included 110 patients who received liraglutide pens showed a significant reduction in HbA1c from 9.6% (± 1.54) to 7.4% (± 1.03) by p < 0.001 and a significant weight loss from 88.3 kg (± 10.68) to 80.8 kg (± 11.83) by p < 0.001. The reported adverse events were in 23 cases of minor hypoglycemia due to gastrointestinal upset. The other group included 60 patients for dulaglutide pens and showed significant decrease in HbA1c = 9.6% (± 1.54) to 7.1% (± 1.2) by p < 0.05 and a significant reduction of bodyweight from 88.3 kg (± 10.68) to 83.8 kg (± 16.3) by p < 0.05. The reported adverse events were mild transient gastrointestinal distress for the initial week of a start and then subside with regular intake. Whereas, 115 patients (67.6%) with HbA1c above 10.0% before starting therapy, no patient with HbA1c above 10.0% after six months of both GLP-RA agents therapy. Thus, the uses of GLP-RA as add-on therapy for obese patients with T2D significantly improved glycaemic control with less hypoglycaemia, accordingly, reduce insulin requirement for blood glucose control and loss in body weight. It can thus be concluded that GLP-1RA therapy is an effective treatment option when used in obese patients with DM.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Tobacco smoking negatively affects the quality of saliva and affects many biological parameters including salivary α-amylase enzyme activity. Salivary α-amylase enzyme is essential for the catabolism of carbohydrates. Forty- five healthy male volunteers aged between 18 and 69 years (40.0 ± 15.0) were divided into two groups, namely, the control group (n = 21) and the cigarette smoker group (n = 24). The effect of smoking on salivary α-amylase enzyme activity depends on the number of smoked cigarettes per day and the type of cigarettes as well as the period for how long the person smoking tobacco cigarettes was investigated. Different methods were used to analyze the activity of salivary α-amylase enzyme including the dinitrosalicylic acid method (standard colorimetric method). The results showed a significant increase (P < 0.05) in salivary α-amylase activity in Libyan smokers compared to the non-smokers in the morning and night, also, the findings showed a significant decline in salivary α-amylase activity during the increasing smoking period. The activity of salivary α-amylase in the young age smokers group increases in morning and night compared to the non-smokers group. There is no change in the activity of salivary α-amylase in the middle and older adult groups in the morning and night compared to young smokers group. In conclusion, smoking for a long period time more than 20 cigarettes per day decreases the activity of salivary α-amylase in Libyan subjects.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Medicinal plants and herbal drugs have widely been used in several diseases which contain highly active pharmacological agents. Several previous studies have mounted about the hepatotoxicity of these remedies which ranges from mild enzyme alterations to liver failure in humans and animals. This study aimed to evaluate the toxicity profile of the crude methanolic seed extract of Calliandra surinamensis on rat liver functions. An acute toxicity study was carried out using modified Lorke’s method and sub-chronic toxicity was done following the Organisation for Economic Cooperative and Development guidelines with testing chemicals 423 and 407 to assess the effect of the seed extract on liver function alongside histopathology assessment of the liver. The haematological indices revealed no significant change in red blood cells and other haematological parameters. The average organ weight of the tested rats showed no significant differences. The histopathological examinations of the rat liver revealed no observable toxic injury to the tissue after treatment with the seed extract across all concentrations. There were desirable morphological vasoactive changes of dilatation and active congestion in the organ across all the concentrations which were dose-dependent. There was induced activation of the sinusoidal kupffer cells, which signified a boost to the local immune system of the liver. The nucleoli in the hepatocyte nuclei were remarkably conspicuous which implied an increase in the production of ribonucleic acid that is deployed in protein synthesis.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Heavy metals and trace elements such as lead (Pb), mercury (Hg), cadmium (Cd), arsenic (Ar), nickel (Ni), Chromium (Cr), cobalt (Co), copper (Cu), mercury (Mg), iron (Fe) and aluminum (Al) are detected in various types of herbal cosmetics. Heavy metals and elements can accumulate at high concentrations causing serious risks to human health when consumed. In this study, the levels of potential heavy metals of Pb, Ar, Cd, and Ni were quantitatively determined using atomic absorption spectroscopy. Samples of Henna leaves, Henna paste, Khol stones and baby Talcum powder were collected randomly from different public markets of Tripoli city. The results were evaluated by using different international guidelines, US-FDA, EU regulation, German (BVL), World Health Organization (WHO) and Canadian Guidelines. Because of controversial global guidelines, the study urgent the ultimate need for setting up harmonized minimum levels of heavy metals in cosmetics that could be applicable worldwide. Generally, the presence of a higher concentration of some of the studied heavy metals was observed, and the effect of these heavy metals at higher levels will be more harmful to consumer health after prolonged usage. In conclusion, nationally, the need for developing and updating the national specification for cosmetics by the Libyan National Centre for Standardization and Metrology (LNCSM) to protect consumers from more catastrophic cosmetic hazards is urgently required.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences