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Table of Contents
October-December 2018
Volume 9 | Issue 4
Page Nos. 119-164
Online since Monday, December 10, 2018
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EDITORIAL
Natural products-based nanomedicine
p. 119
Upendra Nagaich
DOI
:10.4103/japtr.JAPTR_374_18
PMID
:30637227
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REVIEW ARTICLE
Sulfonylurea and neuroprotection: The bright side of the moon
p. 120
Nawar R Hussien, Marwa S Al-Naimi, Huda A Rasheed, Hayder M Al-kuraishy, Ali I Al-Gareeb
DOI
:10.4103/japtr.JAPTR_317_18
PMID
:30637228
Sulfonylurea (SUR) agents are the second and most used oral hypoglycemic drugs after metformin and they still as an imperative tool for most favorable of glucose control. SURs are used mainly in the management of Type 2 diabetes mellitus since; they are effective in the glycemic control and reduction of microvascular complications. First-generation SUR represents 3% of used oral hypoglycemic agents while second and third generations are used in about 25% in patients with Type 2 diabetes mellitus. Upregulation of SUR1 receptor has been observed after stroke and traumatic brain injury, therefore, SUR such as glibenclamide inhibits brain edema and astrocyte swelling following brain insults. SUR drugs mainly glibenclamide is effective at a low dose in the management of cerebral stroke and could be a contestant with corticosteroid in controlling brain edema.
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ORIGINAL ARTICLES
Development and validation of simple simultaneous analysis for amlodipine and glibenclamide by nonderivatization high-performance liquid chromatography-fluorescence
p. 124
Febrina Amelia Saputri, Anisahtul Alawiyah, Ayu Brilliany Firsty, Sandra Megantara, Arif Satria Wira Kusuma, Taofik Rusdiana, Aliya Nur Hasanah, Mutakin Mutakin, Ingrid S Surono, Rizky Abdulah
DOI
:10.4103/japtr.JAPTR_315_18
PMID
:30637229
Studies have shown that about 65% of diabetics have hypertension. Treatment for diabetic patients with hypertension is usually given a combination of drugs such as amlodipine (AML) and glibenclamide (GLI). The aim of this study was to develop and validate the simple simultaneous analysis method for separation of AML and GLI using high-performance liquid chromatography (HPLC) with fluorescence detector without derivatization. The arrangement of isocratic and gradient methods, mobile phase compositions, and flow rates to develop and validate the simple simultaneous analysis method for separation of AML and GLI by nonderivatization HPLC fluorescence was done. Optimum condition was obtained using an RP 18 (125 mm × 4 mm, i.d., 5 μm) and guard column RP 18 (4 mm × 4 mm, i.d., 5 μm) with mobile phase composition containing acetonitrile and phosphate buffer pH 3.0 using a 20:80 gradient condition at flow rate 1.0 ml/min measured at 361 nm for λ excitation and 442 nm for λ emission for AML and 235 nm for λ excitation and 354 nm for λ emission for GLI. The analysis of AML and GLI demonstrated a valid result with
r
2
value 0.999, recoveries were 100.04% and 99.14% relative standard deviations were 0.508% and 0,797%, respectively, detection limits were 0.055 and 0.104 μg/ml, and quantification limits were 0.166 and 0.316 μg/ml, respectively. An accurate method of separation for AML and GLI using HPLC with fluorescence detector without derivatization has been validated.
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Novel aminochromone derivative inhibits tumor growth on xenograft model of lung cancer in mice
p. 130
Ekaterina V Blinova, Marina O Dudina, Irina R Suslova, Elena A Samishina, Dmitry S Blinov, Dmitry A Roshchin
DOI
:10.4103/japtr.JAPTR_313_18
PMID
:30637230
2-Amino-4H-chromene derivatives possess anticancer property proved on different
in vivo
and
in vitro
models of malignancies such breast, nasopharyngeal, bladder, ovary carcinomas, astrocytoma, and osteosarcoma. We assumed it might be effective to apply one of the derivatives as promising approach to lung carcinoma treatment. to evaluate how novel 4-aryl substituted 2-amino-4H-chromene derivative AX-554 impacts tumor growth and progression, as well as possible mechanisms for anticancer effect development on
in vivo
patient-derived heterotopic xenograft model of lung carcinoma in mice. This was an experimental
in vivo
study. 40 nu/nu
BALB
/c female mice were randomly allocated into four equal groups: Intact, control, reference, and main group. Animals of three latter groups were ingrafted with human-derived lung adenocarcinoma. Antitumor and antimetastatic action of AX-554 novel aminochromone derivative as a substance were studied. Mice survival was registered. Kinase of anaplastic lymphoma (ALK), tubulin Beta-3 (TUBB3), and c-mesenchymal-epithelial transition (MET) concentrations in the prime tumor nodes homogenates were determined by quantitative enzyme-linked immunosorbent assay. Dannet's parametric criterion and the nonparametric exact Fisher test were used. The normality of the distribution was determined using ANOVA. The survival curve was analyzed using Gehan's criterion with the Yates's correction. Aminochromone derivative possesses an inhibitory effect on human lung adenocarcinoma transplanted into nu/nu
BALB
/c female mice, as well as significant antimetastatic activity. About 50 mg/kg/day AX-554 intragastric course increases animals' life expectancy of more than 3.3 times when compared with the control and induces remission in 60% of cases. The anticancer effect of the derivative is due to anti-ALK-mediated activation of tumor cells apoptosis and suppression TUBB3-dependent cell proliferation.
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Comparative study of the effect of atorvastatin and fenofibrate on high-density lipoprotein cholesterol levels in patients with type 2 diabetes
p. 135
Mostafa Najafipour, Masoumeh Zareizadeh, Mehri Abdollah Khokhi, Farzad Najafipour
DOI
:10.4103/japtr.JAPTR_314_18
PMID
:30637231
Diabetes is the most common metabolic disease. Type 2 diabetes is a variable combination of insulin resistance and disorder in insulin secretion, leading to disorder of lipids and plasma lipoproteins. The most common pattern of dyslipidemia in diabetic is high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C). This study was conducted to find a more effective drug to increase HDL-C. In this study, 80 patients (26 males and 54 females) with type 2 diabetes received fenofibrate in cross-sectional way for 2 months, and they did not take antilipid drugs for 2 month. Then, they underwent atorvastatin for 2 months and HDL-C was measured before and after taking drugs. Patients did not change their diet during this study. Effect of atorvastatin and fenofibrate on HDL-C levels in patients with type 2 diabetes was evaluated. The mean HDL-C and total cholesterol (TC) before and after taking drugs were 36.5 mg/dL and 174.56 mg/dL, respectively. After atorvastatin, the mean HDL-C and TC were 43.30 and 150.144 mg/dL, respectively, and after fenofibrate, 43.40 were mg/dL and 146.36 mg/dL, respectively. Atorvastatin caused increase in HDL-C by 18.44% and reduction in TC by 13.82% and fenofibrate increase in HDL-C by18.62% and reduction in TC by 16.05%. No difference was seen between atorvastatin and fenofibrate in terms of effect on the HDL-C excess (
P
= 0.449). In addition, no difference was seen between atorvastatin and fenofibrate in terms of effect on TC reduction (
P
= 0.992). In conclusion various factors are involved in increasing the HDL, such as race, sex, nutrition, physical activity and, of course, medications. The effect of medications is also different on races and genetics. The value of increase in HDL-C after Fenofibrate and Atorvastatin was associated with gender so that it caused more increase of HDL-C in females.
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The demographic and paraclinical characteristics of patients with hepatitis B presenting to Shahid Mohammadi Hospital and Clinic and other private clinics in Bandar Abbas, Iran
p. 139
Mirzaali Nazarnezhad, Seyed Hamid Moosavy, Parivash Davoodian, Ebrahim Eftekhar, Abdolazim Nejatizadeh, Mohsen Azad
DOI
:10.4103/japtr.JAPTR_328_18
PMID
:30637232
Considering the crucial importance of hepatitis B and its high prevalence in the society, the present study was conducted to examine the demographic and paraclinical characteristics of patients with chronic hepatitis B. This descriptive cross-sectional study examined 180 patients with hepatitis B presenting to Shahid Mohammadi Hospital and Clinic and other private clinics in Bandar Abbas, Iran, in 2016–17. The patients were divided into three main groups: chronic hepatitis, liver cirrhosis, and healthy carriers. Parametric and nonparametric tests were used to analyze the relationship between the quantitative variables in terms of their normal or nonnormal distribution (
P
< 0.05). About 13.5% of the patients had cirrhosis, 35.4% were healthy carriers, and 51.12% had chronic hepatitis. The number of male patients in the cirrhosis group and the number of female participants in the healthy carrier group were higher. The difference in gender distribution between the three groups was statistically significant. According to the results of this study, male and married people constitute a high percentage of the population of patients with chronic hepatitis B. The clinical symptoms of chronic hepatitis B often do not occur until the patient's progress to advanced stages and cirrhosis, and most of the population is asymptomatic. Contact with a person suspected to have hepatitis B is one of the major risk factors of this disease.
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Comparison of serum procalcitonin level with erythrocytes sedimentation rate, C-reactive protein, white blood cell count, and blood culture in the diagnosis of bacterial infections in patients hospitalized in Motahhari hospital of Urmia (2016)
p. 147
Amir Nasimfar, Ebrahim Sadeghi, Mohammad Karamyyar, Laya Javan Manesh
DOI
:10.4103/japtr.JAPTR_319_18
PMID
:30637233
Blood infection is one of the causes of morbidity in hospitalized patients. While some scholars have identified procalcitonin (PCT) as a potential biomarker for the diagnosis of blood infection, others have questioned its diagnostic value. Thus, the present study was conducted to compare the diagnostic values of PCT with C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), white blood cell (WBC) count, and blood culture in patients with bacterial blood infections. In a prospective case–control study, 45 septic patients (6 months–5 years old), who were hospitalized in Shahid Motahhari Hospital of Urmia over the year 2016 and 45 patients with noninfectious diseases, whose gender and age range were similar to the members of the septic group, were examined. The participants' blood samples were taken for the sake of blood culture and measurement of PCT level, ESR, and CRP. Finally, the collected data were analyzed through the SPSS-21 software. the results indicated that the average PCT, ESR, CRP, and WBC count was significantly higher in septic patients. Moreover, the blood culture of patients with negative or intermediate serum PCT levels was negative, while 50% of blood culture results in patients with positive PCT were positive and the rest were negative. Finally, a significant relationship was detected between the frequency of blood culture results and results of serum PCT tests (
P
= 0.003). serum PCT level can be considered a diagnostic marker of bacterial infections. If used in conjunction with tests of CRP, ESR, and WBC count, the PCT test can enhance the diagnosis of bacterial infections.
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Usability testing of bed information management system: A think-aloud method
p. 153
Mohammad Reza Mazaheri Habibi, Reza Khajouei, Saeid Eslami, Majid Jangi, Azadeh Kamel Ghalibaf, Sara Zangouei
DOI
:10.4103/japtr.JAPTR_320_18
PMID
:30637234
Not considering the usability in designing clinical information systems causes problems in human–computer interaction and patient dissatisfaction. Therefore, in this study, the usability of the bed information management system (BIMS) was examined by think-aloud method. This cross-sectional study was conducted on the BIMS in 50 noneducational hospitals. Participants consisted of three groups including users, facilitators, and technical support. To carry out the study, a scenario consisting of four tasks was designed. Three researchers analyzed the recorded files to identify the usability problems and their severity. The mean time of the evaluation process was 20:33 ± 4:47 s. The total number of the problems identifies by users was 80 cases. Data entry and layout problems with 38 (48%) and 33 (41%) cases were the most frequently found problems, respectively. About 61% and 55% of the data entry and layout problems had a minor severity (Severity 2), respectively. Furthermore, 43 (54%) cases of the problems were resolved by the users and 32 (40%) cases by the facilitator assistance. This study showed that a large number of the problems were due to the system poor design. Furthermore, by increasing the users' level of knowledge about the system, it is possible to enhance user-system interaction. It is recommended that before designing and implementing a system, the system should be evaluated for usability, and the users should be educated in clinical information systems.
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Relationship between Chronic urticaria and autoimmune thyroid disease
p. 158
Mostafa Najafipour, Masoumeh Zareizadeh, Farzad Najafipour
DOI
:10.4103/japtr.JAPTR_342_18
PMID
:30637235
Hives is an erythematous and itchy disease that commonly affects the trunk and the organs. Acute urticaria is a common disease and affects about 10%–20% of the population during its lifetime. In patients with chronic urticaria, about 25%–30% of cases, antithyroid peroxidase (TPO) was detected and Hashimoto's disease was diagnosed. This study aimed to evaluate the anti-TPO antibody in patients with chronic urticaria and the effect of treatment of levothyroxine on its recovery. In this study, 72 people with chronic urticaria and positive anti-TPO antibody were randomly divided into two groups. Low-dose antihistamine was administered to both groups, and the first group received levothyroxine at a dose of 50 μg/day. The severity of itching was evaluated according to the visual analog scale before and after therapy. There was no significant difference in the age, sex, thyroid-stimulating hormone (TSH), and anti-TPO between the two groups. Ninety-two patients were female. In this study, all patients took a small dose of loratadine. Relative healing was observed in both the groups. However, in a group of patients taking levothyroxine and loratadine, recovery was faster and patients with no itching were significantly more likely than the other groups. The prevalence of chronic urticaria and anti-TPO antibody in this study was very high and was due to sex hormones. Therefore, in young women with chronic urticaria, especially in refractory cases, they should be monitored for anti-TPO. Anti-TPO and TSH should be evaluated for the diagnosis and treatment of patients with urticaria or chronic angioedema. Levothyroxine therapy in hives and chronic urticaria is beneficial in the treatment of thyroid dysfunction.
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Value of pathologic Q wave in surface electrocardiography in the prediction of myocardial nonviability: A cardiac magnetic resonance imaging-based study
p. 162
Ashkan Arjmand, Ali Eshraghi, Zahra Alizadeh Sani, Ata Firouzi, Hamid Reza Sanati, Hadi Nezami, Majid Jalalyazdi, Shirin Sadat Ghiasi
DOI
:10.4103/japtr.JAPTR_345_18
PMID
:30637236
In surface electrocardiography (ECG), Q wave is often considered as a sign of irreversibly scarred myocardium. Cardiac magnetic resonance (CMR) imaging is an accurate mean for the detection of myocardial viability. Herein, we study the predictive value of Q wave in nonviable (scarred) myocardium by CMR study. Retrospective analysis of the ECG and CMR data of 35 coronary artery disease patients was performed. The delayed enhancement CMR protocol was used for the detection of viability. The presence of a pathologic Q wave in surface ECG was negatively related to myocardial viability with a kappa measurement of agreement of −0.544 and
P
< 0.0001. Pathologic Q wave in surface ECG can be used as a simple tool for myocardial viability prediction.
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