Open Access Original Research Article

Assessment of the Quality of Postero-anterior Chest Radiographs Seen in a North-west Nigerian Tertiary Hospital

U. Abubakar, A. Ibrahim, V. K. Nwodo, A. A. Sadiq, G. M. Akpaniwo, A. Mohammed, D. Mohammed, I. I. Yusuf, A. D. Gurama

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-7
DOI: 10.9734/jamps/2019/v21i130120

Objectives: To determine the quality of chest radiographs of adult patients x-rayed at Usmanu Danfodiyo University Teaching Hospital (UDUTH) in accordance with Committee of European Commission (CEC) guidelines on quality criteria and to determine the most common factor that affects the radiographs.

Materials and Methods: The data was collected retrospectively from the hospital archives using a data capture sheet.

Results: A total of 266 radiographs were assessed and the age of patients whose radiographs participated in the study ranged from 20-80years. Also, a greater number of male patients 147(55.3%) participated in the study than female patients 119(44.7%). Results from the study revealed that 194(72.93%) and 225(84.59%) radiographs had correct placement of patient details and anatomical marker respectively. Adequate inspiration was achieved in 223(83.83%) radiographs with presence of artifacts seen in only 17(6.39%) radiographs. Thrown-off scapulae out of lung fields was seen in 174(65.41%) radiographs while adequate penetration was demonstrated in 209(78.57%) radiographs. Fog was seen in 16(6.02%) radiographs and rotation was recorded in 86(32.33%) radiographs. Additionally, blurring and darkroom processing faults affected 9(3.38%) and 42(15.79%) radiographs respectively. The most common cause of poor quality chest radiographs was found to be inadequate collimation affecting 110(41.35%) radiographs.

Conclusion: In terms of overall quality, only about 41(15.41%) radiographs met all criteria for a standard chest radiograph according to committee of European commission.

Open Access Original Research Article

Effects of Melatonin on Metabolic Abnormalities in HIV Patients Treated with Antiretroviral Drugs

F. R. Nerone, G. F. Messias, M. Spack Jr, A. R. T. Pupulin

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-10
DOI: 10.9734/jamps/2019/v21i130121

Aims: Highly Active Antiretroviral Therapy (HAART) is the current care standard for treating patients with HIV/AIDS. Although HAART has is the only regimen potent enough to decrease viral load, adverse events may limit its efficacy. Metabolic disorders are common in patients treated with HAART. Melatonin (N-acetyl-5-methoxytryptamine) was initially thought to be exclusively of pineal origin but recent studies have shown that melatonin synthesis may occur in several cells and organs. Melatonin has been shown to have a variety of functions and research during the last decade has proven the indole to be a direct free radical scavenger and indirect antioxidant. Due to these activities and possibly others that remain to be defined, melatonin has been shown to reduce toxicity and increase the efficacy of a large number of drugs. This study evaluated the effects of melatonin supplementation (6mg / day / 30 days) in AIDS patients using antiretroviral therapy (HAART).

Methodology: Current study was carried out in a double-blind, placebo-controlled and completely randomized design. AIDS patients who had metabolic alterations were selected. Patients were divided into two groups: Group I (HAART) consisted of patients receiving placebo once a day in the evening. Group II (HAART+ Melatonin) comprised patients who received the melatonin (6 mg) once a day in the evening for one month. Clinical and laboratorial evaluation was performed before and after 30 days. Clinical evaluation was performed to assess the patients´ overall clinical state. Patients were instructed to report any complications. Laboratorial evaluation was performed. Glucose levels were determined by glucose oxidase method and ELISA (Genway Biotechnology, USA), respectively, following manufacturer’s instructions. Plasma levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) were performed by the kinetic colorimetric method; triglycerides, total cholesterol and creatinine were performed by enzymatic colorimetric method, both provided by Gold Analisa Diagnóstica Ltda. 

Results: Sixty patients who had some metabolic abnormalities (glucose levels above 100.0 mg/dL or total cholesterol above 200 mg/dL or triglycerides above 200 mg/dL) participated in the study. All had been using HAART therapy for at least five years, with an average 15-year infection period. Patient´s age ranged between 35 and 49 years, with a mean of 43.7 years. Fasting glucose was significantly lower in subjects in Group I treated with melatonin when compared with subjects included in the control group not treated with melatonin after one month of treatment. Levels of blood glucose were 23% lower in patients who used melatonin, with reference rates after one month of treatment. Current study revealed that 40% (12/30) of the patients had changes in AST liver enzymes (> 38 U/I), 30% (9/30) had changes in ALT levels (> 38 U/I) and 30% (9/30) had GGT levels (> 40 U/I). Results obtained after the use of melatonin suggest melatonin activity on the liver. Significant differences between groups in plasma cholesterol indicate that melatonin exerted better improvement of blood lipid composition. Melatonin would lower cholesterol in liver and decrease plasma cholesterol. Above all, melatonin could decrease oxidative stress and improve dyslipidemia.

Conclusion: Considering the low toxicity of melatonin and its ability to reduce the side effects and increase the efficacy of the drugs, its use may be important and significant as a combination therapy with HAART. Current study which investigated the effect of melatonin associated with antiretroviral treatment demonstrated beneficent effects on metabolic abnormalities in AIDS patients.

Open Access Original Research Article

Self-medication: Prevalence among Undergraduates in Kathmandu Valley

Kushalata Baral, Maginsh Dahal, Shreya Shrestha, Anup Adhikari

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-13
DOI: 10.9734/jamps/2019/v21i130122

Background: Self-medication is defined as the use of medicines to treat self-recognized or self-diagnosed conditions or symptoms, instead of seeking advice from professionals.

Aim: Our study was aimed to assess knowledge, attitude and practice of self-medication among undergraduates in different colleges of Kathmandu valley.

Methods: Descriptive cross-sectional study was carried out among undergraduates of Kathmandu valley. A semi-structured questionnaire was distributed to students in 4 different colleges. Chi-square test was used to determine statistical significance. Likert’s scale was used to measure attitude.

Results: 240 students participated in this study. Totally, (92.9%) students had known and taken medicine without doctor’s prescription. More than half of the participants (56.6%) had good knowledge on self-medication and nearly three quarter (74.7%) of the respondents had a positive attitude regarding self-medication. Fever, cough/cold and aches/pain were the most common symptoms for self-medication, thus making antipyretics and analgesics the most popular self-medication drugs. Pharmacists and family were the major source of information regarding self-medication.

Conclusion: Based on the findings, the prevalence of self-medication was high (94.9%). Majority respondents had good knowledge of the advantages and disadvantages of self-medication but still practiced it.

Open Access Original Research Article

Analysis the Improvements of the Quality of Life in Ayurvedic Treatment for the Wrist Fracture

R. Rakulini, A. M. H. Sampath Attanayake

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-15
DOI: 10.9734/jamps/2019/v21i130123

Aims: The aim of this study was to analyze the improvements of the quality of life (QOL) in Ayurvedic treatment for the wrist fracture.

Study Design: This is a Retrospective Cohort Study.

Place and Duration of Study: This study was carried out among the wrist fracture patients in Kadum bidum (orthopedic) Clinic who got treatment of wrist fracture at Bandaranayaks Memorial Ayurvedic Research Institute (BMARI).

Methodology: All wrist fracture patients attending the BMIRI clinic were selected for this research study, were interviewed and administrated Qualeffo-41 questionnaire to collect the data. Patients were divided into three groups (A - Patients who took ayurvedic treatment straightly, B - Patients who took ayurvedic treatment after getting western treatment and C - Patients who took ayurvedic treatment after getting alternative treatment). QOL were analyzed in the interventions. There are first visit, after the 6th week, after 3 months, and after the 6th month.

Results: In group A, they were getting quick improvement seen within 3months. QOL score changes from 16, 39, and 55. In group B, QOL score of patients who were getting treatment for 6th weeks QOL score changes from 18, 38.5. QOL of patients who were getting treatment for 6 months QOL change from 17, 26, 35, and 43. In group C, QOL of patients who were getting treatment for 3 month QOL changes from 21, 31.5, and 42.5. QOL score of patients who were getting treatment for 6 months QOL changes from 17, 24, 35 and 41.

Conclusion: The study patients were quickly improved by the Ayurvedic treatment indicating its efficacy in fracture management.

Open Access Original Research Article

Assessment of Antiplasmodial Activity and Toxicity of Crude Extracts and Isolated Compounds from Oncoba spinosa (Flacourtiaceae)

Kodi Philip, Peter Kiplagat Cheplogoi, Mwangi Muthoni Elizabeth, M. Akala Hoseah, Moses K. Langat

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-14
DOI: 10.9734/jamps/2019/v21i130124

Aims: The medicinal plant Oncoba spinosa is used by the local communities in Butebo County in Eastern Uganda for treatment of malaria and other diseases. In vitro antiplasmodial activities of the crude extracts and isolated compounds were screened against chloroquine sensitive 3D7 and resistant Dd2 strains. In vivo acute toxicity of the extracts and structure elucidation were also determined in the study.

Experimental: Crude extracts of: n-hexane, dichloromethane, ethyl acetate and methanol were prepared. Isolation and purification of these extracts were done using chromatographic techniques which consisted of column and thin layer chromatography. The structures were elucidated on the basis of spectroscopic evidence. In vitro antiplasmodial activity was performed on chloroquine sensitive 3D7 and resistant Dd2 strains of Plasmodium falciparum using SYBR Green 1 assay technique. Lorke’s method of acute toxicity was used to determine the in vivo acute toxicity of the crude extracts in mice.

Results: The root ethyl acetate crude extract had highest antiplasmodial activity of IC50:4.69 ± 0.01 µg/mL and 3.52 ± 0.02 µg/mL against 3D7 and Dd2 strains respectively while the remaining three were inactive against both strains of Plasmodium. Isolation resulted in the identification of three known compounds which included: β-sitosterol, benzoic acid and chaulmoogric acid. Among the tested compounds β-sitosterol showed the highest activity of IC50 3D7: 5.51 µM. Dichloromethane and hexane extracts were non-toxic with LD50 > 5000 mg/kg while the EtOAc and MeOH extracts were slightly toxic with LD50 of 547.72 mg/kg. Statistically significance existed between the antiplasmodial activity of the crude extracts and compounds when compared with the controls at (p < 0.05). Extracts and compounds exerted a significant (P < 0.05) decrease in antiplasmodial activity compared to the positive controls.

Conclusion: The findings confirm the ethnobotanical use of O. spinosa by the local communities in Butebo County for the treatment of malaria. The results also suggest that the crude extract of this plant is safe and possesses antimalarial activity which can be used as a basis for in vivo and clinical studies to be done. Therefore the plant can offer a potential drug lead for developing a safe, effective and affordable antimalarial.