Pub Date : 2014-12-05DOI: 10.6084/M9.FIGSHARE.1294839.V1
A. Mecheser, Abdulkhaleq A. Al – Naqeeb, A. Obaid
Descriptive analytic study to asses’ psychosocial aspects of divorcees employers in some of institutes and colleges of the foundation of technical education .From September 2011-December 2012 to determine and to assess the psychology and social aspects and whichever aremore effective on the divorce states for employers in the foundation's institutes and colleges .The study sampling was convenient consist of (thirty) divorces consisted of (ten) who did not respond to questions because the period of their divorce was close and reserved on the response ,because they think back to the case of the former matrimonial .Twenty who are the rest divorces consisted of (four) male and (sixteen) female who work in different functional professions .The researchers concluded that most of the divorced were affected by psychological and social factors. The assessment of the Psychological and social domains were reported as bad assessment with (100%). Descriptive and inferential statistical methods (Frequency, Percentage, Mean of Score, Standard deviation, and Relative Sufficiency and chi square) were used. The researchers recommended establishing the guidance of education and psychology to follow up all divorces and to present management for any problems which cause the separation or divorce.
{"title":"Assessment of psychosocial aspects of divorcees employed in some institutes and colleges of the foundation of technical education in Baghdad city","authors":"A. Mecheser, Abdulkhaleq A. Al – Naqeeb, A. Obaid","doi":"10.6084/M9.FIGSHARE.1294839.V1","DOIUrl":"https://doi.org/10.6084/M9.FIGSHARE.1294839.V1","url":null,"abstract":"Descriptive analytic study to asses’ psychosocial aspects of divorcees employers in some of institutes and colleges of the foundation of technical education .From September 2011-December 2012 to determine and to assess the psychology and social aspects and whichever aremore effective on the divorce states for employers in the foundation's institutes and colleges .The study sampling was convenient consist of (thirty) divorces consisted of (ten) who did not respond to questions because the period of their divorce was close and reserved on the response ,because they think back to the case of the former matrimonial .Twenty who are the rest divorces consisted of (four) male and (sixteen) female who work in different functional professions .The researchers concluded that most of the divorced were affected by psychological and social factors. The assessment of the Psychological and social domains were reported as bad assessment with (100%). Descriptive and inferential statistical methods (Frequency, Percentage, Mean of Score, Standard deviation, and Relative Sufficiency and chi square) were used. The researchers recommended establishing the guidance of education and psychology to follow up all divorces and to present management for any problems which cause the separation or divorce.","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"32 1","pages":"54-64"},"PeriodicalIF":0.0,"publicationDate":"2014-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82200948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Gaonkar, Iosr Phr, R. Gaud, R. S. G. S. P. Bhilegaonkar
Candesartan cilexetil is a poorly soluble antihypertensive agent with solubility limited bioavailability (15%). To initiate process of solubilization , it is very much necessary to displace the air at the surface and wet the drug surface with a non volatile solvent / surfactant ,with which drug is compatible . Solvents used here are surfactant (Tween 20) and modified surfactant (Transcutol) in different drug:solvent (1:1-1:9) ratio’s for preparation of adsorbates. Adsorbates were then converted into free flowing powders as liquisolid compacts and compressed to form tablets. Liquisolid compacts were evaluated for improvement in saturation solubility and dissolution of candesartan cilexetil. All systems exhibited a promising advantage in terms of solubility and dissolution without affecting the drug structure as confirmed by IR and XRD. No considerable advantage in terms of solubility and dissolution was seen by increasing solvent ratio with drug.
{"title":"Improved Wetting For Improved Solubility and Dissolution of Candesartan Cilexetil, Comparative Study Of Surfactant And Modified Surfactant In Varying Ratios","authors":"S. Gaonkar, Iosr Phr, R. Gaud, R. S. G. S. P. Bhilegaonkar","doi":"10.9790/3013-040120109","DOIUrl":"https://doi.org/10.9790/3013-040120109","url":null,"abstract":"Candesartan cilexetil is a poorly soluble antihypertensive agent with solubility limited bioavailability (15%). To initiate process of solubilization , it is very much necessary to displace the air at the surface and wet the drug surface with a non volatile solvent / surfactant ,with which drug is compatible . Solvents used here are surfactant (Tween 20) and modified surfactant (Transcutol) in different drug:solvent (1:1-1:9) ratio’s for preparation of adsorbates. Adsorbates were then converted into free flowing powders as liquisolid compacts and compressed to form tablets. Liquisolid compacts were evaluated for improvement in saturation solubility and dissolution of candesartan cilexetil. All systems exhibited a promising advantage in terms of solubility and dissolution without affecting the drug structure as confirmed by IR and XRD. No considerable advantage in terms of solubility and dissolution was seen by increasing solvent ratio with drug.","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"8 1","pages":"01-09"},"PeriodicalIF":0.0,"publicationDate":"2014-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82918614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pharmaceutical care education was introduced into the country about a decade ago. There is a need to assess the impact of the education and information on the attitude of practicing pharmacists from time to time. Hence, an original research work was undertaken to evaluate the current attitudes towards Pharmaceutical Care (PC) concept and it’s implementation that are prevalent amongst practicing pharmacists and also to examine the impact of demographic factors. A descriptive study was carried out with a questionnaire between the months of January and March, 2013 among 205 out of estimated 400 pharmacists practicing in Rivers and Bayelsa States of Nigeria. Data collected was subjected to descriptive statistical analysis using SPSS version 15. Over 82% strongly agreed that pharmaceutical care was relevant to their practice while 62% are willing to incorporate Pharmaceutical care in their current practice. Most young pharmacists as well as pharmacists in hospital and community practice strongly agreed on the relevance of Pharmaceutical care and indicated willingness to implement the practice.The attitude of Pharmacist in these two states towards the Pharmaceutical Care concept and it’s implementation is good. However, there are challenges that need to be overcome to facilitate proper implementation of the concept. KEY WORDSCurrent Attitude, Pharmaceutical Care Concept, Willing to Incorporate.
大约十年前，药学教育被引入这个国家。有必要不时评估教育和信息对执业药师态度的影响。因此，一项原始的研究工作是进行评估目前的态度，对药学服务(PC)的概念和它的实施，普遍存在于执业药师，并检查人口因素的影响。在2013年1月至3月期间，对尼日利亚河流州和巴耶尔萨州约400名执业药剂师中的205名进行了一项描述性研究。收集的数据使用SPSS version 15进行描述性统计分析。超过82%的人强烈同意药学服务与他们的实践相关，62%的人愿意将药学服务纳入他们目前的实践。大多数年轻药剂师以及医院和社区实践的药剂师强烈同意药学服务的相关性，并表示愿意实施实践。两州药师对药学服务理念的态度和落实情况较好。但是，为了促进适当执行这一概念，还需要克服一些挑战。关键词现状态度药学服务理念愿意融入
{"title":"Attitude of Pharmacists to the Pharmaceutical care concept in rivers and bayelsa states of Southern Nigeria","authors":"Biobarakuma A. Joseph, J. Eniojukan","doi":"10.9790/3013-0401201016","DOIUrl":"https://doi.org/10.9790/3013-0401201016","url":null,"abstract":"Pharmaceutical care education was introduced into the country about a decade ago. There is a need to assess the impact of the education and information on the attitude of practicing pharmacists from time to time. Hence, an original research work was undertaken to evaluate the current attitudes towards Pharmaceutical Care (PC) concept and it’s implementation that are prevalent amongst practicing pharmacists and also to examine the impact of demographic factors. A descriptive study was carried out with a questionnaire between the months of January and March, 2013 among 205 out of estimated 400 pharmacists practicing in Rivers and Bayelsa States of Nigeria. Data collected was subjected to descriptive statistical analysis using SPSS version 15. Over 82% strongly agreed that pharmaceutical care was relevant to their practice while 62% are willing to incorporate Pharmaceutical care in their current practice. Most young pharmacists as well as pharmacists in hospital and community practice strongly agreed on the relevance of Pharmaceutical care and indicated willingness to implement the practice.The attitude of Pharmacist in these two states towards the Pharmaceutical Care concept and it’s implementation is good. However, there are challenges that need to be overcome to facilitate proper implementation of the concept. KEY WORDSCurrent Attitude, Pharmaceutical Care Concept, Willing to Incorporate.","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"44 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2014-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86008633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-12-03DOI: 10.9790/3013-0401201048053
Misonge J.O, Ogeto Jo, Sengera G.O, Mwalukumbi J.M, Mwaura A. M., J. S.D
Over 56 % of pregnant women in Kenya deliver at home with the assistance of mainly traditional birth attendants who use herbal remedies to complete the processes of child bearing in both urban and rural communities. The medicines and indigenous knowledge used by traditional birth attendants deserve to be properly validated through scientific scrutiny under conditions mimicking the indigenous methods of use. This work seek to evaluate the phytochemistry and ethnopharmacology of Uvariodendron anisatum Verdeck (Annonaceae) which is used in the management of a variety of conditions including root decoction to ease labor or if the after birth is late or retained. This study is to investigate the phytochemical group of compounds and effects of of Uvariodendron anisatum aqueous root extract on the uterus of Wistar rats. Phytochemical screening was carried out using the accepted standard procedures and the extract was prepared by maceration. In-vitro pharmacological assay was done using doses of 50 mg, 200 mg, 400 mg and 800 mg. Phytochemical screening revealed the presence of alkaloids, glycosides, tannins, phenols, anthraquinones, steroids, carotenoids, coumarins, tannins, flavonoids, saponins and volatile oils. The extract also demonstrated weak uterine motility which corresponded to the dosage and displayed similar motility as oxytocin at high dose (800 mg). KEYWORD: Annonaceaea, Oxytocic activity, Maceration, Phytochemical screening
{"title":"Evaluation of phytochemistry and uterotonic activity of root aqueous extract of Uvariodendron anisatum verdec. used in childbirth in Eastern/Central Kenya.","authors":"Misonge J.O, Ogeto Jo, Sengera G.O, Mwalukumbi J.M, Mwaura A. M., J. S.D","doi":"10.9790/3013-0401201048053","DOIUrl":"https://doi.org/10.9790/3013-0401201048053","url":null,"abstract":"Over 56 % of pregnant women in Kenya deliver at home with the assistance of mainly traditional birth attendants who use herbal remedies to complete the processes of child bearing in both urban and rural communities. The medicines and indigenous knowledge used by traditional birth attendants deserve to be properly validated through scientific scrutiny under conditions mimicking the indigenous methods of use. This work seek to evaluate the phytochemistry and ethnopharmacology of Uvariodendron anisatum Verdeck (Annonaceae) which is used in the management of a variety of conditions including root decoction to ease labor or if the after birth is late or retained. This study is to investigate the phytochemical group of compounds and effects of of Uvariodendron anisatum aqueous root extract on the uterus of Wistar rats. Phytochemical screening was carried out using the accepted standard procedures and the extract was prepared by maceration. In-vitro pharmacological assay was done using doses of 50 mg, 200 mg, 400 mg and 800 mg. Phytochemical screening revealed the presence of alkaloids, glycosides, tannins, phenols, anthraquinones, steroids, carotenoids, coumarins, tannins, flavonoids, saponins and volatile oils. The extract also demonstrated weak uterine motility which corresponded to the dosage and displayed similar motility as oxytocin at high dose (800 mg). KEYWORD: Annonaceaea, Oxytocic activity, Maceration, Phytochemical screening","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"85 12","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2014-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91454586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-30DOI: 10.9790/3013-04011019026
M. Mustafa, SC. Shimmi, M. Parash, Mds D. S. Rahman, S. Husain
Central line-associated bloodstream infections (CLABSIs) are common in intensive care units (ICUs) and in the medical patients. In the United States approximately 250.000 cases of bloodstream infections (BSIs) reported annually, associated with increase in longer hospital stay, costs and mortality. Primary bacteremia without local infection elsewhere, Including intravascular catheter sources account for approximately one half of ICU related bacteremias. The incidence of CLABSIs in non-ICU, general medical patients compare able to the rate in ICU patients. Sources of BSIs include contaminated fluids, catheter hub and lumen, and contaminated skin at catheter insertion site. Pathogens gain access into to the blood stream through extraluminal or intraluminal surface of the device. Bacterial bioflm is thought to be a virtually universal phenomena following insertion of intravascular device. Gram positive organisms, gram negative organisms and fungi is the frequently isolated BSIs pathogens. Multi drug resistant pathogens,and extended spectrum βlactamase (ESBLs) producing organisms, and bacteremia in elderly has high mortality rate. Molecular methods play important role in the diagnostic laboratory techniques.CLABSIs can be prevented by following CDC’s guidelines for the prevention of devicerelated infections.
{"title":"Role of Arterial catheters as a source of Hospital related Bacteremia","authors":"M. Mustafa, SC. Shimmi, M. Parash, Mds D. S. Rahman, S. Husain","doi":"10.9790/3013-04011019026","DOIUrl":"https://doi.org/10.9790/3013-04011019026","url":null,"abstract":"Central line-associated bloodstream infections (CLABSIs) are common in intensive care units (ICUs) and in the medical patients. In the United States approximately 250.000 cases of bloodstream infections (BSIs) reported annually, associated with increase in longer hospital stay, costs and mortality. Primary bacteremia without local infection elsewhere, Including intravascular catheter sources account for approximately one half of ICU related bacteremias. The incidence of CLABSIs in non-ICU, general medical patients compare able to the rate in ICU patients. Sources of BSIs include contaminated fluids, catheter hub and lumen, and contaminated skin at catheter insertion site. Pathogens gain access into to the blood stream through extraluminal or intraluminal surface of the device. Bacterial bioflm is thought to be a virtually universal phenomena following insertion of intravascular device. Gram positive organisms, gram negative organisms and fungi is the frequently isolated BSIs pathogens. Multi drug resistant pathogens,and extended spectrum βlactamase (ESBLs) producing organisms, and bacteremia in elderly has high mortality rate. Molecular methods play important role in the diagnostic laboratory techniques.CLABSIs can be prevented by following CDC’s guidelines for the prevention of devicerelated infections.","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"8 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2014-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79353546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are limited published data available about the provision of pharmaceutical care in community pharmacies in the UAE. Almost no documentation of efforts was taking place in community pharmacy. Objectives: This study is done to evaluate pharmacists perception of their current practice, as well as their knowledge of drug regulations/ classification by the Ministry of Health (MOH). Also, investigate their opinion on the possible pharmacist patient communication barriers. Methods: 300 cross sectional surveys were distributed to community pharmacies in Ajman and Sharjah. In addition, a pharmacist played the role of a patient with a prescription to measure pharmacists' knowledge. Results: The response rate of the participants was 73.6%. Most of the pharmacists couldn't identify drugrelated problems in the prescription and dispensed antibiotic without a prescription . In addition, most pharmacists were satisfied by the dispensing role in the community pharmacy. Conclusion: Community pharmacists roles must be expanded and they must look for new challenges in their profession in order to improve their experience and capabilities.
{"title":"Patients’ Perceptions of Community Pharmacy Practice in UAE: An Overview","authors":"Sarah Al Akshar, Zakia Metwaly, M. Shamssain","doi":"10.9790/3013-0401108014","DOIUrl":"https://doi.org/10.9790/3013-0401108014","url":null,"abstract":"There are limited published data available about the provision of pharmaceutical care in community pharmacies in the UAE. Almost no documentation of efforts was taking place in community pharmacy. Objectives: This study is done to evaluate pharmacists perception of their current practice, as well as their knowledge of drug regulations/ classification by the Ministry of Health (MOH). Also, investigate their opinion on the possible pharmacist patient communication barriers. Methods: 300 cross sectional surveys were distributed to community pharmacies in Ajman and Sharjah. In addition, a pharmacist played the role of a patient with a prescription to measure pharmacists' knowledge. Results: The response rate of the participants was 73.6%. Most of the pharmacists couldn't identify drugrelated problems in the prescription and dispensed antibiotic without a prescription . In addition, most pharmacists were satisfied by the dispensing role in the community pharmacy. Conclusion: Community pharmacists roles must be expanded and they must look for new challenges in their profession in order to improve their experience and capabilities.","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"68 1","pages":"08-14"},"PeriodicalIF":0.0,"publicationDate":"2014-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85351598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-30DOI: 10.9790/3013-04011049052
Manasi Deshpande, Shobha Khilari, Ankush Mahajan
Aspidium cicutarium L. from Dryopteridaceae family is a folk medicinal plant used in the treatment of shotha (inflammation). The rhizomes of this herb are said to be successful in managing Inflammation. This study is aimed at assessing the scientific evaluation of Aspidium cicutarium in the course of pharmacognostical and phytochemical analysis, which mainly covered the macroscopic and microscopic features of the rhizomes including powder microscopy and Phytochemical parameters such as pH, total ash value, water-soluble extract values were assessed in the preliminary physicochemical screening. Qualitative analysis revealed the existence of certain chemical constituents such as flavonoids, tannins, organic acids and saponin glycosides. The ethanol extract of rhizomes was subjected to TLC for the separation of components.
{"title":"Pharmacognostical and Phytochemical Studies of KukutnakhiAspidium Cicutarium - A Folklore Plant","authors":"Manasi Deshpande, Shobha Khilari, Ankush Mahajan","doi":"10.9790/3013-04011049052","DOIUrl":"https://doi.org/10.9790/3013-04011049052","url":null,"abstract":"Aspidium cicutarium L. from Dryopteridaceae family is a folk medicinal plant used in the treatment of shotha (inflammation). The rhizomes of this herb are said to be successful in managing Inflammation. This study is aimed at assessing the scientific evaluation of Aspidium cicutarium in the course of pharmacognostical and phytochemical analysis, which mainly covered the macroscopic and microscopic features of the rhizomes including powder microscopy and Phytochemical parameters such as pH, total ash value, water-soluble extract values were assessed in the preliminary physicochemical screening. Qualitative analysis revealed the existence of certain chemical constituents such as flavonoids, tannins, organic acids and saponin glycosides. The ethanol extract of rhizomes was subjected to TLC for the separation of components.","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"41 1","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2014-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81263846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steroid resistant nephrotic syndrome (SRNS) remains a challenge for pediatric nephrologists. The underlying histopathology usually affects the course of the disease and the response to treatment. This study was designed to determine clinical presentation, renal histology, complications, treatment and outcome in children presenting with SRNS. A prospective analysis was carried out among 32 steroid resistant nephrotic syndrome patients aged 1-18 year in the department of pediatric nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period of January 2011 to June 2014. Percutaneous renal biopsy were done in all patients. The histopathology slides were reviewed by competent pathologists. Patients with congenital nephrotic syndrome and nephrotic syndrome secondary to systemic diseases were excluded from the study. Thirty two children fulfilled the inclusion criteria, and included 19 boys and 13 girls, male to female ratio was 1.4:1. Their mean age of presentation was 9.2 year (range 16 month to 16 year). Nine patient(28.22) presented with typical presentation and 23 (71.88%) presented with atypical presentation which included hematuria (62.5%), very high cholesterol (>500mg/dl), persistent hypertension (40.63%), unfavorable age (28.13%), hypocomplementemia (21.88%) and azotemia. None had a positive family history or hepatitis B surface antigen. The renal histopathology was compatible with mesengioproliferative glomerulonephritis (MesPGN) in 40.63%% (n=17), membranoproliferative glomerulonephritis (MPGN) 21.88% (n=07), minimal change disease (MCD) 18.75% (n=06), focal and segmental glomerulosclerosis (FSGS) in 12.5% (n=4) and inadequate tissue was found in two cases. All patients were treated by intravenous methylprednisolone four to six pulses along with intravenous cyclophosphamide followed by oral prednisolone. Cyclosporine was added in patients who failed to achieve remission The outcome with steroid and cyclophosphamide-based treatment for iSRNS was further enhanced with addition of ACE inhibitor. Regarding outcome 21(65.63%) patient responded, five (15.63%) patients died, four (12.5%) reached end stage renal disease and two refused to take any treatment. This study revealed that MesPGN was the commonest histopathology in children presented with SRNS, IV methylprednisolone and IV cyclophosphamide are still agood option for treatment of SRNS with a response rate of sixty five percent. KEY WORD: Management, Nephrotic syndrome, Outcome
{"title":"Steroid resistant nephrotic syndrome in children: Clinical presentation, renal histology, complications, treatment and outcome at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh","authors":"R. Roy, Haque Sms, Mamun Aa, Golam Muinuddin, Md. Habibur Rahman","doi":"10.9790/3013-040110107","DOIUrl":"https://doi.org/10.9790/3013-040110107","url":null,"abstract":"Steroid resistant nephrotic syndrome (SRNS) remains a challenge for pediatric nephrologists. The underlying histopathology usually affects the course of the disease and the response to treatment. This study was designed to determine clinical presentation, renal histology, complications, treatment and outcome in children presenting with SRNS. A prospective analysis was carried out among 32 steroid resistant nephrotic syndrome patients aged 1-18 year in the department of pediatric nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period of January 2011 to June 2014. Percutaneous renal biopsy were done in all patients. The histopathology slides were reviewed by competent pathologists. Patients with congenital nephrotic syndrome and nephrotic syndrome secondary to systemic diseases were excluded from the study. Thirty two children fulfilled the inclusion criteria, and included 19 boys and 13 girls, male to female ratio was 1.4:1. Their mean age of presentation was 9.2 year (range 16 month to 16 year). Nine patient(28.22) presented with typical presentation and 23 (71.88%) presented with atypical presentation which included hematuria (62.5%), very high cholesterol (>500mg/dl), persistent hypertension (40.63%), unfavorable age (28.13%), hypocomplementemia (21.88%) and azotemia. None had a positive family history or hepatitis B surface antigen. The renal histopathology was compatible with mesengioproliferative glomerulonephritis (MesPGN) in 40.63%% (n=17), membranoproliferative glomerulonephritis (MPGN) 21.88% (n=07), minimal change disease (MCD) 18.75% (n=06), focal and segmental glomerulosclerosis (FSGS) in 12.5% (n=4) and inadequate tissue was found in two cases. All patients were treated by intravenous methylprednisolone four to six pulses along with intravenous cyclophosphamide followed by oral prednisolone. Cyclosporine was added in patients who failed to achieve remission The outcome with steroid and cyclophosphamide-based treatment for iSRNS was further enhanced with addition of ACE inhibitor. Regarding outcome 21(65.63%) patient responded, five (15.63%) patients died, four (12.5%) reached end stage renal disease and two refused to take any treatment. This study revealed that MesPGN was the commonest histopathology in children presented with SRNS, IV methylprednisolone and IV cyclophosphamide are still agood option for treatment of SRNS with a response rate of sixty five percent. KEY WORD: Management, Nephrotic syndrome, Outcome","PeriodicalId":14540,"journal":{"name":"IOSR Journal of Pharmacy","volume":"25 1","pages":"01-07"},"PeriodicalIF":0.0,"publicationDate":"2014-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74726528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-30DOI: 10.9790/3013-04011053064
L. R. Ferraz, F. L. A. Santos, P. A. Ferreira, Ricardo Tadeu Lourenço Maia Junior, T. A. Rosa, L. Rolim, P. J. Rolim-Neto
Developed originally as an antimalarial agent, hydroxychloroquine sulfate (HCQS) is often used as a slow-acting drug in treating disorders of connective tissue. Over the past two decades, several data have been accumulated on the systemic effects of HCQS, expanding the potential uses of this drug in different therapeutic classes. The purpose of this article was to conduct a narrative review with qualitative approach on clinical, pharmacokinetic and technological aspects of HCQS, aiming to gather relevant pieces of information for the development of new therapeutic approaches to this drug. A search of the literature of scientific experimental and theoretical studies in the period 1980-2013 was performed. According to the data collected, among the activities HCQS, there are the indications for the treatment of autoimmune diseases such as lupus erythematosus and rheumatoid arthritis. Reports also indicate that HCQS improves insulin sensitivity, ability to reduce thromboembolic events, reduction of lipid levels and treatment for infection by human immunodeficiency virus. The evidence found out ocular and cutaneous adverse effects and the formation of three chiral active metabolites, what encourages studies to evaluate the kinetic behavior of HCQS and the intrinsic physicochemical characteristics of the drug, which is yet poorly described in the literature.
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