Jordan Journal of Pharmaceutical Sciences

Distribution of Bacteria according to Drug Resistance among Adult Women with Bacteriuria in Samara City

Ehan Al-Sharifi — 2024-06-25

Background: Bacteriuria is defined as the presence of bacteria in urine without the accompanying signs and symptoms of a urinary tract infection. The most common bacterium causing bacteriuria is E. coli. About 1-5% of healthy premenopausal women and 1.9-9.5% of pregnant women have bacteriuria. The most effective drugs based on urine culture results were Nitrofurantoin (98.3%), followed by Cefuroxime (89.3%) and Cotrimoxazole (20%).

Aim and objectives: To identify the distribution of bacteria according to drug resistance among adult women with bacteriuria in Samara city, Iraq, and to determine certain influencing factors.

Materials and Methods: This descriptive cross-sectional study was conducted on adult women (18-44 years) attending Samara General Hospital. Demographic information and investigation results were obtained and reported using an appropriate questionnaire. A patient with asymptomatic bacteriuria was identified when one species of bacteria grew in the urine with at least 100,000 colony-forming units (CFUs) per milliliter, regardless of the presence of pyuria, even in the absence of any UTI symptoms. Frequencies (number of cases) and percentages were used to statistically describe the data where appropriate. Comparison between the study groups was performed using the Chi-square (χ2) test. P values less than 0.05 were considered statistically significant.

Results: The frequency of bacterial growth in the sample was 19%. The highest frequency of cases was among the age group 28-37 years (22.4%). Positive cases were more prevalent among pregnant women (21.4%) than non-pregnant women (13.3%). Staphylococcus was the most frequently identified bacterium (42%), followed by E. coli (39%), Klebsiella (11%), and Streptococcus (8%). The drug with the highest sensitivity to bacterial growth was Amikacin, followed by Meropenem.

Conclusions: The frequency of bacterial growth was 19%. The most frequently isolated bacteria from the culture were Staphylococcus, followed by E. coli. The most sensitive drug was Amikacin, followed by Meropenem.

Medicinal Plants Used by Traditional Healers in the Treatment of Gastrointestinal Disorders in Oued Souf Region (southeast of Algeria)

layadi Ikram — 2024-06-25

This study aims to analyze indigenous knowledge of medicinal plants used by traditional healers to treat gastrointestinal disorders in the Oued Souf region. Data were collected through open-ended, semi-structured interviews. Various statistical indices, such as UV and ICF, were employed to evaluate quantitative data. The findings reveal that traditional healers utilize 47 medicinal plant species from 22 families for treating gastrointestinal disorders. Lamiaceae and Asteraceae emerge as the most dominant families, with 9 and 7 species, respectively. The most frequently used plant parts were leaves (35%), and the predominant method of preparation was infusion (55%). Among the most popular plants used by local healers were Artemisia herba alba Asso (UV = 0.85) and Juniperus communis (UV = 0.75). The study highlights the significant number and variety of medicinal plants employed by traditional healers to address digestive disorders. Consequently, this research can aid scientists in identifying plants with medicinal properties that may contribute to the development of new medications.

The Relationship between Levels of Zinc and Copper and Insulin Resistance in Polycystic Ovary Syndrome Patients in Homs

Lana Alzahr — 2024-06-25

Objective: To investigate the association between zinc and copper levels and insulin resistance, a key pathological mechanism of Polycystic Ovary Syndrome (PCOS), and to compare these levels with those of healthy subjects in Homs.

Methods: The study included 63 female patients newly diagnosed with PCOS, prior to treatment at Al-Basil Hospital in Homs, Syria, along with 25 healthy subjects of similar age. Blood samples were collected using dry tubes for laboratory measurements of zinc, copper, glucose, and insulin hormone levels. Subsequently, the HOMA-IR and QUICKI indices were calculated.

Results: In the patients' group, serum zinc levels were significantly lower (p-value=0.000), and serum copper levels were significantly higher (p-value=0.000) compared to healthy subjects. Among patients with insulin resistance, serum zinc levels were significantly lower (p-value=0.004), and serum copper levels were significantly higher (p-value=0.000) compared to patients without insulin resistance. Patients without insulin resistance had significantly lower serum zinc levels (p-value=0.000) and significantly higher serum copper levels (p-value=0.000) compared to healthy subjects. There was a positive correlation between copper and HOMA-IR (r=0.572**, p-value=0.000), and a negative correlation between zinc and HOMA-IR (r=-0.865**, p-value=0.000).

Conclusion: The imbalance in zinc and copper levels appears to play a role in the development of PCOS, both in relation to insulin resistance and potentially as an independent factor.

Assessing Knowledge, Attitude, and Practice (KAP) towards Monkeypox among Healthcare Workers in JORDAN: A Cross-Sectional Survey

Samir AlBalas — 2024-06-25

Introduction: The zoonotic features and potential for transmission between animals and humans make the monkeypox (MPX) virus, a member of the orthopoxvirus family, a serious threat. Unfortunately, healthcare staff's lack of knowledge and readiness about MPX has made it harder to implement effective prevention and response plans. Our current understanding of the KAPs (Knowledge, Attitudes, and Practices) among Jordanian clinicians could benefit from additional research.

Methods: This cross-sectional study aimed to evaluate the MPX KAP among 300 healthcare workers (HCWs) in two private hospitals in the Irbid governorate of Jordan. We employed descriptive statistics, such as percentages and frequencies, as well as an independent sample t-test, one-way ANOVA, and multiple linear regression (enter method) for data analysis.

Results: Although differences existed between demographic groups, the study found that participants had an average level of MPX knowledge proficiency. Out of a total of 300 participants, 196 were female and 104 were male, with 52.7% in the 20–30 age bracket. Compared to their female counterparts, male respondents exhibited higher levels of knowledge, attitudes, and practices regarding MPX. Attitudes and practices towards MPX varied by age group and level of education, demonstrating how demographic factors impact these aspects of public health. Additionally, monkeypox attitudes were lower among women, those with a diploma degree, and those aged 31–40.

Conclusions: Healthcare staff require adequate training and continuous education to address their lack of knowledge and attitudes regarding MPX protection. Staying updated about new illnesses like MPX is crucial, as the COVID-19 pandemic demonstrated. To effectively tackle global health concerns, continuous learning and up-to-date knowledge are essential.

Infrared Microscopy: A Multidisciplinary Review of Techniques, Applications, and Ethical Dimensions

Ahmed S.A. Ali Agha — 2024-06-25

Infrared microscopy has become a significant analytical technique with a transformative impact on various scientific disciplines. This review examines its applications in biomedical research, materials science, environmental monitoring, and art conservation. The non-invasive and label-free technique has revolutionized disease diagnostics, drug discovery, and tissue engineering by providing comprehensive molecular and cellular insights. In materials science, it has significantly advanced understanding of microstructure and material properties, facilitating the development of novel materials. In environmental monitoring, infrared microscopy plays a crucial role in assessing microplastics and atmospheric pollutants, supporting environmental protection efforts. In art preservation, the technique offers valuable insights into the composition and deterioration of historical artworks. Recent advancements in sensor technology, particularly InGaAs and graphene-based detectors, coupled with artificial intelligence and machine learning, have greatly enhanced image analysis capabilities. The review identifies key challenges such as surpassing the diffraction limit and interpreting complex data. Ethical concerns, including data privacy and equitable access to technology, are also emphasized. Infrared microscopy remains a vital tool for advancing scientific knowledge and practical applications. Its impact is poised to expand with future technological developments, contingent upon addressing both technological challenges and ethical considerations.

Chitosan/ Alginate/ Gelucire in-situ Gelling System for Oral Sustained Delivery of Paracetamol for Dysphagic Patients

Inam Al-Naji — 2024-06-25

The study aims to formulate an oral in-situ gel for sustained paracetamol delivery, targeting pediatric and geriatric patients. A blend of sodium alginate, chitosan, and Gelucires was used to create the gel. Characterization techniques, such as rheology and in vivo bioavailability tests on rat models, were employed. The in-situ gel transitioned into a gel-matrix system in 0.1N HCl, effectively controlling the release of paracetamol at different pH levels (1.2, 5.4, and 6.8). Gels made solely of sodium alginate or sodium alginate-chitosan exhibited rapid drug release at pH 6.8. The formulation containing paracetamol in a Gelucire (G33/01):3-3% sodium alginate - chitosan ratio of 1:1:4 w/w showed an extended drug release time of over 8 hours. Bioavailability in rats revealed a higher time to maximum concentration (Tmax) and lower peak concentration (Cmax) but comparable mean residence time (MRT) and area under the curve (AUC0-∞) to commercial formulations. The gel's synergistic blend of chitosan, sodium alginate, and Gelucire G33/01 ensures a sustained release of paracetamol, making it a promising drug delivery system for vulnerable populations like children and the elderly.

The Protective Role of Lannea coromandelica (Houtt.) Merr. against Histamine Release and Action: Insights from In vitro, In vivo Investigations

Swathi S — 2024-06-25

This study aims to evaluate the antihistaminic potential of the plant extract from Lannea coromandelica using both in vitro and in vivo models. In vitro antihistaminic effects were studied using isolated guinea pig ileum to assess dose-dependent inhibitory impacts on histamine-induced contractions. Mast cell density was evaluated using a mast cell count model, calculating the average number of mast cells per unit area in the mesentery. For in vivo assessments, a histamine aerosol-induced bronchospasm model in guinea pigs was used, where pre-convulsive dyspnea (PCD) onset time was noted as pre-convulsive time (PCT). Additionally, a clonidine-induced mast cell degranulation model in rats was employed, with cells stained using 1% toluidine blue to count intact and degranulated mast cells. The Lannea coromandelica extract exhibited a dose-dependent inhibition of histamine-induced contractions in isolated guinea pig ileum. Similarly, the extract inhibited mast cell degranulation in a dose-dependent manner, with a higher dose of 400 mg/kg proving more effective than a lower dose of 200 mg/kg. Acute toxicity studies confirmed the safety of the extract at moderate doses, revealing no toxic symptoms at a dosage of 2000 mg/kg body weight. Importantly, the extract significantly increased PCT in guinea pigs and reduced the percentage of disrupted mast cells induced by clonidine. Lannea coromandelica shows promising antihistaminic properties, effectively inhibiting histamine-induced bronchospasm and mast cell degranulation, which can be an option for the development of antiasthmatic drugs.

A Review of Safety, Quality, Regulation, and Delivery Approaches for Phytopharmaceuticals

Pavithra K — 2024-06-25

Phytopharmaceuticals are plant-derived compounds with a wide range of potential health benefits. Their unique characteristics and versatile applications make them promising candidates for the treatment of many diseases. Phytopharmaceuticals contain a wide range of bioactive components, including alkaloids, terpenes, and flavonoids. These compounds have a variety of biological activities, including antioxidant, anti-inflammatory, and antimicrobial effects. In recent years, there has been growing interest in phytopharmaceuticals for the treatment of various conditions, including cancer, cardiovascular disease, and diabetes. However, more research is needed to fully understand the efficacy and safety of these compounds. To ensure the quality and safety of phytopharmaceuticals, quality management procedures have been developed based on the principles of the World Health Organization (WHO) and Good Agricultural and Collection Practices (GACP). Understanding these regulations is essential for assuring effective phytopharmaceutical product development, manufacture, and distribution. While phytopharmaceuticals have shown promise in laboratory research, there are challenges in translating their efficacy to effective clinical applications, particularly in terms of delivery. Innovative approaches, such as targeted delivery methods and nanoparticle-based strategies, are needed to overcome these challenges. This review provides a comprehensive overview of the challenges and opportunities in the field of phytopharmaceuticals.

LC-MS Analysis of Secondary Metabolites of Asphodelus aestivus Brot. (Asphodelaceae) grown wild in Jordan

Tamam El-Elimat — 2024-06-25

The phytochemical composition of Asphodelus aestivus Brot., a plant with therapeutic properties in traditional medicine, remains largely unexplored, particularly in the specific environmental conditions of Jordan. This study utilized advanced LC-MS techniques to comprehensively analyze the secondary metabolites of a plant species endemic to Jordan. The development of the LC-MS method involved optimizing parameters such as solvent composition, gradient elution, and ionization techniques to achieve comprehensive metabolite profiling. The method was validated to ensure accurate, precise, sensitive, and specific identification and quantification of the compounds. Our analysis identified seven distinct compounds, including both familiar molecules and more complex anthrones and glycosides. This finding emphasizes the wide range of chemical compounds found in the plant and highlights the distinct chemical variations influenced by regional environmental factors. These findings contribute to our understanding of Asphodelus aestivus Brot. and highlight the potential therapeutic uses of its distinct phytochemical composition. This research makes a significant contribution to the field of plant-based natural products by combining modern analytical methods with traditional medicinal knowledge to investigate the complex phytochemical composition of Asphodelus aestivus.

Advancements and Challenges in Aptamer-Based Therapeutics and Diagnostics Across Diverse Medical Domains: A Comprehensive Review

Ahmed S.A. Ali Agha — 2024-06-25

Aptamers, which are single-stranded DNA or RNA molecules, are increasingly recognized as important tools in diagnostics and therapeutics across various medical disciplines such as oncology, respiratory diseases, and neurological disorders. This review provides a comprehensive evaluation of the recent progress and obstacles encountered in the field of aptamer-based applications. Aptamers have shown promise in oncology for early cancer detection and targeted drug delivery, effectively reducing off-target effects. They also hold potential for significantly impacting the management of respiratory conditions such as asthma and Chronic Obstructive Pulmonary Disease (COPD) by selectively targeting cytokines and regulating the inflammatory response. In the realm of neurological disorders, aptamers offer novel methods by influencing the gut-brain axis and proposing potential approaches for early detection and specific therapy. Despite these notable benefits, persistent challenges remain in areas such as molecular stability, delivery mechanisms, and economic viability. This review offers a comprehensive overview of aptamer-based diagnostics and therapeutics while exploring potential avenues for future research.

Evaluating the Validity and Reliability of Questionnaires Measuring Knowledge, Attitudes, and Practices Towards Antibiotic Resistance Among Youths: A Systematic Review Protocol

Majd M. Masadeh — 2024-06-25

This protocol for a systematic review describes the methodology for assessing the validity and reliability of questionnaires used in studies on antibiotic resistance among youths. It also seeks to evaluate the methodological quality of these studies in terms of their ability to influence youths' knowledge, attitudes, and practices (KAP) regarding antibiotic resistance, as measured by the identified questionnaires. The review will include an exhaustive literature search spanning 2013 to 2023 using key databases and grey literature sources. Data from eligible studies will be extracted regarding sample characteristics, methodological quality, and questionnaire validity and reliability metrics. The participants will be categorized into secondary school, high school, and undergraduate students. The review thoroughly evaluates the instruments' psychometric features, including face validity, internal consistency, test-retest reliability, construct validity, and hypothesis testing. Moreover, the protocol thoroughly examines the methodology and approach employed in the encompassed research, specifically emphasizing the educational setting and its impact on the efficacy of interventions to combat antibiotic resistance. The classification of individuals based on their educational stages enables a comprehensive evaluation of the effectiveness of KAP questionnaires in various educational contexts. A meta-analysis will be performed to quantify the cumulative effects of studies. The systematic review is anticipated to provide valuable insights into the validity and reliability of questionnaires used in antibiotic resistance studies focusing on youths. By evaluating the methodological quality of these studies, this review intends to contribute to the development of standardized measurement instruments and to enhance our understanding of how interventions impact youths' KAP related to antibiotic resistance.

Association between ABO Blood Group System and the Severity of COVID-19 in the West Bank: A Case-control Study

Maher Khdour — 2024-06-25

Introduction: Several studies have examined risk factors for COVID-19, and there have been conflicting results regarding whether blood type influences the risk of COVID-19. Therefore, this study aimed to determine the association between the ABO blood group system and the severity of COVID-19 in the West Bank of Palestine.

Methods: A case-control study design was used, consisting of 169 cases and 169 controls who had undergone COVID-19 PCR testing in March 2021 in the West Bank, stratified according to their test results. A self-administered questionnaire in Arabic was used, which included the following parts: socio-demographic data, smoking status, seasonal flu, medical history of COVID-19, and the experience of COVID-19 cases. Both descriptive and analytical analyses were carried out. Binary logistic regression (Enter model) was used in the multivariate analysis to demonstrate the odds ratio.

Results: The study included 338 participants (169 cases and 169 controls) with a 95% response rate. Among the participants, 46.4% lived in the northern region (Nablus, Jenin, Qalqilya, Salfit, Tubas, Tulkarm). Blood group B was found to be more protective against COVID-19 than blood group A (AOR=0.40, CI=0.223-0.718). Blood group AB was also more protective against COVID-19 than blood group A (P < 0.05, AOR=0.316, CI=0.143-0.698). There was no statistically significant difference between blood group A and blood group O concerning the severity of symptoms or the composite outcomes of COVID-19.

Conclusion: There is an association between the ABO blood group and the risk of COVID-19. Nonetheless, the precise mechanism and severity of the effect vary, necessitating further investigation through larger and more intensively controlled studies.

Knowledge and Attitude towards Vaginoplasty and Perineoplasty among Jordanian Females

Walid A. Al Qerem — 2024-06-25

Introduction: The global increase in female genital cosmetic surgery (FGCS), including procedures like vaginoplasty and perineoplasty, has raised concerns regarding their safety and effectiveness. Therefore, this study aimed to address this gap by assessing the knowledge and attitudes of Jordanian females towards vaginoplasty and perineoplasty.

Study design: A cross-sectional online survey was conducted among 522 Jordanian females aged 18 or older.

Methods: Quantile regression models were employed to identify variables associated with females’ knowledge and attitudes towards vaginoplasty and perineoplasty.

Results: The study revealed a low level of knowledge regarding vaginoplasty and perineoplasty, despite positive attitudes towards these surgeries. Significant associations were found between knowledge levels and both age and occupation. Similarly, attitudes were significantly associated with age and socioeconomic status.

Discussion: These findings underscore the need for targeted educational campaigns to enhance awareness about these procedures and their associated risks. Moreover, there should be a focus on evaluating physician-patient communication to ensure informed decision-making.

Behavioral Interventions with and without Pharmacological Treatment: A Comparative Study at An Autistic Center in Jordan

Ala’a Alkhatib — 2024-06-25

Autism spectrum disorder (ASD) is a complex and highly variable neurodevelopmental disorder. This manuscript describes an observational study aimed at evaluating the impact of behavioral and pharmacological treatments on autistic patients at a Jordanian Autism Institution. Patients were evaluated every three months to assess their progress in behavioral treatment using the ABLLS (Assessment of Basic Language and Learning Skills) method, which evaluates 25 skills based on a child’s performance. The researcher collected all previous assessments and observed at least two evaluation periods. Males comprised 90.38% of the study population. Among psychiatric conditions, hyperactivity (36.54%) and irritability (30.77%) showed the highest prevalence. The first interval served as the baseline. Results from the second and third intervals showed slight differences but were not statistically significant. In contrast, the fourth interval demonstrated a statistically significant difference (P < 0.0001). In conclusion, combining pharmacological and behavioral treatments appears more beneficial than behavioral therapy alone, although this benefit may take at least a year to manifest effectively.

Community Pharmacists’ Perspectives on Offering Discounted Prices for Prescription Drugs in Jordan

Ibrahim Lewis Mukattash — 2024-06-25

Background: In Jordan, medicines are priced by the Jordan Food and Drug Administration (JFDA), which mandates pharmacists to sell pharmaceutical products without any discounts or rebates. However, discounting drug prices in community pharmacies is commonplace. The present study aims to understand the motives and perceptions of pharmacists regarding drug price discounts in community pharmacies in Jordan.

Methods: Qualitative interview sessions were conducted with a convenient sample of 20 community pharmacists. A total of 25 participants were interviewed, anonymized, and audio recorded. To ensure maximum comfort, respondents were given the option to choose the interview location or participate through audio-visual communication tools. The sessions followed a pre-designed interview guide focusing on discounts offered on prescription drugs in community pharmacies, pharmacists' experiences, and their attitudes toward these practices. Interview recordings were transcribed and analyzed thematically.

Results: Three main themes emerged: patient-related factors, pharmacist-related factors, and rules and regulations-related factors, each with several subthemes. This study identified several barriers that hinder pharmacists’ adherence to medicine pricing policies in community pharmacies in Jordan, including psychosocial and economic factors, customer attraction and profit increase strategies, sales tactics, market share expansion, avoidance of medicine accumulation and expiration, and issues related to regulations and law enforcement.

Conclusion: The findings demonstrate that adherence to medicine pricing policies in community pharmacies in Jordan varies depending on different factors. Pharmacists may exhibit weak adherence under specific circumstances while demonstrating stronger adherence under others. This study provides insights that could inform the revision of regulations and laws governing pharmacy practices and adherence to pricing policies.