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-A pharmacy and Medicine Journal published by the college of pharmacy , University of Mosul. -Date of first issue(2001). -No. of issue per year (1). -No. of papers per issue. -No. of issue published between 2001-2011(11)issue.
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Journal Information

Publisher: Mosul University

Email:  ijp@uomosul.edu.iq

Editor-in-chief: Professor Dr. Faris T. Abachi

Managing Editor: Ass. Prof. Dr. Zeina Abdul mnium Abdul majeed

Print ISSN: 1680-2594

Online ISSN: 2264-2522

Effects of hormonal contraceptives on serum glucose, lipid profile and some liver function test

Isam Hamo Mahmood; Israa Mohammid Jaber

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 1-6
DOI: 10.33899/iphr.2019.161187

Objective: To investigate the effects of  hormonal contraceptives on serum glucose, lipid profile and some liver function tests.
Patients and Methods: One hundred and three women participated in this study. They were taken hormonal contraceptives including oral contraceptive pills  or injection for a period not less than 6 months up to 12 years . Another group consisting of one hundred non contraceptive users taken from the same population participated in the study as a control group. Blood samples were taken from the individual and sera were used for the determination of serum glucose, lipid profile and some liver function tests which include alkaline phosphatase (ALP), aspartate amino transaminase (AST) and alanine amino transaminase (ALT).
Results: A highly significant values of serum glucose concentrations, total cholesterol, triglycerides and LDL- cholesterol were obtained in contraceptive users as compared with contraceptive non users. Whereas a non significant values of ALP, AST, ALT and HDL cholesterol were obtained.
Conclusion: The use of hormonal contraceptives was associated with undesirable effects on serum glucose and lipid profile. Care should be taken when using hormonal contraceptives in women having diabetes mellitus or cardiovascular diseases.
Key Words: Hormonal contraceptives, ALP, AST, ALT, lipid profile.

Oral yeasts infection in children

Niem N. Jammil; Manahil M. Yehia

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 7-15
DOI: 10.33899/iphr.2019.161188

Objective:The study was designed to identify the yeasts which cause oral thrush in children, in addition to other sources including the teat of bottle, nipple of breast, pacifier, and vaginal swabs from mothers of newborn to detect the source of infection.
Patients and Methods: One hundred and twenty clinically diagnosed child with oral yeast infection were enrolled during this study. The clinical specimens were collected from Dec. 2012 – May 2013, and included (120) oral swabs from infected children and (60) swabs from healthy children . In addition to (46) swabs from teat of bottle feeding babies, (37) swabs from nipple of breast feeding mothers, (20) swabs from pacifier , and (17) swabs from mother's vagina of newborn. The identification process employed direct examination , culture in different media , germ tube , chlamydospore  formation and API - 20 C system tests .
Results:Candida  albicans  is the main isolate from both patients and control group (90.1% ; 78.3% respectively) , and also from the other sources . Moreover , other yeasts isolated from the patients only including  Cryptococcus  laurentii (3.9%) and  Saccharomyces cerevisiae (1%) .
Conclusions:Candida albicans and other yeasts were isolated from the oral lesions and other sources indicating that the infection transmitted for and back to the infected children.

Effect of conventional and sustained release sodium valproate on serum leptin and some liver function tests in epileptic patients

Sajid Kh Ameen; Faris A Ahmed

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 16-22
DOI: 10.33899/iphr.2019.161190

Objectives: To compare the effect between conventional and sustained released sodium valproate monotherapy on serum leptin, body mass index (BMI) and some liver function tests including serum alkaline phosphatase (ALP), alanine amino transferase (ALT), aspartate amino transferase (AST), albumin, total bilirubin (TB) and direct bilirubin (DB) in epileptic patients.
Patients and methods: The study is a case control study. It included 40 epileptic patients on conventional sodium valproate at doses 400-800 mg per day, and 42 patients on sustained released sodium valproate at doses 500-1000 mg per day. Forty healthy subjects sex and age matched served as controls were also included in the study. Blood samples were taken from the patients and controls and analyzed for serum ALT, ALP, AST, albumin, total bilirubin and direct bilirubin. Serum leptin was also analyzed by using ElISA technique.
Results: Serum leptin, ALT, ALP, AST and TB in epileptic patients treated by conventional sodium valproate were significantly (p < 0.05) higher than that in patients treated with sustained release sodium valproate. However, serum albumin was significantly (p < 0.05) lower than that in patients treated by sustained released sodium valproate. No significant change was noticed between the two patients groups for BMI and serum DB
Conclusion: Sustained release sodium valproate may have less hepatotoxic effect and cause less weight gain than conventional sodium valproate. The reduced frequency of doses and the possibility of dosing flexibility may all improve compliance of the patients.

Effects of atorvastatin on some inflammatory markers in patients with multiple sclerosis treated by interferon beta-1b

Farah Waleed Mahmood; Shamil Hashim Othman

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 23-31
DOI: 10.33899/iphr.2019.161191

Objective: To investigate the effect of Atorvastatin vs. placebo on some inflammatory markers in patients with multiple sclerosis treated by interferone beta-1b.To achieve the aim of this study, a randomized control comparative trial was adopted.
Patients and Methods: A total of 100 patients with multiple sclerosis were recruited and investigated for some inflammatory markers which included, interleukin-2, tumor necrosis factor-α, C-reactive protein, and erythrocyte sedimentation rate. The patients were divided into 2 groups, namely the atorvastatin group which consisted of 50 patients and the placebo group which consisted of 50 patients. The patient groups were followed- up for 12 weeks during which the above parameters were measured before starting therapies and at the end of the follow-up period using commercially available kits. The patient groups were compared with the control group consisted of 50 apparently healthy subjects.
Results: The IL-2,TNF-α,CRP and ESR at baseline in both patient groups were found significantly elevated as compared with the control group ( p< 0.001) . The use of atorvastatinhas resulted in significant decrease on the above parameters with non-significant effects in the placebogroup. Atorvastatinappeared to be superior in compared with the placebo group.
Conclusion: The use of atorvastatinfor 12 weeks in patients withmultiple sclerosis treated by interferone-beta has beneficial effect on some inflammatory markers studied in this research( IL-2,TNF-α,CRP and ESR).

Comparison of the effect of losartan versus candasartan on uric acid levels in hypertensive patients

Zeina A Munim Al-Thanoon

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 32-38
DOI: 10.33899/iphr.2019.161192

Background: It have been suggested by some studies that uric acid plays a causal role in the development of cardiovascular disease where as other studies concluded that uric acid merely reflects other concomitant risk factors, such as hypertension, insulin resistance, obesity, or lipid abnormality . Sartan drugs or angiotensin II receptor blockers do appear to lower uric acid levels (SUA). The clinical importance of this finding to patients with hypertension, or gout, or both is not yet known. The  present study was aimed to compare the effects of the antihypertensive drugs losartan and candasartan on blood pressure and uric acid level in hypertensive patients.
Materials and Methods: A total of 80 newly diagnosed hypertensive patients were divided into two groups, with 40 patients in each group. Group 1 was given losartan (50 mg/day) and group 2 was given candasartan (8mg/day). A control group of 50 apparently healthy individuals was included. Blood pressure and uric acid were measured for controls and patients before and after drug administration. 
Results:A significant  increase in blood pressure and uric acid were found in hypertensive patients before starting treatment (P<0.001), as compared with controls. After 2 months of treatment, the systolic and diastolic BP were significantly reduced in the both losartan and candasartan groups (P<0.001). Both drugs were similarly effective in reducing the blood pressure in patients with hypertension with no statistical significant difference between the two treatments.  Serum uric acid levels were only significantly reduced after 2 months of treatment with losartan (P < 0.001) but not with candasartan.
Conclusions: Our findings suggest that both losartan and candasartan therapy were similarly effective in reducing blood pressure in patients with hypertension. Losartan, but not candasartan, was associated with a significant reduction in serum uric acid levels. Our findings suggest that the losartan is the drug of choice in patients with hypertension and hyperuricemia and gout.

Histological changes of the rat liver after administration of imatinib mesylate:an experimental study

Luma Ibrahim Khalel Al-Allaf; Hafidh Al-Ashoo

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 39-50
DOI: 10.33899/iphr.2019.161193

Objectives: This study aims to determine the histological changes of the liver of rats after administration of  a low dose  or a clinically relevant high dose of Imatinib mesylate for one month in comparison to control ones.
Study setting and design: This experimental study was performed over a period of four months starting from the 10th march 2013 to the 10th July 2013 and was conducted on male Albino rats purchased from Animal Houses of both Mosul Medical College, and Veterinary College, University of Mosul, Mosul, Northern Iraq.
Methods: The first experiment includes40- 45 days aged rats who administered orally daily dose of 75mg/Kg of imatinib mesylate (Glivec®; Novartis) purchased from IBN-SENA Teaching Hospital , Mosul and bought from some private pharmacies for 30 days with age matched control who administered distilled water. The second experiment includes 40- 45 days aged rats who administered daily dose of 200mg/Kg orally)with age matched control who administered distilled water . Liver of rats from each experimental group were obtained. The tissues were embedded in paraffin and stained with hematoxylin-eosin and periodic acid schiff stain.
Results: The histological examination of the liver tissues of groups receiving imatinib at doses of 75 mg/kg or 200mg/kg on daily for 30 days duration showed different degrees of various histological changes of damage when compared with the control group . Male rats administered with 75 mg/kg of imatinib resulted moderate degree of several histological changes. The most striking feature is disruption in radial arrangement around central vein, sinusoidal dilatation, and hepatocytes with eosinophilic cytoplasm. Perivenular inflammatory cells, accumulation of inflammatory cells. Loss of cellular outline , and loss of euchromatin of the hepatocytes .Light microscopic examination of sections obtained from liver tissues of groups receiving imatinib at dose of 200mg/kg  revealed similar changes, however , these changes were more pronounced in comparison to those in low dose group.
Conclusion: Imatinib causes hepatotoxicity even in low dose group (75mg/kg, however, it has a dose dependant  effect but to some extent. Appropriate protective measures must be applied with anticancer treatment for improving liver function.

Effect of metformin on thyroid function tests in type 2 diabetic patients

Mohammed N. Abed

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 51-57
DOI: 10.33899/iphr.2019.161194

Background: Diabetes mellitus (DM) and thyroid disorder appears to be closely related.It has long been recognised that thyroid hormones have marked effects on glucose homeostasis, and although autoimmune thyroid disease is more prevalent in type 1 diabetes as a result of their common origin, in patients with type 2 diabetes the prevalence of hypothyroidism and hyperthyroidism is similar to that of the general population. The present study was conducted to assess the interplay between metformin treatment and thyroid function in type 2 diabetic patients.
Methods: A total of 73 diabetic patients were enrolled in this study, they were divided into two groups, the first group included 37 type 2 diabetic patients on metformin therapy, whereas the second group involved 36 type 1 diabetic patients on insulin therapy. Another group involved 35 apparently healthy volunteers were also included in the study as a control group. Blood samples were taken from the patients and controls, then  the   serum   was analyzed for measurement of fasting serum  glucose (FSG), total T3,   free T3 (FT3),  total T4, freeT4 FT4) and TSH using ELFA (Enzyme Linked Fluorescent Assay) technique (minividas).
Results: the results showed that there were no significant differences between T3, FT3, FT4 and TSH of the metformin group when compared to the same parameters in the control group. On the other hand FT3 and FT4 of insulin group were significantly lower than that of the control and metformin groups. Also total T4 inmetformin and insulin groups was significantly lower than that of control group, whereas the TSH of insulin group was significantly higher than that of control and metformin groups.
Conclusion:Chronic use of metformin in type 2 diabetic patients has no effects on thyroid function tests, and there was no significant correlation between glycemic control and thyroid hormones or TSH. However, TSH, T4, FT3 and FT4 in insulin group were significantly differe from control group and this may indicate the presence of subclinical hypothyroidism.

Evaluation of direct immunofluorescent method in the detection of Pneumocystis jiroveci among patients with lower respiratory tract infections

Manahil M. Yehia; Asmaa Z. Sheetawy; Zainalabideen A. Abdulla

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 58-62
DOI: 10.33899/iphr.2019.161195

Objective: Evaluate the use of direct immunofluorescent method in the detection of Pneumocystis jiroveci from induced sputum of patients with LRT infections.  
Patients and methods: Thirty patients with LRT infections were included (24 patients were immunocompromised and 6 immunocompetent). The present study conducted for 6 months from January-June, 2011. Smears were prepared from their induced sputa and stained with direct fluorescent antibody stain, then examined under fluorescent microscope.
Results: Sputum of 5(16.7%) patients revealed positive results for the presence of P. jiroveci and all of them were immunocompromised (two acute myloid leukemia, one acute lymphoid leukemia, one non-Hodgkin's lymphoma, and one asthma under long coarse of corticosteroid therapy).
Conclusion: Direct fluorescent antibody technique is more sensitive than the conventional methods for the detection of P. jiroveci in LRT infections.
Keywords: Pneumocystis pneumoniae, Pneumocystis jiroveci, immunocompromised patients.

The Effect of Misuse of Topical Corticosteroids on Skin

Deena K. Al-Samman; Israa M. Al-Banna; Wejdaan N. Al-Shakarchy; Mohammed M. Attar-bashi

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 63-75
DOI: 10.33899/iphr.2019.161196

Objectives: To assess the frequency of misuse of TC on skin , commonly used steroids and the most common dermatological problems resulting from it, as well as, to analyze the motives for such practices with the aim to raise awareness about this problem in Mosul city.
Methods: The study included 155 patients aged 0.8-49 years with dermatological disorders who attended Outpat­ient Department of Dermatology in Al-Salam Teaching Hospital in Mosul City . Inclusion criteria: those who had used TC without medical advice; continued use after short prescription regardless of the duration ;TC used incorrectly or used them for certain skin problems for which steroids are not indicated; Wrong indication (acne); undiagnosed dermatosis as well as a history of TC use continuously(for more than1 month) or intermittently (for more than 3 months) due to any purpose, and presented with ≥ 1 of the side-effects of these drugs as the chief complaint were criteria used to define unjustifiable/inappropriate use.
Patients with natural rosacea; those denying any history of using TC or who not consenting to answering the questionnaire; pregnant women; patients who were using prescribed TC regardless of the duration or side effects such as asthma, rheumatoid arthritis; patients with comorbidities that resembled/could cause changes similar to TC side-effects (polycystic ovaries / Cushing's syndrome/thyroid disorders)were excluded from the study. A questionnaire was designated and skin was examined to study patients.
Results: Of the 155 subjects misused TC most were females 98(63.23%)  and 57(36.77%) were males; of low social class 45(29%). The majority 123(85.2%) thought that corticosteroid use was safe and 56(36.1%) did not feel guilty for using such medications.
Eighty fife(55 %)patients reported that physician and pharmacists advised them for the first time to use TC. Ninety eight (63.3%) patients obtained the drug from the pharmacies, 30(19.3%)from nurse staff and 27(17.4%) from cosmetic shop/Beautician. lightening of the skin (30.6%)  was the main indication for use TC. Potent and very potent preparations were the main TC used by patients.Almost all had some features of TC side effects.
Conclusion: Inappropriate use of TC is a big problem in our country. Easy availability of very potent products without a prescription makes misuse very common which has a huge impact on derm­atological practice. It is responsible for a significant proportion of visits to dermatolo­gy clinics. It is a multiphase problem that needs the cooperation of different sectors in the community to overcome it. Education of the general public through special media programs and the introduction of a continuing medical education programs for medical and paramedical personnel as well as controlling the easy intake from pharmacies are probably the most important steps that could be taken to reduce this problem.

The role of serum cystatin C as an early predictor for the diagnosis of chronic kidney disease in Mosul City

Mohammed Khalid J. Al-Nori; Akram J. Ahmed

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 76-78
DOI: 10.33899/iphr.2019.161197

Background: Diagnostic marker to detect chronic kidney disease (CKD) at early stages is important as early intervention can slow the loss of kidney functions. Serum cystatin C (sCysC) is said to be a superior marker for CKD compared to serum creatinine (sCr) and other known markers in the near past period to detect the mild GFR reduction between 60 and 90 ml/min/1.73m2.
Objective: To detect fordetecting the role of cystatin C as an early predictor for the assessment of chronic kidney disease patients.
Methods:Blood and urine samples from 185 patients suffering from various stages of CKD or subjects under the risk of CKD were taken from Ibn-Sina teaching hospital during the period from 15th of March 2012 to 10th of sept 2013. Serum Urea (sUr), serum uric acid (sUA), serum creatinine (sCr), serum cystatin C (sCysC), 24 hour excreted urine protein and 24 hour excreted urine creatinine where analyzed then compared to corrected creatinine clearance for each patient.
Results:Theresults showed that serum CysC started to change from abnormal border line level at stage 2 to clearly abnormal level at stage three of CKD comparing to other assessments which used sCr, sUr, sUA. The results also indicated that the urinary 24h excreted protein was starting to be observed at stage 3 of CKD.
Conclusions:  The present study indicated that sCysC have the potential benefit for early detection of CKD especially in those with high risk before appearance of the symptoms and before occurrence of the complications.

High Performance Liquid Chromatographic Method for Determination of Tadalafil in Tablets and Wastewater

Nief Rahman Ahmed

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 87-94
DOI: 10.33899/iphr.2019.161198

Objective: A reverse phase high performance liquid chromatographic method (RP-HPLC) has been developed for the determination of  tadalafil in the pharmaceutical formulations  and environmental wastewater samples.
Method: Different analytical columns with various  stationary phases were tested. Good separation was achieved using supelcoC18 column (25cm x 4.6 mm. 5 µm) . The mobile phase (methanol: water: Triethylamine) , pH adjusted to 4.0 with dilute phosphoric acid was pumped at a flow rate of 1.3 ml/min in the ratio of 60:38:2   and the peaks  were detected at 220 nm.
Results: Linearity was obtained in the concentration range of 0.0 4-0.28 mg/ml .The RSD was found to be less than 1% indicating the method is precise and the recovery was100±1.25% indicating the method is accurate
 Conclusion: The proposed HPLC method may be used for determining tadalafil in pure drug samples , pharmaceutical dosage forms and environmental wastewater samples.

Comparative Effects of Telmisartan versus Valsartan on serum Leptin level, in hypertensive type 2 diabetes mellitus patients

Najlaa Saadi Ismael; Fathel Abaas Al-hamamy

Iraqi Journal of Pharmacy, Volume 14, Issue 1, Pages 95-104
DOI: 10.33899/iphr.2019.161199

Objective: The aim of this study was to compare the effects of telmisartan and valsartan onblood pressure and serum leptin in hypertensive type 2 diabetesMellitus patients.
Study design:A randomized control comparative clinical trial with open label design.
Study period: From 1st  February, 2012 to 30th March, 2013.
Patients and method: Eighty eight type 2 diabetic hypertensive  patients were randomly assigned to received either telmisartan (n = 46)  or valsartan (n = 42) with body mass index (BMI) 31.52±4.73 kg/m², 30.39±3.95 kg/m² respectivly. Forty one diabetic normotensive patients (n=41), age, sex, BMI, duration of diabetic  disease, duration of diabetic treatment matched to the diabetic hypertensive  patients groups were kept as control group. blood pressure (BP), leptin levels were measured at baseline and after 2 months of treatment.
Results: The study showed a significant higher systolic blood pressure (SBP), diastolic blood pressure (DBP) and serum leptin in the diabetic hypertensive patients before starting therapy as compared with the diabetic normotensive patients. Both telmisartan and valsartan significantly reduced serum leptin and BP. More reduction in DBP seen with valsartan  than with telmisartan.
Conclusion: Monotherapy with telmisartan and valsartan produce a beneficial reduction effects on BP and reduce leptin level. The improvement of leptin sensitivity may play a role directly or indirectly in the induction of hypertension control.

The effect of antioxidant supplementation in the treatment of epilepsy

Nazar A.K. hamid

Iraqi Journal of Pharmacy, Volume 11, Issue 2, Pages 27-33
DOI: 10.33899/iphr.2011.49893

Aim: To assess serum level of malondialdehyde (MDA) and total antioxidant status
(TAS) as a representative of oxidative stress in patients with generalized epilepsy and
to evaluate the therapeutic effect of the antioxidant (vitamin E and vitamin C) on the
levels of MDA,TAS and frequency of seizures attacks after two months therapy. for a
period of two months as a supplementation therapy.
Subjects and Methods: The study was conducted in Iben-seena Hospital in Mosul
city-Iraq. Fifty three patients with generalized epilepsy were included in this study
(32 male and 21 female). The study included 40 apparently healthy subjects, age and
sex matched as a control group. Initially from both the patients and controls, blood
samples were taken. Another blood samples were taken from the patients 2 months
after vitamin E and vitamin C treatment, blood samples were analysed for serum
MDA and serum TAS.
Result: Serum MDA was found to be significantly higher ( P<0.001) and serum TSA
was significantly lower (P<0.001) in patients with generalized epilepsy prior vitamin
E and vitamin C supplementation in comparison to controls. After vitamin E and C
supplementation there was a significant reduction (P<0.001) in the serum MDA levels
with a significant increase (P<0.001) in the serum TAS. Also we found a reduction in
seizure frequency of greater than 70% after vitamin E and C supplementation.
Conclusion: a significant reduction of TSA was reported in patients with epilepsy.
Administration of vitamin E and C produced a significant reduction of serum MAD
levels and a significant elevation of serum TAS, associated with a reduction of greater
than 70% of seizure frequency. The study suggests the administration of vitamin E
and C as adjunct to antiepileptic drugs.

Evaluation of CA 15-3, Her-2/neu and estrogen/progesterone status in breast cancer patients treated by surgical removal and chemotherapy

Taha H Taha Al-siagh; Shahbaa A Al-bayati; Faris A Ahmed

Iraqi Journal of Pharmacy, Volume 12, Issue 1, Pages 1-7
DOI: 10.33899/iphr.2012.62338

Objective: This study was conducted to evaluate serum CA 15-3 in breast cancer patients after surgery and chemotherapy. The relationship between serum CA 15-3 and Her-2/neu, estrogen, or progesterone receptors were also studied in the breast cancer patients.
Patients and methods: This study was conducted at Al-Jammhori Teaching Hospital, and Al-Zahrawi Private Hospital, Mosul, Iraq, during the period from January to Jun 2011. Fifty breast cancer women diagnosed by using triple assessments by a surgeon (history examination, ultrasound mammography, and fine needle aspiration cytology) were included in the study. Blood samples (5 mL) were taken from the patients and analyzed for serum CA 15-3 by monoclonal antibody technique. The blood samples were taken from the patients a week before and after one week of the operation and other blood samples were taken after two weeks of the first cycle of chemotherapy treatment. Combination therapy of 5-fluorouracil, epirubicin, cyclophosphamide, for three cycles every 21 days, was given to the patients, followed by three cycles docytaxil every 21 days. Samples from the tumor on paraffin sections taken from the patients were analyzed for Her-2/neu, estrogen and progesterone receptors by immunochemical methods.
Results: Serum CA 15-3 was significantly decreased by 54% (p ≤ 0.001) after surgical removal of the cancer compared with results before surgery. Chemotherapy of the patients further decreased serum CA 15-3 significantly by 78% (p ≤ 0.001) compared with the results before surgery. CA 15-3 and tumor size in positive Her-2/neu patients were significantly higher than in negative Her-2/neu patients. However, serum CA 15-3 and tumor size in positive estrogen patients were significantly lower than in negative estrogen patients. In progesterone positive patient's serum CA 15-3 was only significantly (p ≤ 0.001) lower than in the negative progesterone patients. Mean ages was significantly (p ≤ 0.001) higher in positive Her-2/neu patients than in negative Her-2/neu patients. However, mean ages was significantly (p ≤ 0.001) higher in positive estrogen and progesterone patients than in negative receptors. Metastasis occurred in 39 patients (78 %) out of the studied patients. Negative significant correlation was noticed between Her 2/neu and estrogen receptors (r= - 0.745, p ≤ 0.001). Negative significant correlation was also noticed between Her 2/neu and progesterone receptors (r= - 0.786, p ≤ 0.001). Weak but significant correlation was found between serum CA 15-3 and tumor size (r= 0.281, p≤ 0.05).
Conclusion: CA 15-3 and Her 2/neu are useful tumor markers for diagnosis of breast cancer in the treatment through surgery and chemotherapy. The co-expression between hormonal and Her-2/neu receptors is negative. The need for more sensitive tumor markers is still wanted.

Evaluation of the clinical effect of melatonin on oxidative stress markers in patients with lead poisoning

Ashwaq Najeem Eldeen; Mohammed Mahmood Mohammed; Mohammad Dakhel

Iraqi Journal of Pharmacy, Volume 9, Issue 1, Pages 16-20
DOI: 10.33899/iphr.2010.49979

Lead is a neurotoxic metallic element that can be absorbed by the body, primarily through the lungs and stomach. Generally, lead poisoning occurs slowly, resulting from the gradual accumulation of lead in bone and tissue after repeated exposure. Left untreated, lead poisoning can damage many internal organs, including the kidney and the nervous system. Recent studies have shown that lead causes oxidative stress by inducing the generation of reactive oxygen species and reducing the antioxidant defense system of cells. This suggests that antioxidants may play an important role in the treatment of lead poisoning as a kind of scavengers of free radicals.
Antioxidant is any substance that reduces oxidative damage such as that caused by free radicals. Free radicals are highly reactive chemicals that attack molecules by capturing electrons and thus modifying chemical structures. Melatonin, a powerful antioxidant, is a hormone produced naturally in the pineal gland at the base of the brain.
This study was designed to evaluate the clinical significance of melatonin in ameliorating the oxidative stress induced due to chronic exposure to lead.
Twenty male patients with chronic lead poisoning and their 20 aged matched normal controls with an age range 35-45 years were included in this study. Treatment included 3 mg capsule of melatonin antioxidant at night for two months. Heparinized venous blood samples were collected from patients before treatment and at one and two months after treatment as well as from controls to measure erythrocytes malondialdehyde (RMDA), plasma total antioxidant status (TAS), blood lead (Pb) and serum zinc (Zn) levels.
The results of the study showed a significant antioxidant activity of melatonin in eliminating the oxidative consequences of lead exposure revealed by significant reduction in oxidative stress markers ( RMDA and Pb) with a significant increase in body antioxidant defense mechanisms(TAS and Zn).

Synergistic activity of azithromycin combined with metronidazole against toxoplasmosis in experimental mice

Ziad H.Al-jader; Abdulsalam M. Al-Mukhtar

Iraqi Journal of Pharmacy, Volume 9, Issue 1, Pages 32-35
DOI: 10.33899/iphr.2010.49981

Objective: To evaluate the efficacy of synergistic activity of azithromycin combined with metronidazole against toxoplasmosis experimentally induced in murine model.
Material & Methods: Albino mice model (balb/c mice) acutly infected with tachyzoites, were treated for 10days from day +1 postinfection with administration of azithromycin combined with metronidazol.
Results: The results showed that prolonged survival of albino mice relative to that of untreated control, and the dead mice were found only in the control group. This experiment showed that a remarkable synergistic effect on toxoplasmosis was obsereved when azithromycin was adminstratered in combination with metronidazole at cuurative dosage i.e.(250 and 200 mg/kg/day), respectively. These results showed that azithromycin, which is remarkably active on toxoplasmosis, significantly potentiates the curative effect of metronidazol in the treatment. The treated mice in uncontrolled group were completely cured from toxoplasmosis as their brain were free of T. gondii cyst either microscopically or by bioassay.
Conclusion: Combined drugs of azithromycin and metronidazole showed a cure rate of 100% in experimental murine toxoplasmosis.

Serum magnesium in diabetic retinopathy: relation to glycated haemoglobin and lipid profile

Amjad H. Al- Naemi

Iraqi Journal of Pharmacy, Volume 7, Issue 1, Pages 57-67
DOI: 10.33899/iphr.2008.50097

The aim of this study was to evaluate serum magnesium status in diabetic retinopathy and to investigate its relation to serum lipid profile and glycated haemoglobin (HbA1c) as a marker for long- term metabolic control in diabetes. The current case control study has enrolled 25 type 2 diabetics without retinopathy (Group 1), 25 diabetics with retinopathy (Group 2) and 21 apparently healthy non- diabetic control subjects (Group 3). Overnight fasting serum magnesium, lipid profile and HbA1c concentration were analyzed for all subjects. The mean serum magnesium level was significantly lower in Group (2) compared to that of Group 1 (p< 0.001). The mean serum triglycerides (TGs) and HbA1c levels were significantly higher in Group 2 (p< 0.0001). No statistically significant differences were noticed comparing the mean serum total cholesterol (TC) and LDL-cholesterol concentrations in both groups 1 and 2 (p> 0.05).
The study revealed a significant negative correlation between serum magnesium on one hand and serum TGs, TC, LDL- cholesterol and HbA1c on the other hand where r= - 0.646, - 0.47, - 0.335, and - 0.825 respectively. Meanwhile serum magnesium was significantly and positively correlated with HDL- cholesterol levels (r= 0.395, p> 0.001). Using Forward Stepwise Multiple Regression analysis, the study revealed that hypomagnesaemia, poor glycaemic control and increasing duration of diabetes are the most important contributors to the cumulative risk for the development of diabetic retinopathy (Odds ratios 16.65, 566 and 7.36 respectively).
In conclusion, magnesium depletion is a significant risk factor for, and a frequent finding in, diabetic retinopathy beside poor glycaemic control, dyslipidaemia (mainly hypertriglyceridaemia), and increasing duration of uncontrolled diabetes. The significant association between hypomagnesaemia and high fasting serum levels of TGs, TC, LDL-cholesterol and HbA1c would rather support the suggested role for magnesium depletion in the metabolic derangements associated with retinopathy in diabetic patients. Further studies on the effects of magnesium supplementation for diabetic patients are necessary to investigate the spectrum of metabolic improvements following magnesium therapy and the degree to which the risk of diabetic retinopathy might be reduced.

Evaluation of CA 15-3, Her-2/neu and estrogen/progesterone status in breast cancer patients treated by surgical removal and chemotherapy

Taha H Taha Al-siagh; Shahbaa A Al-bayati; Faris A Ahmed

Iraqi Journal of Pharmacy, Volume 12, Issue 1, Pages 1-7
DOI: 10.33899/iphr.2012.62338

Objective: This study was conducted to evaluate serum CA 15-3 in breast cancer patients after surgery and chemotherapy. The relationship between serum CA 15-3 and Her-2/neu, estrogen, or progesterone receptors were also studied in the breast cancer patients.
Patients and methods: This study was conducted at Al-Jammhori Teaching Hospital, and Al-Zahrawi Private Hospital, Mosul, Iraq, during the period from January to Jun 2011. Fifty breast cancer women diagnosed by using triple assessments by a surgeon (history examination, ultrasound mammography, and fine needle aspiration cytology) were included in the study. Blood samples (5 mL) were taken from the patients and analyzed for serum CA 15-3 by monoclonal antibody technique. The blood samples were taken from the patients a week before and after one week of the operation and other blood samples were taken after two weeks of the first cycle of chemotherapy treatment. Combination therapy of 5-fluorouracil, epirubicin, cyclophosphamide, for three cycles every 21 days, was given to the patients, followed by three cycles docytaxil every 21 days. Samples from the tumor on paraffin sections taken from the patients were analyzed for Her-2/neu, estrogen and progesterone receptors by immunochemical methods.
Results: Serum CA 15-3 was significantly decreased by 54% (p ≤ 0.001) after surgical removal of the cancer compared with results before surgery. Chemotherapy of the patients further decreased serum CA 15-3 significantly by 78% (p ≤ 0.001) compared with the results before surgery. CA 15-3 and tumor size in positive Her-2/neu patients were significantly higher than in negative Her-2/neu patients. However, serum CA 15-3 and tumor size in positive estrogen patients were significantly lower than in negative estrogen patients. In progesterone positive patient's serum CA 15-3 was only significantly (p ≤ 0.001) lower than in the negative progesterone patients. Mean ages was significantly (p ≤ 0.001) higher in positive Her-2/neu patients than in negative Her-2/neu patients. However, mean ages was significantly (p ≤ 0.001) higher in positive estrogen and progesterone patients than in negative receptors. Metastasis occurred in 39 patients (78 %) out of the studied patients. Negative significant correlation was noticed between Her 2/neu and estrogen receptors (r= - 0.745, p ≤ 0.001). Negative significant correlation was also noticed between Her 2/neu and progesterone receptors (r= - 0.786, p ≤ 0.001). Weak but significant correlation was found between serum CA 15-3 and tumor size (r= 0.281, p≤ 0.05).
Conclusion: CA 15-3 and Her 2/neu are useful tumor markers for diagnosis of breast cancer in the treatment through surgery and chemotherapy. The co-expression between hormonal and Her-2/neu receptors is negative. The need for more sensitive tumor markers is still wanted.

Unlicensed and off-label drug use in paediatric wards

Suhair Moayid Rasheed

Iraqi Journal of Pharmacy, Volume 9, Issue 1, Pages 53-57
DOI: 10.33899/iphr.2010.50063

Objective: To determine the proportion of unlicensed &/or off-label prescriptions in paediatric
patients.
Patients & Methods; This prospective study of drugs administered to children in two
paediatric hospital (ib-A!theer, A!-Kanasaa hospital for pediatrics in mosul city, over 6 months
from 1st Nov. 2007 to 1st May 2008. One hundred-forty children were included in this study
aged from at birth to 6 years admitted to paediatric medical wards. Drug-licensing status of all
prescriptions given to these patients was determined.
Results: Of the 1208 prescription given to these children, more than half of all prescriptions
626 (51 ,8%) were unlicensed or off-label. Where as 582 (48.2%) licensed. The most common
category of off-label use 365 (30.2%) was related to age 217 (17.9%), the other off-label uses
were related to dose and frequency of administration 77 (6.4%), indication 55 (4.6%) and
route of administration 16 (1.3%) and the most common reason of unlicensed preparation
was the administration of preparation not licensed for use at all.
Conclusion: The use of unlicensed or off- label medicines to treat children was found to be
common in paediatric patients, this problem is Widespread in peadiatric wards &the clinical

Screening of developmental dysplasia of the hip in the newborns

Mohamad Ah. Jasim; Bashar Sh. Mustafa

Iraqi Journal of Pharmacy, Volume 11, Issue 1, Pages 79-91
DOI: 10.33899/iphr.2011.49597

Background: Newborn babies are known to have risk for occurrence developmental
dysplasia of the hip so early clinical screening test is very important to detect this
problem and prevent further abnormal growth. The aim of this study is to find the rate
of occurrence of developmental dysplasia of the hip (DDH) among newborn babies
and establish good screening program.
Patients and methods: From August ٢٠٠٦ to March ٢٠٠٩ in AL-Khansaa
Maternity and Children Teaching hospitals, ٩٥٩٢ newborn babies were examined
clinically using Barlows and ortolani tests for detecting DDH.
Results: Only ١٦٢ newborn babies out of ٩٥٩٢ examined babies had DDH and it was
found more common among female and more on left side than right side. Female sex,
rural residence, first born baby breach, caesarean section positive family history,
multiple pregnancy post-mature babies, high birth weight (>٣٥٠٠ g).
Conclusion: The occurrence of neonatal DDH is still form a major problem among
newborn babies causing a lot of morbidity need to follow up to avoid further
complicating problem.

Comparative evaluation of different marketed products of ciprofloxacin tablets in vitro

Mus; ab M. Khalaf; Hiyam A Al-Taii; Imad A-J Thanoon

Iraqi Journal of Pharmacy, Volume 9, Issue 1, Pages 9-15
DOI: 10.33899/iphr.2010.49978

The contents of four ciprofloxacin tablets products available in the private pharmacies of Mosul city were measured according to the British Pharmacopoeia (BP). Some biopharmaceutical parameters such as content uniformity, disintegration, and hardness were also measured for the same products. In addition, the antibacterial activity of these four products were assessed by microbiological assay on different types of gram negative bacteria in vitro.
The results indicated that there is a little differences in the content uniformity of these products and they are within acceptable requirement of BP and United State Pharmacopoeia (USP). In the same manner, the weight variation, disintegration, and hardness were within acceptable range according to the BP and USP. The microbiological assay indicated that these different products produce approximately the same inhibition zones on the same bacterial type.
The above results may be useful to predict the bioavailability of these different products .

Serum uric acid level and renal function tests in hypertensive patients treated by captopril

Dr. Wahda B Al-Youzbaki; Yasir Y T Al-Taee

Iraqi Journal of Pharmacy, Volume 13, Issue 2, Pages 1-10
DOI: 10.33899/iphr.2013.86549

Objective: To evaluate the effect of captopril on the serum uric acid level and renal function tests in hypertensive patients, in relation to the age and gender patients , and dose and duration of captopril use.
Patients & methods: This is a case control study conducted in the Consultatory Clinic for Internal Medicine in Ibn-Siena Teaching Hospital in Mosul/Iraq, from the 15th of October 2009 to the 15th of June 2010. A total number of 100 patients (56 males and 44 females) with mild to moderate primary hypertension, non diabetic, neither having renal diseases nor other chronic illnesses, were taken and divided into two groups: First group included 50 patients using captopril (captopril group) for more than three months , The second group included 50 newly diagnosed untreated hypertensive patients (control group). Serum uric acid, serum urea, creatinine, sodium and potassium concentration were measured using special kits and creatinine clearance (Crcl) were calculated by Cockroft and Gault equation and all were compared in the two groups.
Results: Serum uric acid decreased significantly in captopril group while the renal function tests did not show any significant difference in comparison with the control group. There was a significant reduction of creatinine clearance in the captopril group in the older patients using captopril than younger patients. There were no significant effect of the dose and the duration of captopril use on serum uric acid and renal function tests , except that increasing the dose of captopril lead to a significant increase in serum potassium. Also, there was a significant increase in serum uric acid, urea , and creatinine and a significant reduction of crcl in males patients than in females patients in both groups.
Conclusion: Captopril is a safe drug for the treatment of patients with essential hypertension regarding renal function tests beside that captopril therapy causes a significant reduction of serum uric acid, but no significant effects for the dose and duration of use of captopril on serum uric acid and renal function tests except that increasing the dose of captopril lead to a significant increase in serum potassium. There were a significant reduction of mean Crcl in the captopril group with increasing of the age. Male hypertensive patients were more prone for renal impairment than female hypertensive patients.

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