Volume 7, Issue 1, Summer and Autumn 2008, Page 1-73

Effect of depot-medroxyprogesterone acetate injections on serum immunoglobulins and complements level

Wahda B. Al-Youzbaki

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 1-7
DOI: 10.33899/iphr.2008.50085

Background: Depot medroxyprogesterone acetate (Depo-Provera) is a highly effective, nondaily hormonal contraceptive option that has been available in the worldwide for 40 years and provides a very high level of contraceptive efficacy. Benefits and risks of hormonal therapy are often under scrutiny, however, long-term clinical experience has established the safety of this long-acting contraceptive in that it does not increase the risk of cardiovascular events, breast cancer , other gynecologic malignancy, or postmenopausal fracture.
Aim: To evaluate the effect of depot medroxyprogesterone acetate injections on the serum immunoglobulin (IgG, IgM, IgA), and complements (C3,C4).
Study design: Prospective cohort study.
Study period: 1st January 2006 to 31st March 2007.
Subjects & Methods: Thirty healthy married women, their age ranged between 20-35 years, who were attending Al-Batool and Al-Khansa Family Planning Centers in Mosul/ Iraq and started (for the first time) to use depot medroxyprogesterone acetate (DMPA) injection. Each injection contains 150 mg medroxyprogesterone acetate. These women called DMPA users group, were compared to another thirty healthy married women who did not use any hormonal contraceptives and were drawn from the same population and matched for age, height and weight with the DMPA users group, and they were considered to be the non users group. Both groups were followed for one year, during which blood samples were obtained from both groups, before starting to use DMPA, after 6 months and then after 12 months. The sera obtained from the blood samples were used for the estimation of the biochemical studied parameters using commercial kits.
Results: Serum IgG was significantly elevated after 12 months (p = 0.028) among DMPA users in comparison to non users but non significant increase according to the duration of use. While there was a non significant changes in the serum IgM, IgA, C3 and C4 level after 6 and 12 months in the DMPA users in comparison with non users and in relation to the duration of use. DMPA caused a non significant changes in the total serum protein and serum albumin levels.
Conclusion: The significant raise of serum levels of IgG may be indicative of improved humeral immunity in DMPA Iraqi users, a change that is potentially beneficial.

The effect of rofecoxib and diclofenac on blood picture in male patients

Mohammed Z.K. Al-Hayali

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 8-12
DOI: 10.33899/iphr.2008.50086

Objectives: To assess the effect of roficoxib and also the effect of diclofenac as a standard nonsteroidal anti-inflammatory drug (NSAD) on complete blood picture.
Methods: Complete blood picture was taken for 29 male patients on roficoxib therapy at 25 mg/day for 14-21 consecutive days. Complete blood picture was also taken for 15 male patients on roficoxib thearapy at 100 mg/day for 14-21 consecutive days. Comparison was made between measurements of blood picture before and at the end of treatment by using Students paired t-test.
Results: Roficoxib or diclofenac showed no significant changes in complete blood picture in the male patients in comparison with the measurements before treatment.
Conclusion: Roficoxib or diclofenac has no significant effect on blood picture in patients when used for short term with moderate doses

Lipid profile, Beta-lipoprotein shift ratio and serum glucose in metabolic syndrome patients

Mohammad A. AL-Kataan

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 13-17
DOI: 10.33899/iphr.2008.50088

Objectives: (a) To determine the change in the lipid profile, β-lipoprotein shift ratio (B-LSR) and serum fasting glucose (SG) in metabolic syndrome( MS) and control.(b) To determine the effects of age and body mass index (BMI) on the measured parameters.
Methods: This study was conducted in AL-Darkeslea area in Mosul province. during the period from January to April 2007. Fasting blood samples were collected from100 patients, 60 patients with metabolic syndrome MS according to WHO criteria and 40 apparently healthy subjects. The collected data were analysed by 2- sample t-test and the effects of the age and BMI on the measured parameters were determined by correlation coefficient.
Results: B-LSR was higher in MS patients than in the control group (P<0.001), Total serum cholesterol (TC), triglycerides (TG), Low density lipoprotein-cholesterol (LDL-C), Very low density lipoprotein-cholesterol (VLDL-C) and atherogenic index (AI)showed significant increases in MS patients when compared to the controls (P< 0.05), while serum high density lipoprotein-cholesterol (HDL-C) showed significant reduction in MS than controls (P<0.001), also SG showed same increase (P<0.001).TC and LDL-C were significantly correlated with the age in controls while no significant correlation were seen in the MS patients. No significant correlation was noticed between BMI and the measured parameters, in both MS patients and control group.
Conclusion: MS is associated with significant changes in B-LSR, lipid profile and SG. Age and BMI showed no significant correlation with theses parameters in the MS patients.

Design and formulation of piroxicam tablets

Shaimaa Dhia M.S. Al-Shakarchi

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 18-24
DOI: 10.33899/iphr.2008.50090

Piroxicam is a potent nonsteroidal anti-inflammatory drug (NSAID) with a long half-life that permits once daily dose. It exerts a better toleration than other NSAID's with a relatively low incidence of adverse effects. In this study many trials were made to formulate piroxicam as plain tablets with properties comparable to those of capsules and in agreement with pharmacopoeial standards. Different formulas were prepared by the application of direct compression method and wet granulation method with the addition of different excipients. The wet granulation method used in the preparation of piroxicam tablets was modified to improve the properties of the produced tablets. The characteristics of the prepared formulas were tested and the results showed that formula D prepared by wet granulation method, containing PVP as binder and lactose as diluent is the most appropriate formula with a rapid disintegration time and complete dissolution as that of piroxicam capsules.
Accordingly, formula D was chosen to be a promising formula of piroxicam plain tablet that could be manufactured as a mass product.

The effect of antioxidants administration on the response rate in patients with alopecia areata

Ashwaq N. AL-jaff

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 25-33
DOI: 10.33899/iphr.2008.50091

Alopecia areata (AA) is autoimmune, nonscaring, multifocal disorder of hair growth characterized by circular bald areas which occur on any hair bearing site of the body. The exact cause of AA remain unknown, but the most widely accepted hypothesis suggests a T-cell mediated autoimmune activation and subsequent oxidative stress and shortage of cellular antioxidant defense to most likely occur in genetically predisposed individuals. Our previous study showed a significant contribution of oxidative stress in the pathogenesis of AA and the beneficial role of nutrient antioxidant in the modulation of the clinical picture of the disease. In this context, the present study was conducted to correlate between the duration of the attack of AA and their response rate to antioxidant vitamins. In this study, ,thirty patients with AA, with a duration of disease ranged from 20 days-18years were allocated into 3 group according to the duration of attack: group 1 (less than one year), group 2 (1-2year), and group 3 (more than 2 year).All groups received treatment schedule including a combination of antioxidants [vitamin A tablet (5000 I.U/day), vitamin E tablet (100mg/day) and vitamin C tablet (500mg/day)] continued for two months. Heparinized venous blood samples were collected from patient before treatment and at one and two months after treatment. Fresh blood sample were used for malondialdehyde (MDA) and glutathione (GSH) measurement in lymphocytes and erythrocytes. The susceptibility of lymphocytes and erythrocytes to oxidative stress was measured by in-vitro challenge with 7.5% H2O2. The result of this study revealed that there is no significant difference in the response rate between the study groups to antioxidant treatment, so the use of antioxidant by patients with AA improve rate of hair growth regardless the duration of attack.

Synthesis of new metronidazole derivatives with suspected antimicrobial activity

Yasser F. Mustafa; Karam A. Al - dabbagh; Manal F. Mohammed

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 34-41
DOI: 10.33899/iphr.2008.50092

Metronidazole has a bactericidal effect against many anaerobic gram positive and gram negative bacteria, but has no activity against aerobic bacteria.
Metronidazole activity is mostly contributed to its reduced form that produced from anaerobic reduction inside the micro-organisms.
In this research, the reduced form of metronidazole was synthesized and termed compound ( I ) which diazonated to form a diazonium interme-diate, this intermediate coupled with two phenolic compounds to give compounds ( II ) and ( III ) which are azo derivatives.
The structures of these compounds were identified by physical and spectroscopic ( U.V. and FTIR ) techniques.
The antibacterial activity of the synthesized compounds were examined against two aerobic gram positive bacteria ( Staphylococcus aureus, Streptococcus pneumoniae ); two aerobic gram negative bacteria (Pseudomonas aeruginosa, Escherichia coli ) and one anaerobic gram positive bacteria ( Clostridium Perfringens ) by using two techniques: dilution and disc diffusion methods.
Opposite to our expectance, these products showed no antibacterial activity against the tested bacteria at the concentrations used

Synthesis and preliminary pharmacological evaluation of aminobenzensulfonamides derivatives of diflunisal as a anti-inflammatory agents

Munther F. mahdi; Abdul-Rassoul Wars; Samira Fingan

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 42-49
DOI: 10.33899/iphr.2008.50094

Objective: Synthesized of amino derivatives [4-aminobenzenesulfonamide, 4-amino-N-methylbenzenesulfonamide, or N-(4-aminophenylsulfonyl) acetamide] bound to carboxyl group of diflunisal, a well known nonsteroidal anti-inflammatory drugs (NSAIDs). and evaluation as a potential anti-inflammatory agent with expected selectivity against COX-2 enzyme.
Design: Expermental study
Results: In vivo acute anti-inflammatory activity of the final compounds (13, 14 & 15) was evaluated in rat using egg-white induced edema model of inflammation in a dose equivalent to (50mg/Kg) of diflunisal. All tested compounds produced significant reduction of paw edema with respect to the effect of propylene glycol 50% v/v (control group). Moreover, compound (14) exhibited comparable anti-inflammatory activity to diclofenac (3mg/Kg), while compound (13) showed short duration of action, and compound (15) exhibited comparable effect to that of diclofenac with slower onset of action.
Conclusion:The result of this study indicate that the incorporation of the 4-aminobenzenesulfonamide pharamacophore & its derivatives into diflunisal enhanced its anti-inflammatory activity& may increased its selectivity toward COX-2 enzyme which can be confirmed in future by assessing COX-2:COX-1 inhibitory ratio using whole blood assay.

Iron status in intrauterine contraceptive device users

Wahda B. Al-Youzbaki; Luma S. AL-Nuri; Janan Gazzi

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 50-56
DOI: 10.33899/iphr.2008.50095

The objective of this study is to evaluate the effect of one year use of Copper-T380A intrauterine contraceptive devices (IUCDs) on iron status of the body. It represent a Cohort study that was carried at Family Planning Center in AL-Batool Teaching Hospital, during the period from April 2006 - August 2007. Thirty women enrolled in this study, age ranged between 20-42 years, and with initial level of hemoglobin (Hb) ≥ 10 g/dl, were followed up at the time just before the insertion, then after 6 months and one year of the insertion of the IUCDs. Another thirty healthy women age ranged between 20-43 years who did not use neither hormonal contraceptives nor IUCDs were considered as a control group, all followed by measuring Hb level and PCV by Cyanomethaemoglobin method , serum iron and total iron binding capacity (TIBC) using Enzymatic Calorimetric method and percent iron saturation was calculated by equation.
The results of this study showed that IUCDs caused a significant decrease in the mean serum level of Hb, PCV and iron among the IUCDs users after 6 months and one year of the insertion of the IUCDs compared with the initial serum level at the time of the insertion. But a significant decrease in TIBC and % saturation only after one year of the insertion of the IUCDs. Also there were a significant decrease in mean serum Hb and % saturation of the IUCDs users after 6 months in comparison with the non users, while a significant decrease in all the iron status parameters of IUCDs users after one year in comparison with the non users. There were no significant difference between the iron status parameters of IUCDs users in relation with number of children the IUCDs users have delivered.
This study concluded that the Copper-T380A IUCDs use for one year cause a significant decrease in the iron status parameters, which is more with the increase duration of use but not affected by the number of children of the users of the IUCDs. It is recommended that iron supplementation, be a part of the IUCDs services provided in Family Planning Centers in the view of the high prevalence of anemia among women in child bearing age in Iraq.

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

Amjad H. Al- Naemi

Iraqi Journal of Pharmacy, 2008, 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.

Assessment of serum immunoglobulin and complement components level in patients with pulmonary tuberculosis

Imad A.J Thanoon; Hani M. Salih; Suhair M. Rashees

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 68-73
DOI: 10.33899/iphr.2008.50098

Objective: To assess , the serum levels of immunoglobulin IgG, IgM, IgA and , complement C3 and C4 in patients with pulmonary tuberculosis at diagnosis and 3 months after therapy in comparison to age- matched healthy controls.
Methods: This case-control study was conducted at the Advisory Clinic for Chest and Respiratory Diseases at AL-Fasalaa in Mosul City and the Department of Pharmacology –College of Medicine University of Mosul during the period from December 2007 to April 2008. Forty newly diagnosis patients with pulmonary tuberculosis were included in this study , with 50 apparently healthy age- matched subjects taken as a control . Initially from both the patients and the control group , blood sample were taken and assay of serum immunoglobulin levels ( IgG, IgM, IgA) and complements ( C3, C4) was done using single radial immunodiffusion method using commercial kits. After 3 months of therapy another blood sample was taken from the patients group and assay of the same parameters was done .
Results :Initially , there was a highly significant increase in the serum levels of IgA, IgM, IgG and complement C3 in patients with active pulmonary tuberculoses with insignificant differences in the C4 levels in comparison to controls .
After 3 months of therapy there was a significant reduction in the serum levels of IgM , C3 with insignificant reduction in IgG, IgA and C4 concentration in comparison to pre- therapy stage . In addition there was a significant differences in the serum levels of IgA, IgG, C3 in comparison to controls .
In conclusion Tuberculosis as a disease and anti- tuberculous therapy do affect the immune system as reflected by the serum immunoglobulin IgA, IgM, IgG and complements (C3, C4) levels