Volume 13, Issue 2, Summer and Autumn 2013, Page 1-78

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, 2013, 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.

Glycosylation gap in a group obese subjects

Mohammad Abdul Gafoor Al kataan

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 11-16
DOI: 10.33899/iphr.2013.86550

Back ground: Obesity is major health problem worldwide that increase risk for a wide range of diseases including diabetes mellitus and heart disease. As such, it increasingly important to understand how excess adiposity can perturb normal metabolic functions specially for glucose and lipid homeostasis.
Objectives: The study design to evaluate the effects of obesity on the glycosylation process and determine the effects of increase age and BMI on measured parameters.
Materials and Methods: This study was conducted during the period from October 2010 to September 2011 in the department of Clinical Pharmacy under approval of scientific and ethics committee. One hundred individuals were included in this work divided into 2 groups. The first group included fifty apparently healthy individuals (30 males and 20 females) with BMI (21±3.1 Kg/m2). The second group included fifty individuals (30 males and 20 females) with BMI (28.± 1.3 Kg/m2) whose defined as obese.
Results: The study demonstrated a significant elevation in serum glucose, mean blood glucose, serum fructosamin, measured and predicted HbA1c in obese individuals as compared with those of control individuals. Glycosylation gap showed a significant elevation in obese subjects when compared to control individual that mean significant elevation in intracellular glycosylation process. Regarding the relation between age and measured parameters, the study showed no significant correlation between age and measured parameters in the control group, while in obese group there were a significant correlation( r = 0.03) between ages and predicted HbA1c and BMI( p ≤ 0.05).Regarding the relation between BMI and measured parameters, the study showed significant correlation between measured parameters and BMI in obese individuals, while in control group only serum glucose and MBG were correlated to BMI ( r = 0.01) at ( p ≤ 0.05).
Conclusion: obese subjects shows significant increase in glycosylation gap, so there is a significant intracellular glycosylation process that was related to many diseases process and their complication.

Oral candidal colonization in immunocompromised patients

Zahraa S. Kasim; Manahil M. Yehia

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 17-26
DOI: 10.33899/iphr.2013.86551

Objective: 1. To identify Candida species isolated from saliva of predicatively immunocompromised (cancer, diabetic) patients and control group. 2. To test the susceptibility of all the isolated yeasts against 6 antifungal agents, namely amphotericin B, nystatin, fluconazole, ketoconazole, voriconazole and itraconazole. 3. Then to compare the growth and density of yeasts from immunocompromised patients to those from healthy control group.
Patients and Methods: This study included 120 saliva samples from immunocompromised patients, 60 of them with cancer and under treatment, the other 60 patients have uncontrolled diabetes mellitus, attending the Al-Wafa'a Center for diabetic patients and the consultative clinic of Oncology and Nuclear Medicine Hospital. The clinical specimens were collected during the period from January-June 2011. In addition to 60 saliva samples from a healthy individuals. The identification of the isolated yeasts was carried by fluorescent and/or light microscope, culture on different types of media, biochemical tests and API-20 C system. Susceptibility test to six antifungal agents was prepared for each isolate.
Results: Eighty seven (72.5%) patients showed the presence of yeasts in their saliva in comparison to 18(30%) from the control group. Eighty four isolates from genus Candida identified into 8 species mainly C. albicans. The isolates showed the best susceptibility to amphotericin B.
Conclusions: A higher frequency of yeasts were detected in the immunocompromised patients in comparison to the control group. This is considered a risk factor for infection. Candida albicans is the main isolate but there was a shift to non –albicans Candida spp. in immunocompromised patients. This means that are more resistant to antifungal agents.

Evaluation of biochemical parameters in calcium oxalate renal stone formers

Mannal Abd AL-Monim Ibrahim

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 27-35
DOI: 10.33899/iphr.2013.86552

Background: Calcium oxalate renal stones are the most predominant cases of renal stones, their formation is more complex and no specific cause for the stone can be identified so called 'idiopathic'. This study was designed to analyze the metabolic and biochemical alterations in serum, urine and their relation to pathophysiology of calcium oxalate stone formation
Patients and Methods : In this study, individuals have been classified into three groups: Group (A) included (29) apparently healthy persons of non calcium oxalate stone formers aged (20-35 years), group (B) included (16) patients with calcium oxalate renal stone aged (20-35 years) and group(C) included (15) patients with calcium oxalate renal stone aged (40-70 years). Fasting serum, random urine and 24-hours urine samples were collected from all individuals to determine urine volume, creatinine clearance, serum and urine levels of calcium, phosphate ,uric acid ,zinc, copper and serum levels of total cholesterol, high density lipoproprotien-cholesterol and urea .
Results: Calcium oxalate stone formers group (B) exhibited significantly decreased serum levels of uric acid (P=0.015),zinc (P=0.031) with increased serum level of total cholesterol(P=0.034) when compared to similar age group of healthy control ,group (A). Urinary parameters in calcium oxalate stone formers also showed significantly increased levels of 24-hour urine calcium(P=0.05) and urine calcium: creatinine ratio (P=0.05)when compared to healthy control. While, older age calcium oxalate stone formers, group (C) showed significantly decreased urine volume (P=0.015)with increased kidney stone size(P=0.03) when compared to younger age calcium oxalate stone formers, group (B).
Conclusions: Level of urinary calcium and urine volume are the most important urinary factors in enhancing calcium oxalate stone formation. While the observed changes in biochemical measurements of serum in calcium oxalate stone formers may indicate a probable metabolic relation in pathogenesis of this disease.

Effects of antioxidant supplement and metformin therapy on C-reactive protein and oxidative stress in patients with type 2 diabetes mellitus

Zeina A Munim Al-Thanoon

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 36-46
DOI: 10.33899/iphr.2013.86553

Objectives: The study aims to compare the effects of metformin and antioxidant vitamins C and E on C-reactive protein (CRP) and oxidative/antioxidant status (represented by serum malondialehyde (MDA) and total antioxidant status (TAS) in newly diagnosed patients with Type 2 diabetes mellitus (T2DM) at baseline and after 3 months of therapy compared with the control group.
Patients and Methods: The study was performed in Al-Wafaa Center of Diabetes Management and Research in Mosul, Iraq. They included 91 type 2 diabetic patients and 50 healthy controls. The patients were divided into two groups: The first group (n = 44) was received metformin alone orally for duration of 3 months and the second group (n = 47) was received metformin with vitamin C and E orally for duration of 3 months also. Fasting blood samples were obtained from both controls and patients (before and after treatment) and assays were done for determination of serum MDA, TAS, and CRP.
Results: Compared with controls, patients serum levels of MDA, and CRP were significantly high and TAS were significantly lower. After 3 months of treatment, both patients groups reported significant reductions in serum levels of MDA, CRP and a significant increase in serum levels of TAS, compared with the pre-treatment levels. The present study found that there was a non significant difference in serum MDA levels between the two patients groups (p=0.026), whereas serum TAS levels was significantly higher and CRP was significantly lower in the second group as compared to the first group.
Conclusion: The present study concluded that three months oral consumption of combined antioxidant vitamins C and E with metformin in patients with T2DM showed significantly beneficial effect on oxidative stress and inflammatory response compared with metformin alone. The findings of this study necessitate investigating the overall clinical impact of antioxidant treatment of type 2 diabetes mellitus to maintain good glycemic control.

Anthropometric and Hormonal Study of Breast Cancer Patients in Slemani City.

Gulshan Omer Ahmed; Ban Mousa Rashid

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 47-54
DOI: 10.33899/iphr.2013.86554

Cancer is a group of diseases characterized by uncontrolled cell division leading to growth of abnormal tissue.
The aims of the study were to evaluate the serum levels of Progesterone, Estradiol and Prolactin in women with breast cancer and to study the effect of anthropometric factors on breast cancer development. The subject enrolled in the study were divided into (58) breast cancer women and (30) healthy women as controls in Slemani city. The data obtained showed: highly significant elevation of Prolactin in breast cancer women compared with control (P<0.005), while no significant difference in Progesterone and Estradiol. The percentage of breast cancer is higher in urban areas than rural area, in the age ≥45 years, in the body weight ≥70 kg, in non smokers than smokers, and in those who did not have a family history of breast cancer.

The effects of glibenclamide on thyroid function tests in type 2 diabetic patients

Marwan M. Merkhan

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 55-61
DOI: 10.33899/iphr.2013.86556

Objective: to determine the long-term effect of glibenclamide on thyroid function tests in type 2 diabetic patients.
Materials and methods: A total of 63 diabetic patients, 32 type 2 on glibenclamide and 31 type 1 on insulin, were enrolled in this study. Thirty two, 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 were analysed for measurement of fasting serum glucose (FSG), thyroid hormones (total T3, fT3, total T4, fT4) and TSH.
Results: the result showed that there were no significant differences between thyroid hormones and TSH of the glibenclamide group when compared to the same parameters in the control group, however the fT3 and fT4 of insulin group were significantly lower than that of the control and glibenclamide groups. There were no significant differences between total T3 and total T4 of control, glibenclamide and insulin groups when compared to each others, whereas the TSH of insulin group was significantly higher than that of control and glibenclamide groups.
Conclusion: long term therapy with glibenclamide have no effect on thyroid function tests in type 2 diabetic patients and there was no correlation between glycemic control and thyroid hormones or TSH.

Effect of atorvastatin in combination with different oral antidiabetic medications on lipid parameters and glucose level

Mohammed N. Abed

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 62-69
DOI: 10.33899/iphr.2013.86557

Background: Dyslipidemia is common in patients with type 2 diabetes mellitus and is regarded as independent risk factor for cardiovascular disease.
The aim of this study was to evaluate the efficacy and safety of atorvastatin for the treatment of dyslipidemia in type 2 diabetics using either metformin or glibenclamide as oral hypoglycemic agents.
Materials and methods: Fourty five type 2 diabetic patients diagnosed with dyslipidemia met the study criteria and received 20 mg/day atorvastatin, then followed after 2 months. The various biochemical parameters studied included glycated hemoglobin (HbA1c), fasting serum glucose levels (FSG), total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol and atherogenic index (AI).
Results showed that atorvastatin in both studied groups caused significant reduction in all measured parameters with an elevation in HDL, but this effect was obvious and more significant in patients using metformin than those using glibenclamide.
Conclusion: This study concluded that the combination of atorvastatin and metformin was more effective on lipid profile and glucose level than atorvastatin plus glibenclamide in type 2 diabetic patients with dyslipidemia.

Comparative evaluation of the effect of Nigella sativa extracts and nystatin as a traditional drug on Candida albicans in the primary school students in Mosul and Tikrit cities.

Maymona K.Yahya; Rahman A. Altae; Maymona Yahya

Iraqi Journal of Pharmacy, 2013, Volume 13, Issue 2, Pages 70-78
DOI: 10.33899/iphr.2013.86558

Objectives: To detect and compare the inhibitory effect of Nigella sativa extracts and compare their effects with traditional drugs on Candida albicans.
Introduction: The developing microbial resistance to the existing anti-microbial agents has become a real challenge and a serious problem. Seeds of Nigella sativa have been used for a long time in folk medicine for the treatment of such infections. Production of new potent agents is urgently needed, especially for hospitals and health centers. Therefore, the antifungal effect of aqueous and alcoholic extracts of the seeds against Candida albicans from primary school students were investigated.
Materials and Methods: The in vitro antifungal effect of the extracts at a concentration of (10, 15, 20, 25, 30, 35, 40)mg ⁄ ml on C. albicans isolated was assessed and compared with traditional drug, nystatin using agar diffusion assay.
Results: The aqueous extract did not show any inhibitory effect against the isolated Candida. The alcoholic extract indicated significant inhibitory effect. nystatin show inhibitory effect higher than alcoholic extract at a concentration 40 mg ⁄ ml.
Discussion: The results of this study revealed clear potentiality of N. sativa as a source for antifungal drugs and support its use in folk medicine for the treatment of fungal intestinal infections. This finding warrants necessity of further investigation of this product of folk medicine.