kerbala journal of pharmaceutical sciences

Topical dosage forms represent about 90% of the formulations available in market. Since many years ago till now, ophthalmic dosage forms elucidate major challenges in clinical and pharmaceutical fields, thought a lot of progress and advanced technology have been achieved to improve the currently available ophthalmic drug delivery systems. Generally, the ocular diseases are complicated and difficult to treat. Besides, the ophthalmic dosage forms should be sterile, isotonic, safe and non-allergic for the patients. This review article briefly introduces different types of ophthalmic dosage forms and the advantages and limitations of each.

World Health Organization persistently calls for establishing a universal healthcare insurance systems, capable of providing equitable, accessible, qualified, and affordable services. Solidarity is the doctrine through which healthcare insurance philosophy built. Different sociopolitical notions about solidarity had yielded four different models: Bismarck, Beveridge, Private Health Insurance (PHI), and Out-of-Pocket Payment (OOP). Accordingly; each model characterizes with certain merits in scope of the funding system, reimbursement techniques, and the total cost containment. Consequently, these merits have their own impact on the patient satisfaction in term of the rate of population coverage and waiting list size. This is a review study aimed to understand the economic and administrative features of each healthcare insurance model and their impact on the clinical outcomes. It’s an attempt to pave the way to design a hybrid healthcare insurance system capable of optimally use the local resources of the society.

The aimed of this study was to detect the efficacy of rotavirus vaccine (Rtarix vaccine) by estimation of its potential antigenicity to induce immunity through insilco production with bioinformatics tools therefore vp7 gene (glycoprotein) was chosen to analyses its antigenicity because it is one of Rotarix vaccine component, fifty outer capsid of vp7 gene proteins from human Rotavirus A of different strains from different countries with desired amino acids by Immunobioinformatic tools these desired amino acids selected as conservancy region to describe an epitope based peptide vaccine design against Rotavirus, using a combination of T-cell and B-cell epitope predictions. To perform this, sequences of Rotavirus VP7 proteins were retrieved from the NCBI database (genbank) and subjected to different bioinformatics tools to predict most immunogenic T-cell and B-cell epitopes. From the identified epitopes, the sequence NPMDITLYYY of VP7 was identified as the most potential epitopes based on their antigenicity, conservancy and interaction with major histocompatibility class I and class II (MHC-I and MHC-II) alleles. Moreover, the antigenicity score (2.7150) for vp7. Combined population coverage for our identified epitopes was found 92.09% at a higher percent and 41.26% for United States and South west Asian (Iraq) respectively. All these results suggest that, the epitopes identified in this study could be considered as less potential for vaccine candidate for the strains of Rotavirus circulating in Iraq therefor further studies are needed for improvement of Rotarix vaccine and the update vaccine should contain variant strains from variant species such as animal species because it is a zoonotic virus and have ability to reassortment between human and animal.

Background: the number of cancer cases increasing not only in adult patients but also during childhood overall the world. Treatment with chemotherapy differs according to the case and type of cancer. Some of these systems produce toxic effects especially for the children which may be dangerous or even fatal. So that, studying these toxicities and adverse effects may help in improving patient outcomes and survive their life.
Objective: to investigate the most common acute adverse effects of cancer patients undergoing cytotoxic chemotherapy.
Methodology: sixty one (61) patients diagnosed with different types of cancer were enrolled in this study (39 males and 22 females) in the Oncology center, Pediatric Department/ Imam Hussein hospital of Kerbala/Iraq. The age of them was from 7 months to 17 years. Types of cancers were classified according to the histopathological features and clinical diagnosis and classified according to the affected organ. Venous blood was taken from each patient at morning before taken the drug for further investigations such as complete blood count and biochemical assay.
Results: mean ± stander error for weight of male (20±1.71) and for female (18.86±1.80), and the age of patients was (7months-17years). The cases where distributed as 56.45% of cases were in urban area and 41.53 % in rural area. 76.57% of patients were poor, while 26.31 % were middle and 15.78% were classified as rich patients. Significant differences were observed in types of cancers between male and female patients (p≤0.05). In addition, the effect of chemotherapy was clear on the number of White Blood Cells (WBC) since etoposide and cytosar have no effect on WBC number other than drugs. While drugs have non-significant effect on hemoglobin concentration. Effect of vincristine and Leucovorine drugs led to a significant decrease in the number of blood platelets. Effect on renal function markers also were examined and the urea and creatinine were affected largely by the interactions between the drugs.
Conclusion: patients who are diagnosed with cancer may lose their life not only by cancer disease, but may because of the treatment by chemotherapy drugs systems since some interactions between these drugs may be fatal in addition to their toxicities. There for, choosing correct drugs with correct doses have a large role to save their life.

Catechol amines are one of the most common pharmaceutical compounds, that used for treatment of bronchial asthma, hypertension and Parkinson’s disease. Determination of active catechol amines agents in pharmaceutical samples is an important step for pharmaceutics industries and quality control. Most of available determination methods are based on using very expensive instruments beside the sophisticated conditions such as time consuming , expensive solvents. This article review focused on simple and quick spectrophotometric methods. These methods might be based on redox reaction of the catechol amines using an oxidizing agents, use of polyvalent cations for chelation and complexometric reactions, oxidative coupling reactions or aziotization coupling organic reactions.

Congenital heart diseases (CHD) are considered as anomaly of the heart that has been seen after birth. They are classified according to abnormalities in the walls; great vessels and valves .These abnormalities affect the normal flow of blood. Sonographic screening during 2nd trimester of pregnancy could detect the defects .Nowadays great improvement has been achieved with the use of advanced ultrasound machine and good training for the operator.
Keywords: ASD, CHD, Ebstein’s anomaly, TGA, TOF and VSD.

Background: Acinetobacter baumannii is one of the most important opportunistic bacterial pathogens that cause serious health care associated complications in hospitalized patients. This leads to prolong hospital stay which increase cost to both healthcare provider and family of the patients.

Objective: The study aimed at molecular characterization of A. baumannii.

Methodology: A total of 384 specimens were collected from urine, wounds, blood cultures and full depth burns from patients at different hospitals in Baghdad city. Identification of A. baumannii isolates was one using Phenotypic methods was confirmed by polymerase chain reaction (PCR) to amplifying 16S rRNA and bla-OXA-51 like gene. Out of 384 specimens collected 115 (29.9%) were isolated as Acinetobacter baumannii-calcoaceticus complex.

Results: Eighty two isolates give positive results for 16S rRNA (21.3%) and seventy six (19.79%) isolates give positive results for both rRNA and bla-OXA-51 like gene. This study showed the dominance of bla-OXA-51 in A. baumannii isolates from Baghdad hospitals and it is necessary to adopt appropriate strategies to control the spread of this bacteria and looking for effective drugs far from beta-lactam family.

Conclusion: Data of the current study reveal (19.79%) of isolates were positive for both biochemical and molecular detection as A. baumannii that was terrible percentage and it is necessary to use new strategies to treat baumannii infections far from ineffective drug.

Background: Urinary tract infection (UTI) is one of the most common bacterial infections around the world. UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal tract (GI).
The aim of this study: To detected the Minimal Inhibitory Concentration (MIC) of Augmentin, Ciprofloxacin, Doxycycline, Levofloxacin and Amikacin against uropathogenic Escherichia coli (UPEC) by broth microdilution method.
Method: thirty – one urine sample from confirmed UPEC were collected from patient in Al-Hussein Teaching Hospital and Al-kafeel Super-Speciality Hospital. Cases with mean age 24.38 ± 15.80 (range from 1 to 65 years) during the period from June 2019 to September 2019 in Karbala city. The gender is 16 female (51.6%) and 15 male (49.4%). To determine the (MIC) of Augmentin, Ciprofloxacin, Doxycycline, Levofloxacin and Amikacin against (UPEC) by broth microdilution method. The method depended on Clinical and Laboratory Standards Institute (CLSI2015) (M07-A10).
Result: The results showed that these samples had high resistance to Augmentin (Amoxicillin - Clavulanic Acid) (100%) while the resistance was less to Ciprofloxacin (80.6%) and low resistance to Doxycycline (0%), Levofloxacine (3.2%), and Amikacin (3.2%). The results also showed the highest sensitivity to Amikacin 4 mg / l, by (58.1%).
Conclusion: UPEC more susceptible to amikacin and doxycycline (inhibitor of protein synthesis).UPEC high resistance to augmentin ® amoxicillin - clavulanic acid (inhibitor of bacterial cell wall synthesis) while the resistance was less to ciprofloxacin and levofloxacin (inhibitor of bacterial nucleic acid synthesis).

Background: Management of steroid dependent nephrotic syndrome and frequent relapsing nephrotic syndrome in children are more complicated than the management of simple steroid sensitive nephrotic syndrome.
Aim of study: Our purpose was to compare the efficacy of (levamisole, cyclophosphamide, cyclosporine A, mycophenolate mofetil and prednisolone) in patients with steroid dependent and frequent relapsing nephrotic syndrome.
Patients and methods: A retrospective study was conducted in the nephrology unit in central teaching hospital of pediatrics, Baghdad, Iraq. Records of patients from January 2011 to December 2015 were analyzed during the study period from the first of April 2016 to the first of February 2017, children (age from one to fifteen years) diagnosed with steroid dependent and frequent relapsing nephrotic syndrome, their data were collected based on the record of the patients ( sex, age of patient at time of diagnosis, time at which the drug was started, treatment protocol, treatment duration, response to treatment, time of 1st relapse after administration of alternative drug with steroid, time of second relapse after treatment, and number of relapses during two years follow up) to evaluate the efficacy of (Levamisole, Cyclophosphamide, Cyclosporin A, Mycophenolate mofetil and Prednisolone) for long term remission up to two years in these patient.
Results: Seventy six children diagnosed with steroid dependent and frequent relapsing nephrotic syndrome were enrolled in this study, forty seven cases (61.84%) were diagnosed as steroid dependent nephrotic syndrome and twenty nine (38.15%) of them were frequent relapsing nephrotic syndrome. Relapse free survival for each medications as following; for Levamisole group 53.3%, 13.3%, 6.6% at six months, one and two years interval of treatment respectively, for Cyclophosphamide group 76%, 48%, 24% at six months, one and two years interval respectively, for Cyclosporine A group 63.6%, 36.3%, 13.6% at six months, one and two years interval respectively ,in Mycophenolate mofetile group 62.5%, 37.5%, 12.5% at six months, one and two years of treatment respectively and for Prednisolone group only two patients out of six (33.3%) remain relapse free for the first six months of treatment, the difference was significant in patients with remission during two years follow up between these five groups (P = 0.006, long-rank test).
Conclusions: Cyclophosphamide is more effective in short and long term treatment (more than two year of remission) of steroid dependent and frequent relapsing nephrotic syndrome, whereas Prednisolone the least effective in long term remission. Cyclosporine A is more effective than Mycophenolate mofetile and Levamisole but most patients relapse after stop taking these drugs.