Al Mustansiriyah Journal of Pharmaceutical Sciences

Lipids are organic fatty or waxy compounds which are used to make nanocarriers that are promising for drug delivery. When lipids associated covalently (lipid-drug conjugate LDC) or non- covalently (drug-lipid complex) to drugs to form Lipid Drug Conjugates (LDC). Most common types of lipids

used for drug conjugation are fatty acids, glycerides, steroids, and phospholipids. Conjugation with lipids may change the properties of the drug and significantly increase the drug lipophilicity. Lipid-drug conjugation could improve the delivery of drugs by the lymphatic system, enhance bioavailability of oral administered drugs, improve drug targeting in tumor diseases, enhance the loading of drugs into some delivery carriers, increase drug stability, and many others. Lipid-drug conjugates can be prepared through different strategies for conjugation and by chemical linkers depending on the chemical structure of both drugs and lipids, careful selection of lipids and drug are necessary in designing the lipid-drug conjugate to achieve maximum benefits.

Purpose

To assess the impact of pharmacist intervention on the health related quality of life (QoL) among anemic patients with chronic kidney diseases in a hemodialysis center.



Methods

A single blind, randomized control study was carried out at the hemodialysis center of Kirkuk Hospital in Kirkuk-Iraq. The patients were randomized into two groups; interventional group received clinical pharmacist services delivered by a qualified registered pharmacist and non-interventional group received usual hospital care and. The pharmacist proposed clinical interventions at the level of patients, drugs, hospital level to improve the patient’s quality of life. The impact of clinical pharmacist’s intervention on improving quality of life of patients was assessed by using the Rand 36-Item Short Form Health Survey questionnaire. The assessment of the QoL was carried out for both groups for a total of 4-month follow-up; at baseline, day 60 and day 120.

Results

A total number of 120 patients were recruited from the hemodialysis centers and 1437 interventions were applied for interventional group (n=60), 41.4% at the drugs level, 51.1% at the patient level and 7.5% at the hospital and administrative level. The health related QoL scores were significantly improved over time in the domains noticed with regard to the “physical functioning, general health, emotional role” of interventional group compared to the baseline and non-interventional group with conventional hospital care with P <0.05.

Conclusion

Interventions provided by the pharmacist had a positive impact on QoL of anemic patients in the hemodialysis center of the city.

is increase evidences suggested the existence of new hepatitis viruses that play a role in this disease. This study aimed to determine the synergistic effect of concordant infection with SEN virus

and Torque Teno virus in patients with hepatitis and apparently healthy blood donors as control. Sera were collected from 50 patients who had hepatitis type B or C as a case group and from 50 apparently healthy blood donors as control. All samples were tested by polymerase chain reaction (PCR) for detection of SEN-V DNA, while TTV antigen were tested by immunoassay. In addition, ALT and AST enzymes have been tested using biochemical test. TTV and SEN-V co-infections had been detected in hepatitis patient and apparently healthy blood donors with exposure rate (26%) and (4.65%), respectively. Current study indicated that there were no significant differences between the mean level of ALT or AST enzymes and the SENV/TTV co-infection. Also, there was no significant associated between SENV/TTV co-infection and risk factors under study.

Carbapenems are considered as the most effective antibiotic against Acinetobacter baumannii infections, as the pathogen has a resistance to the most of the other beta-lactam antibiotics; however, recent studies proved that this pathogen has developed

resistance to carbapenems, as well. Therefore, development of novel therapeutics targeting A. baumannii resistant strains is an urgent global requirement. One of the causes responsible for this bacterial resistance against beta-lactam antibiotics is the decreased strength of interactions between A. baumannii Penicillin-Binding Proteins 1A (PBP1A) and carbapenems. Therefore, the aim of this study is to design a novel analogue of imipenem with significantly higher binding affinity and improved drug-likeness properties to overcome resistance of the pathogen and optimize bioavailability, respectively. De novo drug design was performed using virtual screening to predict the ligand(s) with the highest binding affinity. The two-dimensional and three-dimensional structure of the designed molecules were sketched using Chemdraw professional and MarvinSketch, respectively. After separating the targeted protein from A. baumannii PBP1A-imipenem complex structure (3UDX) and retaining a monomer (chain A) from a dimer of the protein structure using Text Editor (ConTEXT v0.98.6), docking was achieved using virtual screening AutoDock Vina program. Finally, drug-likeness properties were assessed. The results could find the selected compounds with significantly higher binding affinity and improved physicochemical properties compared with imipenem.

Background: Novel coronavirus what known now as COVID-19 pandemic represents worldwide health problem. It presented as an upper respiratory infection, acute respiratory distress syndrome, micro thrombosis, sepsis, septic shock, and multi-organ failure and death. Early recognition of suspected cases allows health staff and local gover-



Nment the sufficient time to initiate the appropriate international and national protocols to control the transmission of infection.

Aim: Evaluate the effectiveness of two- intervention social distancing strategy that was applied to control COVID-19 in Mosul city.

Method: Using mathematical simulation model for COVID-19 spread implemented in Santa Clara City in US to estimate the expected burden of the pandemic in Mosul City. This model give a numerical data about the number of the infected cases and time interval of applying the appropriate intervention control strategies by comparing single-strategy (social distancing) to two-intervention strategy (social distancing & light switch approach).

Results: The two interventions strategy shows that on average, the baseline epidemic scenario affected 12.3% of the population in comparison to 11.6% with single-strategy at 70% contact rate. While at the rate of 20% of social contact, only 0.11 % of the population will be infected in the two-intervention strategy in comparison to 0.165% when the single strategy applied. This means a significant reduction in the spread of the infection and the peak time incidence in all hypotheses will be significantly delayed.

Conclusion: The two- intervention social distancing strategy is an efficient tool to control COVID-19 in Mosul city and this represents a big success for Crisis Cell in controlling the pandemic in Mosul city.

Ketorolac Tromethamine (KT) is prepared for the first time by double emulsion procedure. The current research involves preparation and evaluation of microsponges for ocular applications. This work included preparation of sixteen formulas of KT-microsponges by double

emulsion (w/o/w) method using poly lactic-co-glycolic acid (PLGA) as a polymer and poly vinyl alcohol (PVA) as a stabilizer, with different mixer types for different time and power. The prepared microsponges were characterized by Scanning Electron Microscopy (SEM) to investigate the morphology and particle size, the entrapment efficacy and percentage yield were calculated as well as in vitro drug release. Best formula (F14) of KT-microsponges had EE (74%), % yield (83%) with initial drug release (approximately 21% within the first fifteen days) which continued to reach (approximately 86% within 90 days) by using 30% of PLGA concentration with 0.05% of PVA and 200 ml of the external aqueous phase using a probe sonicator for 4 minutes at 200 Watt power. This formulation technique will be the interest of pharmaceutical company.

Herbs have been utilized for all time as the significant sours of medication. Medical plants are significant by optional metabolites, for example; Silybum marianum, is a remedial herb with a thousand years history of utilization. It is a blend of flavonoids, called silybin, which isn\'t just the major silymarin component but at the

same time is the most dynamic element of this extract, which has been affirmed in different studies.

This compound has a place with the flavonoid group known as flavonolignan. Silybin\'s structure comprises in two fundamental units. The first depends on a taxifolins, the second a phenyllpropanoid unit, which for this situation is conyferil liquor. These two units are connected together into one structure by an oxeran ring contains mixes (taxifolin, silychristin, silydianin, silybinin A and silybinin B.

The present study is fundamentally centered on the medicinal important of Silybum marianum, its utility as a medicinal plant for the treatment of different issue of mind, cardiovascular, hepatic, kidney, and oxidative stress also, malignant growth is outstanding. As far as its medicinal properties, Silybum has no symptoms. In any case, it might cause mild nausea or gastrointestinal difficulties in uncommon cases. The leaves, seeds or some of the time the entire plant is utilized inmedicinal preparation.

Background: The complications of End Stage Renal Disease ESRD attributed to high morbidity and mortality such as hyperphosphatemia and vascular disease. Vascular smooth muscle cells (VSMCs) are sensitive to elevation in serum phosphate levels and have the ability to modify their functions in response to this



elevation through h many processes that promote calcification. Vascular calcification is highly correlated with the major events of cardiovascular mortality which are included heart failure, sudden cardiac death, and ischemic heart disease. The control of hyperphosphatemia in HD patients remains poor in spite of the effectiveness of all the available phosphate binders. However, calcium based binder may promote the aggravation of vascular calcification while Aluminum- based binder associated with osteomalacia, and encephalopathy. Calcium/aluminum free phosphate binder may cause gastrointestinal adverse effect in addition to their high cost of treatment. The active phosphate transport inhibitors are the newest interesting agents in the management of hyperphosphatemia alone or as add-on therapy to the existing phosphate binders. Niacin is one of this novel drug classes that has been demonstrated to show promising therapeutic potential in the treatment of hyperphosphatemia in HD patients.

Aim of study: This study is designed to evaluate the efficacy of niacin as adjuvant therapy to calcium carbonate (as a phosphate binder) in hemodialysis patients.

Method: In this prospective, randomized interventional study, 56 patients confirmed with end stage renal disease (ESRD) and hyperphosphatemia on regular hemodialysis were included. Only 40 patients completed the study and were classified randomly into two groups: group (1); composed of 19 patients who received 1500 mg/day of calcium carbonate tablets, and group (2); composed 21 patients who received 1500 mg/day calcium carbonate tablets plus niacin both for 2 months’ duration. Blood sample was taken thrice, at baseline, after 1 month and at the end of month 2 for measurement of serum study parameters: (inorganic phosphorus (Pi), calcium (Ca), Calcium-Phosphorus product (Ca x P) .

Results: Results of this study showed that the patients who administered orally niacin as adjuvant to calcium had the superiority over using calcium alone in the reduction of serum phosphorus level (-20.3% and -13.5%) respectively after 2 months of treatment in respect to baseline levels. Meanwhile, there was a marked increase in serum Ca level in both groups after 2 months of treatment however, it was non-significant. In addition, treatment with combination of calcium and niacin resulted in more reduction in serum (Ca x P) product level at the end of study than with calcium alone compared to baseline, nevertheless the change was non-significant.

Conclusion: Administration of niacin for hemodialysis patients is an effective strategy for reducing the serum levels of inorganic phosphorus and calcium-phosphorus product which may lead to reduce the risks of cardiovascular diseases associated with hyperphosphatemia.

For many years, oral solid dosage forms were the most preferred dosage forms for a wide range of population due to their safety, efficacy, stability, cheapness and ease of administration. Swallowing difficulties and bioavailability problems are the main disadvantages for this rout.

For this reason, researchers try to develop easier rout of administration such as orodispersible tablet, mucoadhesive, sublingual and oral jelly was developed in an attempt to overcome this restriction. The ultimate purpose for this research is to introduce opportunities of providing the oral jelly as a suitable alternative to the readily available solid dosage forms of the same medicament, representing by that easily swallowed dosage form with improved bioavailability

Objectives: To find out whether there is a lipid profile changes in pregnant women with preeclampsia and if we can use these lipid profile changes as markers of the severity of preeclampsia (for follow up to avoid leaving the patient reaching ecplamptic stage).



Design: A prospective case-control study.

Setting: AL- Kadhimiya Teaching hospital/department of Obstetrics and Gynecology.

Materials and Methods: The study included 120 pregnant women in the third trimester. They were divided into three groups. The study group consists of 60 preeclamptic and eclamptic women, 25 women had mild pre-eclampsia and 35 women with severe preeclampsia. The control group consists of 60 normotensive pregnant women. Blood sample was drown after 8-10 hours fasting. Triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels were measured.

Results: Triglyceride and VLDL-C level of severe Preeclampsia group and mild Preeclampsia group was higher than the control group, but the difference between the severe PE group and the control group was statistically significant (p<0.05). Serum cholesterol in the severe PE group was significantly higher than in mild PE group and in the control group (p<0.05). LDL-C and HDL-C levels were determined similarly in all groups (p>0.05). A highly significant positive correlation between the level of proteinuria and serum cholesterol levels, LDL-C, TG and VLDL-C levels. While there was significantly negative correlation between proteinuria and HDL-C levels. Also, a significant positive correlation between the systolic-tension and serum cholesterol levels, TG, VLDL-C levels and among the diastolic-tension and with LDL-C, TG, VLDL-C levels.

Conclusion: Changes in levels of lipid profile are related with preeclampsia, especially with severe preeclampsia.