Thesis 2013

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Role of Glucosamine Sulphate, Chrondoitin Sulphate & Vitamin C in Enhancing Chrondoprotective Effects and Management of Pain in Osteoarthritis
(East West University, 1/19/2014) Chowdhury, Ekram Ahmed
Osteoarthritis (OA) is a degenerative joint disease involving the cartilage and many of its surrounding tissues. The risk of disability is so great that it is now a costly burden to society and loss of productivity. So, the objectives in managing the patient with OA are to reduce/eliminate pain & stiffness, maintain/improve mobility, optimize function & hence minimize disability. Currently, there is no cure to osteoarthritis. Available treatment options are only aimed at alleviating pain and improving functionality of joints. NSAIDs are recommended as second line treatment (after acetaminophen) for mild OA and as first-line treatment for moderate to severe OA. However, due to the potentially serious adverse reactions of NSAIDs, they are not suitable for long term use. Numerous clinical studies have demonstrated that the targeted administration of selected micronutrients leads to a more effective reduction of OA symptoms, with less adverse events. Consistent with the in vitro and in vivo studies done on glucosamine and chrondoitin sulphate, some clinical trials thus far reported support the demonstrated favorable effects of glucosamine and chondroitin sulfate alone or in combination in relieving OA pain. However, none of a larger number of randomized clinical trials gave such positive results, suggesting an ambiguity of the benefit of these two nutraceuticals in OA. The study has been conducted in 3 groups of 20 patients in order to evaluate and compare improved treatment outcomes combining Paracetamol, Gucosamine hydrochloride, Chrondoitin sulfate & Vitamin C. Superior effects of combination treatment considering paracetamol, glucosamine sulphate, chrondoitin sulphate and vitamin C over glucosamine sulphate, chrondoitin sulphate and paracetamol were seen during the study suggesting the combination of vitamin C with Glucosmine sulphate and chrondoitin sulphate may play a vital role in alleviation of pain in knee OA patients. Since the other treatment options carry a considerable risk of side effects over long term use, this treatment combination maybe a very valuable and safe method of ensuring long term treatment of knee OA with negligible side effects.
Study of Clinical, Social and Behavioral Factors Affecting Maternal Health in Bangladesh
(East West University, 1/18/2014) Tanzin, Sadia
Globally, more than 500,000 women die each year because of complications related to pregnancy and childbirth. They die due to haemorrhage, sepsis, hypertensive disorders, unsafe abortion and prolonged or obstructed labour – complications that can often be effectively treated in a health system that provides skilled personnel facilities to handle emergencies when they occur and post-partum care. Prenatal care is known to improve the outcome of pregnancy and birth for both mother and child. It not only monitors the health of the mother and foetus but also allows for the identification of potential complications. MDG 5 (Millennium development goal 5) on improving maternal health is one of the goals towards which least progress has been made. Teenage pregnancy, pregnancy within 19 years of age, is a public health concern both in developed and developing counties. Most of the studies found that pre-term delivery, still birth, fetal distress, birth asphyxia, anaemia, low birth weight, pregnancy-induced hypertension (PIH) and spontaneous abortion were most frequently encountered complications during teenage pregnancies. As per a major survey by the Government of Bangladesh maternal mortality ratio in Bangladesh has dropped by 40% in the last nine years. However, as per this study conducted on 654 pregnant women, maternal health in Bangladesh is still under considerable risk. Majority of the participants 75% were married during their teen ages. 44% of the respondents first conceived during their teen ages. Pre-term delivery, still birth, fetal distress, birth asphyxia, anaemia, low birth weight, pregnancy-induced hypertension (PIH) and spontaneous abortion were most frequently encountered complications during teenage as per previous studies. 94% of the pregnant women had no understanding or knowledge of the different complications that may occur during pregnancy. 98% of the patients did not know the blood group of their husband and 59% of the patients did not know their own blood group along with their husband’s. A close relation was found between education level, the marriage in teen age, age of 1st abortion as well as age when 1st time conceived.
Current Prescribing Practices of Hospitalized Children Suffering From Pneumonia With Respect to Essential Drug List of Bangladesh
(East West University, 1/17/2014) Hemal, Hamza
This retrospective study was designed to observe the adherence of the prescribing practices of hospitalized children suffering from pneumonia with the essential drug list (EDL) of our country. During ten months study period, 532 children (under 5 years of age) suffering from Pneumonia were enrolled from the Institutes of Child Health & Shisu Sasthya Foundation Hospital, Mirpur, Dhaka. This research revealed that cephalosporin alone or in combination with an aminoglycosides was most common antibiotics which were prescribed for the treatment of children suffering from pneumonia. But surprisingly this given treatment had very insignificant (7.98%) adherence with the essential drug list (EDL) of Bangladesh. So, this result supports the need of updating the Essential drug list of Bangladesh with modern evidence based effective drugs. Another outcome of this study indicated that in 75.2% cases there is a practice of polypharmacy in Bangladesh. Polypharmacy and overuse/misuse of drugs, especially antibiotics, should be discouraged to avoid drug resistance and its consequences. Furthermore, countywide multicenter research with a larger sample is still needed to consolidate the observation of this study.
Preliminary Phytochemical Screening, Antioxidant Activity & Cytotoxic Activity Evaluation of Spondias Pinnata Barks
(East West University, 1/4/2014) Hafiz, Md. Al
Spondias pinnata is a flowering and glabrous tree upto 10.5 m high with straight trunk and smooth ash coloured bark having pleasant aromatic smell. The leaves and bark are aromatic, astringent and useful in preventing vomiting, dysentery and diarrhoea. The purpose of the study was to investigate the phytochemical compounds and cytotoxic compounds from ethyl acetate extract which will be pharmacologically effective. From phytochemical screening, the presence of some compounds was found such as alkaloids, flavonols, phenols, steroidal compounds and saponins. This indicates, it will be effective pharmacologically. Antioxidant properties are also found by DPPH test, Total Reducing power test and Total phenol content test. The Reducing power test showed percentage of reducing potential which is similar to standard (ascorbic acid). Sometimes it showed greater potential than the standard indicates the presence of phenol and polyphenolic compounds. For example, in the concentration of 1000 (μg/ml) the reducing potential of extract was 24.397% and of the standard was 13.941%. DPPH scavenging activity test also showed similar activity as ascorbic acid. Here, the extract showed greater activity than the standard. The extract showed the IC50 of 409(μg/ml) and the standard showed IC50 of 425(μg/ml). Estimation of total phenolic content also determined by Folin-Ciocalteu method and showed significant amount of phenolic compound’s presence. The extract showed greater absorbance than the standard. These indicate that, it will be effective pharmacologically to treat free radical mediated diseases. Cytotoxic activity was also found by Brine Shrimp Lethality test. The LD50 was measured for both the standard and the extract. The extract showed greater activity than the standard. That means the ethyl acetate extract of Spondias pinnata has potential cytoxic effect.
Phytochemical and Pharmacological Investigations of Genoderma Lucidum
(East West University, 12/3/2013) AKANDA, MD. RAFI-UZ-ZAMAN
The popular edible mushroom Ganoderma lucidum(strain GL-4) has been widely used for the general promotion of health and longevity in Asian countries. The present study was carried out to evaluate the antibacterial and antioxidant activity of the methanolic extract of Ganoderma lucidum. The phytochemicals evaluation reveals the presence of Flavonoids, Steroids, Terpinoids, Alkaloids, Gums carbohydrates, Saponins & Tannins. The antibacterial and antifungal activity of methanolic extract of Ganoderma lucidum was evaluated with selected twelve bacterial pathogenic such as Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Staphylococcus aureus etc and one fungi was Candida albican. For antimicrobial test, disc diffusion technique was used and the zone of inhibition of microorganisms was measured in mm. The extract of G. lucidum showed moderate antimicrobial activities against the selected strains and maximum inhibition zone 15 mm was recorded from 1500ug/disc of aqueous extract of G. lucidum against Escherichia coli and minimum (8mm) by the Salmonella paratyphi, Betahemolytic streptococcus, Beta megaterinium, and Vibrio mimicus at 1000ug/disc of extract. The methanolic extract showed the maximum antifungal activity 11.5mm inhibition zone was recorded from 1500ug/disc of extract against Candida albican. These extracts were also checked for their cytotoxicity using a sensitive in vitro Brine shrimp lethality bioassay. The results of brine shrimp lethality bioassay are showed different mortality rate at different concentration. The mortality rate of brine shrimp napulii was found to be increased with the increase with the concentration of the sample. The antioxidant effect of methanolic extract of G. lucidum was significant in the DPPH method used. Free radical scavenging abilities of the test samples were determined by measuring the change in absorbance of DPPH (1,1-Diphenyl-2-picrylhydrazyl radical) at 517 nm by the UV-Spectrophotometer. Concentration providing 50% inhibition (IC50) was calculated from the graph plotted inhibition percentage versus concentration of the extract. IC50 value of the standard and methanol extract of G. lucidum were 12.6 ug/ml and 581.52 g/ml respectively. So, comparison with the ascorbic acid, it is clear that plant extracts possess moderate antiradical activity. In conclusion, Further investigations are needed to identify the active constituents and the exact mechanism(s) of action responsible for the reported antimicrobial, cytotoxicity and antioxidant properties of G.lucidum.
In Vitro Dissoluion Study to Determine Drug – Drug Interaction of Atorvastatin Calcium
(East West University, 12/15/2014) Islam, Md. Nazmul
Atorvastatin calcium is a selective and competitive inhibitor of HMG – CoA reductase which is responsible for converting HMG – CoA to mevalonate, a precursor of cholesterol synthesis. Thus Atorvastatin is extensively used to lower cholesterol and triglycerides in patients with hypercholesterolemia, mixed dyslipidemia Drug – Drug and Drug – Food Interaction of Atorvastatin is well established. Thus, the objective of the present research was to study and compare the dissolution profile of Atorvastatin Calcium alone and with Pantoprazole and Calcium Carbonate For the present study, Dissolution Apparatus II, USP XIII was used to conduct the experiment. Six tablet of atorvastatin alone was subjected to dissolution study followed by another six tablets of atorvastatin with six of Pantoprazole and Calcium carbonate each. Same media of phosphate buffer of pH 6.8 was used in conduction of both experiments. Then in both cases, 5 ml samples were withdrawn at time intervals of 5, 10, 15 and 30 minutes. The samples were then subjected to UV-Vis Spectroscopy and the UV absorbances were recorded.From the UV absorbances percentage dissolutions were calculated by the designated formulas. And the data of Atorvastatin alone and in combination were compared in orderto assess the changes in the dissolution profile. The changes in percentage dissolution in both cases were considerably different indicating the effect of Pantoprazole & Calcium carbonate on the dissolution profile of Atorvastatin.Bioavailability of atorvastatin is 12%. Initial Increases in dissolution profile of atorvastatin with Pantoprazole and calcium carbonate followed by a substantial decrease can lead to variable dissolution & bioavailability of atorvastatin in presence of other drugs while, also increases the risk of side – effects and toxicity of atorvastatin. Thus, further studies are needed to confirm whether, such effect on dissolution profile is beneficial or harmful
Prescribing Practice for Geriatric Patients in Selected Hospitals
(East West University, 11/3/2013) Khandoker, Sirajul Munir
Due to the improvement of medical facility the elderly population in Bangladesh continues to rise. Management of many acute and chronic disease for the aging population have contributed to wide-rangemedication use among aged patients, these circumstancesmay lead to drug related problem (DRPs) especially unnecessary drug therapy. The aim of this study was to identify unnecessary drug therapy on outdoor geriatric patients and to investigate whether polypharmacy is a suitable indicator for occurrence of redundant or irrational drug therapy in a hospital outdoor patients. Research type was cross-sectional. Data taken through preformed questionnaire among outdoor geriatric patients. The study was conducted with inclusion criteria: patient with 60 year and above.Total of 120 patients were under study during a 7-month period from February, 2013to August, 2013.An average of 4.30 drugs was prescribed.50% of thedrugs were prescribed by generic name & 50% in brand name.Polypharmacy was observed in 35.83% of total patients. The maximum number of 12 prescribed drugs were received by The maximum number of 12 prescribed drugs are received by 0.84% patients. Among the total patients 6.66% patients receive single drug. 30% of patients received 5-7 medecine& 5% off patients received 8-10 drugs.About 24.16% were prescribed antibiotics and 10.19%of total drug was combination of calcium carbonate and vitamin D. Most of the geriatric patients (89.16%) were counseled for more than 5 minutes. Prevention of redundant drug therapy problem can be conducted through promoting the rational use of drug (it is recommended to reduce all medications without therapeutic benefit, goal or indication). This study exposesthe prescription trends, and indicates possible areas of improvement in prescribing practice.
Influence of Omeprazol and Ramipril on In-Vitro Dissolution of Atorvastatin 10 mg Tablet with To Determine the Drug-Drug Interaction
(East West University, 11/12/2013) Rashid, Fahmia
The main objective of this study was to determine the change of pharmacokinetic property; specially dissolution of Atorvastatin when it’s taken with combination of two drugs; Ramipril and Omeprazol. Atorvastatin is a widely used lipid lowering drug which is usually prescribed with various drugs like Omeprazol, Ramipril, Metformin, Multivitamin etc usually after dinner, what came out in some recent prescriptions collected before the study. Famous brand of these drugs were used, as in Lipicon 10mg for Atorvastatin, Ramoril 2.5mg for Ramipril, Cosec 20mg for Omeprazol so that a standard value of percent dissolution can be achieved. First the dissolution profile of Atorvastatin individually was studied going through the standard in-vitro dissolution test then the same procedure was run using Atorvastatin, Ramipril and Omeprazol in combination. However, it was found out from the study that Atorvastatin showed a greater percent of dissolution when taken with combination of those drugs than that of only Atorvastatin. From time range of 5min to 30min dissolution rate of Atorvastatin increased gradually. After 5min, 10min, 15min and 30min dissolution rate of atorvastatin was 2.093%,2.64%,7.01 %,36.14% respectively, and for the combination these were 5.063%,11.872%,32.38%,63.641% respectively. It means that if patients take Atorvastatin along with Ramipril and Omeprazol at a time, dissolution rate of Atorvastatin increases.
Investigation of Phytochemical and Cytotoxic Activity of Methanol Extract of Spondias pinnata Bark
(East West University, 1/5/2014) Khan, Ekhlas Uddin
Spondias pinnatais a medicinal herb belonging to the family Family- Anacardiaceae also known as wild mango, hog-plum, which has been used to dysentery, diarrhea, stomach ache, rheumatism properties according to indigenous systems of medicine in this sub continent. But its antioxidant, antimicrobial, cytotoxic potential and phytochemical screening is still unknown. Therefore, the present study was designed to investigate antioxidant, antimicrobial and cytotoxic properties and to investigate the phytochemical compounds of spondias pinnata. For phytochemical screening, we found the presence of alkaloids, flavonols, phenols and saponins. In order to investigate the antioxidant property, we are experiencing DPPH test, Total Reducing power test and Total phenol content test. In DPPH scavenging IC50 value of extract was 397 whereas the IC50 value of standard was 409. The Reducing power test showed lower reducing potential of extract compared to standards which indicates the slightly presence of phenol and polyphenolic compounds. For example, in the concentration of 1000 (μg/ml) the reducing potential of extract was 8.58% and of the standard was 24.93 %. In Brine shrimp lethality test the LC50 of the extract was 0.362 and the LC50 of the standard was 1.412 which showed lower cytotoxic activity compare to standards.
Pharmacological Investigation of Leaves of Carica papaya
(East West University, 1/7/2014) Chowdhury, Ruhama
The study was designed for pharmacological investigation of methanolic extract of leaves of Carica papaya and screening of their biological activities like, antimicrobial and free antioxidant activities. The powdered leaves of Carica papaya was extracted with methanol. This study was conducted using only the methanolic extrarct. In antimicrobial activity investigation, methanolic crude extract of Carica papaya (leaves) showed moderate activity against the tested bacteria. They were appeared very little zone of inhibition against gram positive & gram negative bacteria. The three different concentration of methanolic extract of papaya leaves was used in antibacterial test. Which is compared to kanamycin (30 μg/disc) used as positive control in this study. The range of zone of inhibition was observed in between 6-11 mm depending on the concentration of the extract. Another study was conducted to evalute the total antioxidant capacity of methanolic extract of carica papaya leaves using 2,2-Diphenyl-1-Picryl-Hydrazyl (DPPH) free radical scavenging method. In evaluation of free radical scavenging activity it was found that crude methanolic extract of carica papaya (leaves) exhibited moderate free radical scavenging activity

Thesis 2013

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